What’s this “Kratom” I’m hearing about? Is it a problem at my workplace?

Kratom leaves, which contain psychoactive substances, come from a tree native to Southeast Asia. Traditionally used in countries like Thailand and Indonesia, kratom leaves are generally crushed and then can be consumed in various forms: smoked, vaped, powdered in beverages, liquid extract “shots,” or taken as capsules. However, we are now seeing Kratom in all forms pop up in the United States in smoke shops, gas stations, convenience stores, and online.

The most recent usage data of kratom reports that about 1.6 million people in the United States use kratom.1 Kratom, which is an opioid, has what might seem like strange effects; at lower doses, kratom acts like a stimulant, while at higher doses, can act like a sedative. People take the drug for all sorts of (not scientifically supported) reasons, such as pain, anxiety, depression, etc.

Despite its accessibility, kratom is intoxicating, impairing, and can pose serious health risks. It is not controlled by the Controlled Substances Act, nor is it approved by the Food and Drug Administration (FDA) for any medical use. The FDA warns consumers not to use kratom “because of the risk of serious adverse events, including liver toxicity, seizures, and substance use disorder (SUD)”.2 Further research indicates that up to one-third of users may experience adverse side effects, which can include cardiac arrest, liver damage, seizures, brain hemorrhaging, and even overdose deaths.3 Kratom has been labeled as a “drug of concern,” with a  particular focus on products containing 7-hydroxymitragynine (7-OH), a potent component found naturally in kratom, but which is readily being synthesized into higher concentrations to create a stronger effect for users.

The presence of 7-OH in kratom products is particularly concerning for employers. This opioid-like substance can lead to severe health complications, including addiction and withdrawal symptoms similar to those experienced with traditional opioids. Employers may face challenges in workplace testing and safety protocols due to the unregulated nature of kratom. As kratom use increases, the likelihood of employees using it at work or being impaired by its effects rises, leading to potential safety hazards and decreased productivity.

Employers must also be aware that traditional drug tests may not detect kratom or its metabolites, making it difficult to identify users. This gap in testing can lead to a false sense of security and complicate workplace safety initiatives. As a result, businesses should consider implementing specific policies regarding psychoactive substance use (including drugs legally available) and conduct regular training for employees about the risk of drug use affecting the workplace environment.

Recognizing that some employees may be using kratom is vital for maintaining a safe and productive work environment. Educating your team about the risks associated with kratom use can be an effective first step – check out this FDA created resource that illustrates the dangers of kratom. Consider fostering open discussions about substance use in a supportive environment and establish a clear substance use policy that helps set expectations and outlines potential consequences for impairment on the job. By promoting health resources, such as counseling and support services, you provide employees with the tools they need to address any substance-related challenges.

As kratom continues to gain traction, it’s vital for employers to stay informed. By fostering a culture of awareness and support, you can help ensure a safe and productive workplace for your employees.

Citations:

1. CrossTab | SAMHSA DAS. (n.d.). https://datatools.samhsa.gov/das/nsduh/2023/nsduh-2023-ds0001/crosstab?row=AGE3&column=KRATOMYR&weight=ANALWT2_C
2. Office of the Commissioner. (2025, December 2). FDA and Kratom. U.S. Food And Drug Administration. https://www.fda.gov/news-events/public-health-focus/fda-and-kratom
3. Striley, C. W., Hoeflich, C. C., Viegas, A. T., Berkowitz, L. A., Matthews, E. G., Akin, L. P., Iheanyi-Okeahialam, C., Mansoor, U., & McCurdy, C. R. (2022). Health Effects Associated With Kratom (Mitragyna speciosa) and Polysubstance Use: A Narrative Review. Substance Abuse Research and Treatment, 16, 11782218221095873. https://doi.org/10.1177/11782218221095873

Sources:

• DISA. (2024). 7-OH Kratom: Risks for Employers—An Emerging Threat in Workplace Testing. https://disa.com/news/7-oh-kratom-risks-for-employers-an-emerging-threat-in-workplace-testing/
• Healthline. (2024). Rising kratom use: Health risks. https://www.healthline.com/health-news/rising-kratom-use-health-risks#More-awareness-about-kratom-needed
• CrossTab | SAMHSA DAS. (n.d.). https://datatools.samhsa.gov/das/nsduh/2023/nsduh-2023-ds0001/crosstab?row=AGE3&column=KRATOMYR&weight=ANALWT2_C
• Office of the Commissioner. (2025, December 2). FDA and Kratom. U.S. Food And Drug Administration. https://www.fda.gov/news-events/public-health-focus/fda-and-kratom
• Striley, C. W., Hoeflich, C. C., Viegas, A. T., Berkowitz, L. A., Matthews, E. G., Akin, L. P., Iheanyi-Okeahialam, C., Mansoor, U., & McCurdy, C. R. (2022). Health Effects Associated With Kratom (Mitragyna speciosa) and Polysubstance Use: A Narrative Review. Substance Abuse Research and Treatment, 16, 11782218221095873. https://doi.org/10.1177/11782218221095873