Kratom (Mitragyna speciosa)

Tier 4 — risky / avoid · Opioid-like dependency

Kratom (Mitragyna speciosa) acts on opioid receptors. The FDA’s position is that it is not a lawful dietary ingredient. Regular use causes dependence, and stopping can bring opioid-style withdrawal: vomiting, cramps, insomnia, and anxiety. The FDA and CDC have also described seizures, liver injury, and deaths, often with other drugs on board, so a single “body count” oversimplifies a bad safety record. The DEA proposed scheduling it in 2016 and then withdrew that proposal; that is not an FDA approval. Avoid it, including teas and capsules sold as supplements.

Dose: Do not take kratom. It is not an approved medicine and not a lawful dietary supplement.