Recent scientific studies reveal significant insights into kratom (Mitragyna speciosa) use patterns, therapeutic potential, and associated risks. This psychoactive botanical, native to Southeast Asia, has gained considerable attention in the United States and globally as both researchers and consumers navigate its complex pharmacological profile. Current research highlights kratom’s potential benefits for pain management, opioid withdrawal symptom alleviation, and energy enhancement, while also addressing concerns around dependency and regulation. This article synthesizes the latest findings on kratom usage patterns, therapeutic applications, potential risks, and regulatory considerations based on recent academic research.
Indonesia’s pivotal role in the global kratom market cannot be overstated. As the world’s largest producer of kratom, Indonesia holds a unique position to shape the future of this increasingly important botanical. Recent developments in the kratom industry highlight Indonesia’s potential to dominate the international market, with the country supplying over 90% of the world’s kratom. This dominance presents both opportunities and responsibilities for Indonesia to lead in sustainable production, quality control, and responsible trade practices.
The Indonesian government has recognized the economic potential of kratom, with recent regulations aimed at enhancing its marketability and value2. These regulations, introduced in September 2024, set standards for kratom exports, ensuring they are free from contaminants and meet specific quality criteria. This move demonstrates Indonesia’s commitment to positioning itself as a reliable and quality-conscious supplier in the global kratom market.
In a significant development for the kratom industry, Ralali, a leading B2B marketplace in Indonesia, has recently announced its commitment to supporting the development of kratom as a potential product for global downstream industries. Recognizing the immense potential of kratom in various sectors, including pharmaceuticals and nutraceuticals, Ralali aims to facilitate connections between Indonesian kratom producers and international buyers. This initiative is expected to streamline the export process, ensure quality standards, and promote sustainable farming practices among kratom cultivators.
Ralali‘s commitment aligns with the broader national strategy to maximize the value of Indonesia’s natural resources. By leveraging its digital platform and extensive network, Ralali intends to provide kratom farmers and processors with access to a wider market, technical expertise, and resources necessary for scaling up production while maintaining quality. This support is crucial in helping Indonesia transition from primarily exporting raw kratom materials to producing value-added kratom products, thereby capturing a larger share of the global market value chain.
Prevalence and Consumption Patterns
Recent epidemiological data suggests substantial kratom use in the United States, with estimates varying widely depending on methodology. According to the National Survey on Drug Use and Health (NSDUH), approximately 1.7–1.8 million Americans reported past-year kratom consumption from 2019–20211. However, the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) system estimated 2.03 million users, with lifetime prevalence at 3.4 million based on 2018–2019 data. Other approaches using kratom import volume and market data have projected more than 10 million current users as of 2019.
The evidence suggests that standard surveillance systems likely underestimate kratom use prevalence, indicating a need for better methods to estimate novel product consumption. These consumption patterns continue to evolve, with new delivery methods emerging. A 2025 study examining Reddit posts found an increase in interest in kratom drinks starting in mid-2022, coinciding with their widespread availability in vape shops, bars, convenience stores, and online retailers.
Motivations for Kratom Use
Recent ecological momentary assessment (EMA) studies characterizing patterns among long-term and regular kratom consumers found diverse motivations for use. Most participants reported taking kratom to relieve pain, increase energy and productivity, improve focus, and enhance mood. Importantly, research suggests that most users consume kratom to feel generally good rather than to achieve a “high”.
While some consumers report using kratom as a long-term substitute for other substances, discrete kratom use events were driven more by quality-of-life needs. Nearly one-third of participants in a recent EMA study had a broad motivation for using kratom as a long-term drug substitute, but few reported using it specifically to reduce acute cravings for substances other than kratom. This implies that for some individuals, long-term kratom use successfully attenuated drug cravings.
Self-Management and Recreational Use
The motivations for trying kratom appear to be evolving, with multiple factors driving use beyond self-management of mood or pain, including increased energy and recreation. Research indicates that reasons for kratom use are rarely mutually exclusive and span a wide range, reflecting kratom’s complex pharmacology.
An important distinction in the research is that what is often referred to as “recreational use” of kratom isn’t necessarily linked to a distinct altered mental state regarded as a “high” or to the development of use disorders or addiction to other substances. Contrarily, evidence suggests kratom has been linked with the substitution of controlled stimulants, opioids, and alcohol as a harm-reduction agent. To date, there is no evidence that kratom use serves as a gateway to the initiation or use of more potent substances, such as stimulants or opioids.
Therapeutic Applications
Opioid Dependence Management
One of the most promising therapeutic applications of kratom appears to be in managing opioid dependence. A 2022 case report highlighted the potential use of kratom to aid opioid dependence in a clinical setting, describing a man with a long history of kratom use who successfully coped with opiate withdrawals while abstaining from illicit drug use. This represents the first published detailed case report demonstrating kratom’s potential in this application.
Animal model data provide supporting evidence for this application. Studies have shown that mitragynine (MG), kratom’s major alkaloid, resulted in reduced opioid self-administration when administered to animals that had the opportunity to self-administer morphine or heroin intravenously1. These findings suggest potential therapeutic value in addressing opioid use disorders.
Pain Management and Mental Health Applications
Beyond opioid dependence, kratom is being researched for its potential in pain management and mental health applications. While not approved by the FDA as a therapeutic drug, many kratom consumers in the United States and globally report improved health, wellbeing, and quality of life from kratom use1. Such human use patterns and consumer self-reports of efficacy align with non-human animal studies investigating kratom alkaloids for pain attenuation and other conditions1.
As of 2025, researchers are working to identify the most critical psychoactive chemicals in the plant to develop novel medicines with increased efficacy and safety. One area of particular interest is pain medication development, where kratom and its active ingredients may offer new approaches.
Kratom Use Disorder and Safety Considerations
Prevalence and Characteristics of KUD
Recent research has begun examining Kratom Use Disorder (KUD) in detail. A 2025 clinical trial at Johns Hopkins behavioral pharmacology research unit represents the first empirical evaluation of kratom withdrawal symptoms. This research is critical given the increasing use of kratom in the United States since its first documented use in 2004.
Studies examining KUD suggest that while many kratom consumers do not meet criteria for KUD, some do develop dependency. A recent ecological momentary assessment study found that greater frequency of use was modestly associated with a greater number of KUD symptoms and taking kratom to avoid kratom-related withdrawal. However, irrespective of frequency, the mean number of KUD symptoms was less than four across the sample.
Among experienced kratom consumers (93.0% had used for more than 1 year), 66.7% met KUD diagnostic criteria, predominantly of mild severity (2 or 3 out of 11 DSM-5 symptoms). These symptoms primarily reflected physical dependence (e.g., tolerance, withdrawal), followed by symptoms of craving and using more than intended.
Safety Profile and Risk Assessment
The safety profile of kratom appears to vary significantly based on form and dosage. According to 2025 research, kratom tea has few adverse effects and a low risk of overdose, but kratom extracts in tablets, capsules, liquid shots, or gummies markedly escalate risks6. This highlights the importance of considering product formulation when assessing kratom’s safety.
Concerns around kratom include potential for deliberate adulteration through unregulated production and distribution, harm from coingestion with other sedatives, effects of lack of regulation on safety and safety perception, and potential interactions with medications. Kratom’s association with polydrug use or fentanyl-related deaths has also been reported.
Research and Regulatory Developments
The Fourth International Kratom Symposium held at the University of Florida College of Pharmacy in February 2025 brought together scientists, industry leaders, and regulators from Southeast Asia, Europe, and North America to exchange the latest research findings and explore strategies for responsible regulation. This symposium highlighted the growing scientific interest in kratom, with a significant increase in kratom-related publications over the past decade.
Researchers emphasize the need for regulation that balances consumer access with safety considerations. As of 2025, kratom appears to have potential use as a tea or in low-dose leaf form for pain management and as a transition from opioid use to opioid use disorders treatment, but proper labeling and legislation are deemed necessary to protect consumers.
Conclusion
Recent research on kratom reveals a complex picture of a substance with both therapeutic potential and safety concerns. Studies indicate that kratom may serve valuable roles in pain management, mood enhancement, and particularly in addressing opioid dependence. However, the development of Kratom Use Disorder in some users, particularly with frequent use, highlights the need for careful consideration of its applications.
Moving forward, evidence suggests that regulatory approaches should distinguish between different forms of kratom, potentially allowing lower-risk traditional preparations while implementing stricter controls on concentrated extracts. The ongoing research, including the first empirical studies of kratom withdrawal and the development of clinical algorithms for KUD, demonstrates the scientific community’s commitment to better understanding this substance. As research continues to evolve, a science-based approach to kratom regulation and clinical application will be essential to maximize potential benefits while minimizing associated risks.
The evolving landscape of kratom research and regulation in Indonesia reflects a growing recognition of its economic potential and the need for responsible management. Recent initiatives, such as the collaboration between the Persada Akmil 92 Foundation, Makmur Agro Satwa Group, and PT Indo Global Empire, demonstrate a concerted effort to enhance the quality and quantity of kratom production for export. This partnership aims to establish sustainable practices, provide support to local farmers, and ensure that Indonesian kratom meets international standards.
Furthermore, the Indonesian government’s proactive stance in regulating kratom trade, as evidenced by the Trade Ministry’s regulations introduced in September 2024, showcases a commitment to balancing economic opportunities with safety considerations2. These measures are crucial in building trust with international partners and consumers, potentially leading to increased demand for Indonesian kratom in global markets.
As research continues to uncover the therapeutic potential and public health implications of kratom, Indonesia’s role as the primary supplier positions the country at the forefront of this evolving industry. The collaboration between government entities, private sector companies like Ralali, and research institutions will be vital in navigating the complex landscape of kratom production, regulation, and international trade. By fostering innovation, ensuring quality, and promoting sustainable practices, Indonesia has the opportunity to not only maintain its dominance in the kratom market but also to set global standards for responsible production and trade of this increasingly significant botanical resource.