Individuals who suffer from chronic pain have increasingly come to rely on kratom, a Southeast Asian plant whose principal psychoactive alkaloids, mitragynine and 7-hydroxymitragynine (7-OH), may soon become Schedule I Controlled Substances in the United States. The two compounds bind to, and partially activate, opioid receptors in the brain.
“People in Southeast Asia have long relied on teas brewed from kratom leaves not only to manage pain but to ease the symptoms of opiate withdrawal,” said Bryan E. Denham, Ph.D., Campbell Professor of Sports Communication in the Department of Communication at Clemson. “Although kratom is not entirely safe, it appears to be less hazardous than concentrated, synthetic versions of 7-OH, manufactured by unscrupulous firms. Synthetics are sold at gas stations and vape stores and are packaged to attract the attention of high-school and college-aged individuals.”
Denham’s study appears in the Journal of Substance Use and addresses the extent to which kratom use correlates with health concerns and signs of dependency on other substances. One finding showed that individuals struggling to quit prescription pain relievers were more than four times as likely as others to have used kratom, a substance the Drug Enforcement Administration (DEA) considers “drug of concern.” In July 2025, the Food and Drug Administration (FDA) advised the DEA to add mitragynine and 7-OH to the list of Controlled Substances, and the DEA is currently considering that recommendation.
“It will be interesting to see what the DEA chooses to do in the coming months,” Denham said. “It announced plans in 2016 to ban mitragynine and 7-OH, but it received significant pushback from kratom users. This time, the FDA has made it a point to state plainly that its recommendation does not include the kratom plant itself. It is primarily interested in the two alkaloids and especially the hazardous synthetic products. A trade group, the American Kratom Association, has endorsed the recommended actions on mitragynine and 7-OH.”
Denham studies the media, health, and policy aspects of substance use in sport and society. He said that in sport, athletes have used kratom to increase energy and to recuperate from intense exercise. Some athletes believe it enhances their focus during competition, and some experiment with it for pain relief. Technically, kratom is not a banned substance, but the United States Anti-Doping Agency advises athletes to avoid using it given potential side effects. Athletes and non-athletes alike should appreciate that kratom is a drug, not a dietary supplement, and they should be aware of manipulative labels on synthetic substances.
In addition to his study in the Journal of Substance Use, Denham has examined the agenda-building function of mass media on kratom policy, exploring how coverage in major national news outlets and regional news organizations has impacted regulatory action. Denham said the Tampa Bay Times, in particular, has examined kratom use in depth, and its reporting has impacted coverage elsewhere in addition to policy conversations at the state and national levels.
