Kratom: The Opioid at the Gas Station

Many parents have never heard of kratom.

That unfamiliarity makes its risks easier to miss.

While families are watching for the substances they recognize, another substance may escape their attention. Kratom products are sold in smoke shops, convenience stores, gas stations, and online. They may be marketed as natural supplements, herbal energy products, or wellness aids.

They often look more like ordinary commercial products than something families would associate with addiction risk.

Unfamiliarity does not create the risk. But it makes the risk far easier to miss.

Kratom hides in plain sight.

For families who have never heard of it, kratom does not fit the familiar picture of dangerous drug exposure. It looks like something that belongs on a convenience store shelf, rather than something capable of producing opioid-like effects and dependence.

What Kratom Actually Is

Kratom comes from Mitragyna speciosa, a tree native to Southeast Asia. Its best-known active compounds, mitragynine and 7-hydroxymitragynine, act at opioid receptors in the brain. The FDA has warned about risks associated with kratom, including liver injury, seizures, and substance use disorder.

There is also an important distinction between kratom leaf and concentrated products.

Small amounts of 7-hydroxymitragynine, commonly called 7-OH, occur naturally in kratom. Products containing added or enhanced levels of 7-OH are substantially different from the leaf itself. The FDA describes these products as potent opioids and warns consumers to avoid them. They may appear as tablets, gummies, drink mixes, or small liquid shots.

Knowing that a young person uses “kratom” is therefore only the beginning. The actual product, ingredients, amount, and frequency matter.

A young person may try something because it seems energizing, manageable, or natural, without understanding what it contains or recognizing the possibility of dependence.

It does not look like heroin. It does not look like prescription pain medication. It may not even look like a drug.

But its pharmacology matters more than its packaging.

Why Awareness Is So Low

Research on U.S. adolescent kratom use remains limited. An analysis of the 2019 National Survey on Drug Use and Health found relatively uncommon use and associations with other substance use. Those findings provide a starting point, rather than a complete picture of today’s products and patterns of use.

A substance does not have to be widely used to deserve a place in the conversation.

Families may never have been told to look for kratom. It may not come up at school or during a medical visit. Young people may not mention it because they do not believe they are using something dangerous.

They bought it at a gas station. It was packaged like a supplement. As far as they know, it does not belong in the same category as other drugs.

That misunderstanding can keep use out of the conversation precisely when a conversation would help.

The Detection Problem

A drug screen only detects the substances included in that particular test. Specific testing for mitragynine is available, but families and clinicians should not assume it was included simply because a drug screen was performed.

Testing for newer 7-OH products also requires attention to the laboratory method. Clinicians should confirm what the test measures and consult the laboratory when the product history and results do not align.

A young person can be using a psychoactive substance without a familiar test result explaining what is happening.

Changes in mood, sleep, or physical comfort may prompt concern, but those changes alone do not identify the cause. A direct conversation about supplements, extracts, powders, and shots remains essential.

A negative drug screen does not rule out use of a substance the test did not measure.

Dependence Can Be Easy to Underestimate

Regular kratom use can lead to dependence. Reported problems include craving, tolerance, withdrawal, and continued use despite consequences. Withdrawal associated with concentrated 7-OH products can include anxiety, irritability, restlessness, insomnia, body aches, and gastrointestinal symptoms.

For a young person who began using a product because it seemed harmless or natural, difficulty stopping can be frightening.

This is where the gap between marketing and reality becomes dangerous.

A young person may not understand what is happening until stopping feels much harder than expected. Families may notice discomfort or a growing reliance on a product without knowing what questions to ask.

The pattern matters: taking more than intended, struggling to cut back, or feeling increasingly unable to get through the day without it deserves attention.

Treatment Is Not as Straightforward as Many Assume

Published case reports and case series describe buprenorphine-based treatment as one approach used for kratom use disorder. These reports offer useful clinical information, but they do not establish a single treatment pathway for every person, particularly adolescents.

Treatment decisions require an individualized assessment of the product, pattern of use, withdrawal symptoms, other substances, and the young person’s overall health.

For families, the practical message is to seek medical guidance if use is becoming difficult to control or stopping causes symptoms.

Recognition has to come first.

Why This Matters Right Now

The adolescent substance-use landscape keeps changing. Some risks appear in products that are easy to buy and easy to explain away.

A young person may be experimenting, following a peer’s suggestion, or trying to manage stress or discomfort. Understanding that reason matters too. It helps families respond to both the substance use and the concern that may be driving it.

The entry point may look nothing like what families imagine addiction looks like.

What Families and Professionals Need to Do

For families, awareness begins with specific, calm questions:

“What is the product called? What do you take it for? How often do you use it? How do you feel when you do not take it?”

Looking at the packaging together can help identify what was actually taken. The goal is to understand enough to respond appropriately and make it easier for a young person to speak honestly.

For clinicians and other professionals working with young people, substance-use screening should include kratom and 7-OH by name. A young person may not mention them otherwise because they do not think they count or do not know what category they belong in.

Families should also recognize an emergency. If someone cannot be awakened or has slow or shallow breathing, call 911 and administer naloxone if available. Stay with the person until emergency help arrives.

The danger of kratom is not only what it does pharmacologically.

It is also how easily it escapes notice.

Naming it, asking about it, and understanding the actual product can help families recognize a problem sooner and seek appropriate support.