Characteristics of adverse reactions to kratom and implementation of harm reduction strategies in a sample of ethnobotanical tea bar patrons in Colorado.
Harm reduction journal March 2, 2026 Cianna J Piercey, Joseph Cameron, Riley Ahern et al.
Kratom, a psychoactive botanical, is increasingly used in the United States. A survey of 102 participants (average age 22.34 years, 39.2% women) recruited from ethnobotanical tea bars in Northern Colorado found that 75.5% had experienced at least one adverse reaction. Adverse reactions most commonly occurred when kratom was consumed on an empty stomach, with certain foods, without adequate hydration, or combined with other substances. Participants used strategies like stopping or pacing use, adjusting hydration and food intake, and resting to mitigate reactions, though the effectiveness of these techniques remains unknown. The findings suggest that contextual factors may contribute to adverse reactions, highlighting the need for more research to inform harm reduction and public health messaging.