If you have chronic pain, as 11% of American adults do, the allure of a natural plant-based painkiller is powerful—especially one with a reputation for helping people get off opioids.

But this cure can be worse than the disease. The natural painkiller is kratom (Mitragyna speciose), a plant that has been used for centuries in Southeast Asia to manage pain. In the US, kratom is illegal in some states, but it’s widely available online (and in stores in other states). Its leaves can be chewed, brewed into tea or smoked, and kratom powder is available in capsules.

Kratom has now been declared by the FDA to be an opioid. Its active ingredients bind to opioid receptors, and it has milder but ­similar painkilling and euphoria-inducing properties. It’s addictive, too. Unlike other opioids, it doesn’t depress respiratory function—a positive.

But there’s plenty evidence of harm. Calls to poison control centers about kratom are skyrocketing, with reports of seizures, psychosis…and death. Proponents of kratom argue that it’s really contamination with other drugs that is hurting people, and more research is needed. Meanwhile, the FDA has issued a strong public warning not to consume kratom—or other illegal drug products that contain its components mitragynine and 7-hydroxymitragynine—for any purpose.

Fortunately, there are herbal supplements for pain relief that are legal in all states. These include willow bark, devil’s claw, turmeric and ginger. They contain powerful anti-inflammatory and pain-relieving compounds—willow bark’s salicin (similar to the active ingredient in aspirin), devil’s claw’s iridoid glycosides, turmeric’s curcumin, ginger’s gingerols. Each has been the subject of clinical trials demonstrating efficacy (although more clinical research is warranted)—and they all have good safety records. Reminder: Always consult with your physician or pharmacist before taking a new drug or supplement.

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