Kratom leaves are commonly used by smoking or chewing, as a tea, powdered in capsules or pills, or extracted for use in liquids.

In cultures where the plant grows, kratom has been used in traditional medicine. The leaves are chewed to relieve musculoskeletal pain and increase energy, appetite, and sexual desire in ways similar to khat and coca.^[7] The leaves or extracts from them are used to heal wounds and as a local anesthetic. Extracts and leaves have been used to treat coughs, diarrhea, and intestinal infections.^[3][4][20] They are also used as intestinal deworming agents in Thailand.^[18]

Kratom is often used by workers in laborious or monotonous professions to stave off exhaustion as well as a mood enhancer and painkiller.^[20] In Thailand, kratom was “used as a snack to receive guests and was part of the ritual worship of ancestors and gods”.^[25] The herb is bitter and is generally combined with a sweetener.^[21]

Kratom is not an opioid; Kratom is an alkaloid that interacts with the mu- and delta- opioid receptors.

Alkaloids are any of a class of naturally occurring organic nitrogen-containing bases.

Alkaloids are found primarily in plants and are especially common in certain families of flowering plants. In fact, as many as one-quarter of higher plants are estimated to contain alkaloids, of which several thousand different types have been identified.

The phytochemicals isolated from various parts of the tree include over 40 structurally related alkaloids as well as several flavonoids, terpenoid saponins, polyphenols, and various glycosides. The main psychoactive components in the leaves are mitragynine and 7-hydroxymitragynine, both found only in Mitragyna speciosa.