Mixing Kratom and Opioids
Dangerous
Kratom's ceiling does not protect you once heroin or oxycodone is on board, and a second opioid is almost always found in kratom deaths. Do not combine. Keep naloxone nearby.
Kratom is often taken to take the edge off between doses or to self-manage withdrawal, which puts it in the same window as a full agonist far more often than people intend. Mitragynine binds the same receptors without kratom's ceiling protecting you once heroin or oxycodone is also on board. In coroner data, mitragynine is almost never found alone — a co-ingested opioid is the usual companion.
The risk here is to the body — breathing, heart, temperature or organs. Set limits before you start, because this kind of harm does not announce itself in time to react.
Headspace vs physical riskWhat to do
- Say what was taken and how much.Responders need it, and in most US states Good Samaritan laws protect both of you from drug possession charges when you call for an overdose.
- Unresponsive: put them on their side, tilt the head back, and stay until help arrives.Never leave someone alone to “sleep it off”.
- Give naloxone (Narcan) if you have it.It is sold over the counter in every US state and does no harm if opioids turn out not to be involved.
- Never Use Alone 1-800-484-3731Stays on the line and sends help if you stop responding.
- Full steps: what to do if it is already happeningOverdose signs, the recovery position, what to say on the call, and whether you can be charged for making it.
- Poison Control 1-800-222-1222Free and 24/7, for “is this bad?” before it becomes an emergency.
Can you mix Kratom and Opioids?
MixSafe rates mixing Kratom and Opioids as "Dangerous" — high risk of death or life-changing injury. Do not combine. Source: MixSafe research. Educational information, not medical advice.
- Kratom
- Partial agonist — a ceiling other opioids do not have
- Opioids
- Full agonists — heroin, oxycodone, morphine
- Kratom also called
- mitragynine, mitragyna, mitragyna speciosa, krat
- Opioids also called
- opiate, opiates, opioid, heroin, dope, smack
- Respiratory effects of oral mitragynine and oxycodone in a rodent model. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9671979/
- Dangerous Kratom Drug Interactions: Benzos, Alcohol, and More. Bicycle Health. https://www.bicyclehealth.com/kratom/dangerous-kratom-drug-interactions
- The Associations of Kratom (Mitragynine), Opioids, Other Substances, and Sociodemographic Variables to Drug Intoxication-related Mortality. https://pubmed.ncbi.nlm.nih.gov/39560283/
- Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological report. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10806006/
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All combinations →Rated dangerous. Educational information only, not medical advice. Absence of a documented interaction is not evidence of safety.