Kava vs Kratom: What's the Difference?

Kava and kratom are not the same thing. They come from different plants, contain different active compounds and affect the body in different ways. What they share is a place on the same shelves and in the same drinks, and a link to liver injury.

Kava vs kratom at a glance

What kava is

Kava (Piper methysticum) is a plant in the pepper family, native to the Pacific Islands. Its root is traditionally made into a water-based drink.

Its active compounds, kavalactones, have sedative and anti-anxiety effects. Kava is a central nervous system depressant: it slows brain activity. It is not an opioid.

Commercial kava products can contain 2 to 10 times the kavalactones of traditional preparations, according to a 2026 CDC report.

What kratom is

Kratom (Mitragyna speciosa) is a tree from Southeast Asia. The name also covers products made from its leaves. For more detail, see our guide: what is kratom.

Its best-studied compounds are mitragynine and 7-hydroxymitragynine (7-OH). Both act on the brain's mu-opioid receptors, the same targets as opioid pain medicines. Their effects only partly resemble those of opioids like heroin or oxycodone, according to the National Institute on Drug Abuse (NIDA).

People report stimulant-like effects at lower doses and opioid-like or sedating effects at higher doses. Studies haven't established how dose relates to effect. Effects last about 5 to 7 hours and are strongest at 2 to 4 hours, according to a 2022 review.

Kratom is not approved by the FDA for any medical use. Regular use can lead to dependence, and stopping can cause kratom withdrawal.

Kava and kratom drinks and bars

Kava and kratom are now often taken together. Since 2017, poison center reports of kava used with kratom have risen. In 2025, kratom was involved in 61 of 203 kava reports (30%), according to a 2026 CDC report. Serious outcomes rose from 12% of kava reports in 2000 to 32% in 2025.

Kava drinks are sold in stores and at kava bars, which are often promoted as alcohol-free places to socialize. Some products combine kava and kratom.

A product sold as kratom may not be plain leaf. Tablets, gummies, drink mixes and shots sold online, in smoke shops and at gas stations may have 7-OH added or concentrated. The FDA calls 7-OH a potent opioid.

Before you try a drink, check the label for kratom, mitragynine or 7-OH. If a label doesn't say what's in it or how much, you can't know what you're taking.

Liver and other risks

• Kava: in 2002, the FDA warned that kava supplements may be linked to severe liver injury. By then, 11 people in the US and Europe who used kava had needed liver transplants. In 2020, the FDA concluded that indiscriminate kava use isn't safe as a recreational or relaxation drink.

• Kratom: published cases are uncommon, but they include jaundice and hospital stays, and a few people have needed a transplant. Read more about kratom and your liver.

Kratom carries other risks too. The FDA warns people not to use it because of liver toxicity, seizures and substance use disorder. Most kratom-related deaths reported to poison centers involved other substances as well.

See a doctor soon if you notice yellow skin or eyes, dark urine, belly pain, nausea or unusual tiredness after using either one. Call 911 if someone has trouble breathing or won't wake up. For a possible poisoning, call Poison Control at 1-800-222-1222.

Does kava help with kratom withdrawal?

No study we found shows that it does, and kava brings its own liver risk.

No medicine is FDA-approved for kratom withdrawal either. The safest plan is one you make with a licensed doctor, not a swap from one plant to another. Don't stop or change your kratom use on your own if you've used it heavily or for a long time: talk to a doctor first.

Is it worth a morning off and a clinic bill to ask how to cut back safely? Ask Doctronic first. The medical AI chat is free, and a video visit with a licensed doctor is $39. Doctronic doesn't treat addiction, but a doctor can help with symptoms and refer you to addiction care.

Frequently Asked Questions

Is kratom legal in the US?

It depends on where you live. As of November 3, 2026, kratom and 7-OH aren't federally controlled. The DEA has proposed temporarily placing 7-OH above a set strength in Schedule I. That order could come on or after November 13, 2026. Some states and cities already ban kratom or 7-OH, so check your state's current law.

Can I drink kava or kratom with alcohol?

It's best not to. Mixing kratom with alcohol, benzodiazepines or opioids adds to the risk of heavy sedation and slowed breathing. Kava also slows the nervous system, so ask a licensed doctor before you combine it with anything that makes you drowsy.

Can I use kava or kratom if I have liver problems?

Not without asking a licensed doctor first. Bring a list of everything you take, including supplements and drinks, so the doctor can see the whole picture.

The Bottom Line

Kava and kratom are different plants with different effects, but they share a liver risk and are often sold side by side. Kratom acts on opioid receptors and can lead to dependence, and some products sold as kratom are concentrated 7-OH. If you use either one and have questions about symptoms or stopping, talk to a licensed doctor.