Skip to main content
Quest Diagnostics

Kratom has the potential for dependence and addiction

Dosing and purity vary widely, making effects unpredictable and sometimes dangerous

Kratom is a rising drug of concern—and it may not appear on routine drug testing

Kratom (mitragynine) is a plant-derived substance sold as powders, capsules, drinks, and extracts—often in vape shops, smoke shops, and gas stations.

Kratom is increasingly used for self-medication or to achieve opioid-like effects—and is often overlooked in routine drug monitoring.

Patients to consider testing for kratom

Patients receiving pain management therapy who demonstrate inconsistent response to prescribed opioids

Patients reporting self-detox strategies

Patients exhibiting unexpected sedation, agitation, or mood changes

New patients entering chronic pain or substance-use treatment programs

Podcast—Kratom: Identifying a drug of concern

In this podcast, Jack Kain, PharmD, Medical Science Liaison at Quest Diagnostics, talks with Jeff Gudin, MD, Senior Medical Advisor at Quest Diagnostics about the toxicity of kratom, testing for kratom, and what the testing will uncover.

Listen to our new podcast—Kratom: Identifying a drug of concern

Listen now

The US Food and Drug Administration is warning consumers not to use kratom, which has properties that expose users to the risks of addiction, abuse, and dependence.3

Quest Diagnostics offers definitive testing to help identify kratom use

Quest uses a 2-step drug monitoring approach that allows clinicians to differentiate possible use from confirmed presence of mitragynine.*

Test codes

Test name

Use case

39432

Drug Monitoring, Mitragynine, with Confirmation, Urine

Most economical choice for clinical monitoring when positivity is expected to be low (~5%)

39431

Drug Monitoring, Mitragynine, Quantitative, Urine

 For practices that already perform preliminary screening or require concentration data
*When ordering an NPS panel, mitragynine testing must be ordered separately to detect kratom use.

References

  1. Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health (NSDUH), 2023: Crosstabulation of AGE3 by KRATOMYR (weighted by ANALWT2_C). SAMHSA data analysis system. Accessed November 4, 2025.
 https://datatools.samhsa.gov/das/nsduh/2023/nsduh-2023-ds0001/crosstab?row=AGE3&column=KRATOMYR&weight=ANALWT2_C
  2. American Psychiatric Association. What is kratom and why is it raising concerns? APA Blogs. October 22, 2025. Accessed November 4, 2025.
https://www.psychiatry.org/news-room/apa-blogs/what-is-kratom-and-why-is-raising-concerns
  3. Food and Drug Administration. FDA and kratom. March 4, 2019. Accessed November 4, 2025. https://www.fda.gov/news-events/public-health-focus/fda-and-kratom


Test codes may vary by location. Please contact your local laboratory for more information.

Clinical support for interpretation

Call our Rx Tox Line for clinical consultation and assistance with interpretation
1.877.40.RXTOX (1.877.407.9869)

Our company

Quest® is the brand name used for services offered by Quest Diagnostics Incorporated and its affiliated companies. Quest Diagnostics Incorporated and certain affiliates are CLIA-certified laboratories that provide HIPAA-covered services.  Other affiliates operated under the Quest® brand, such as Quest Consumer Inc., do not provide HIPAA-covered services. 

 

Quest®, Quest Diagnostics®, any associated logos, and all associated Quest Diagnostics registered or unregistered trademarks are the property of Quest Diagnostics. All third-party marks—® and ™—are the property of their respective owners. © 2026 Quest Diagnostics Incorporated. All rights reserved. Image content features models and is intended for illustrative purposes only.