Kratom, Injury Litigation, and Pharmacy Costs: What PI Attorneys Need to Know

James Wong — Founder & CEO, LienScripts | March 4, 2026 | 7 min read

Kratom use among PI plaintiffs raises evidentiary and pharmaceutical issues that attorneys must navigate carefully. LienScripts pharmacy lien services cover FDA-approved medications while attorneys manage the complications that kratom use can create in injury cases.

Kratom (Mitragyna speciosa) is an herbal supplement used by millions of Americans for pain relief, mood enhancement, and opioid withdrawal management. For personal injury attorneys, kratom use by plaintiffs creates specific case management challenges: defense counsel may exploit kratom use to undermine credibility, argue alternative causation for symptoms, or challenge the necessity of prescribed pain medications. Pharmacy lien services through LienScripts cover all FDA-approved medications for injury treatment, providing documented, pharmacy-dispensed medication records that stand up to litigation scrutiny regardless of whether the plaintiff also uses kratom.

• Kratom is an unregulated herbal supplement used by millions for pain relief and mood enhancement
• PI plaintiffs who use kratom face defense arguments about credibility, alternative causation, and medication necessity
• LienScripts pharmacy liens cover all FDA-approved prescribed medications for injury treatment
• The MERIT report documents pharmacist-verified medication dispensing that is distinct from supplement use
• LienScripts generates a MERIT (Medication Evaluation & Rationale for Injury Treatment) report for every case, providing pharmacist-signed documentation for demand packages

Kratom in the Personal Injury Context

Kratom products are sold as dietary supplements in most states, though some states and municipalities have banned or regulated the substance. Kratom contains alkaloids that interact with opioid receptors, producing pain-relieving and mood-altering effects at various doses.

Personal injury plaintiffs may use kratom for several reasons:

Self-treating injury pain. Some plaintiffs use kratom to manage injury-related pain, particularly if they are between medical appointments, unable to afford prescribed medications, or seeking to avoid opioid prescriptions.

Pre-existing use. Some plaintiffs used kratom before their injury for chronic pain, mood management, or other purposes and continue use after the injury.

Opioid alternative. Some patients use kratom as an alternative to prescribed opioids, either by personal choice or because they face difficulty obtaining opioid prescriptions through traditional channels.

According to James Wong, PharmD, founder of LienScripts, "Kratom is not an FDA-approved medication, is not dispensed through pharmacies, and has significant quality control variability. When a PI plaintiff uses kratom alongside prescribed medications, the case documentation needs to clearly distinguish between regulated pharmacy-dispensed drugs and unregulated supplements. The MERIT report does exactly that."

Defense Strategies Involving Kratom

Credibility Attacks

Defense counsel may attempt to portray kratom use as evidence that the plaintiff is engaged in risky self-medication behavior. In jurisdictions where kratom carries negative connotations, this can affect jury perception. Defense may characterize kratom use as drug-seeking behavior that undermines the plaintiff's claims about pain severity.

Alternative Causation

Defense may argue that symptoms the plaintiff attributes to the injury, such as cognitive difficulties, mood changes, or GI problems, are actually caused or worsened by kratom use rather than the accident. Kratom's effects on the central nervous system and GI tract can produce symptoms that overlap with injury-related complaints.

Medication Necessity Challenges

If the plaintiff uses kratom for pain alongside prescribed medications, defense may argue that the prescribed medications were unnecessary because the plaintiff was already managing pain with kratom. This argument seeks to reduce the value of pharmacy lien amounts.

Drug Interaction Concerns

Kratom interacts with certain medications, particularly opioids, benzodiazepines, and other CNS depressants. Defense may argue that kratom use created drug interaction risks that complicate the treatment picture.

Attorney Strategies for Kratom-Related Issues

Document Prescription Medication Separately

The MERIT report from LienScripts documents every FDA-approved medication dispensed through the pharmacy lien. This documentation is entirely separate from any supplement use and carries the credibility of pharmacy-verified dispensing records. Maintain clear separation between prescribed medication records and supplement use.

Address Kratom Proactively

If the plaintiff's kratom use will be discovered in discovery, address it proactively rather than allowing defense to introduce it as a surprise. Deposition preparation should include discussion of kratom use, the reasons for it, and the relationship between kratom use and prescribed medication compliance.

Obtain Prescriber Input

The treating physician's documentation explaining why prescribed medications are necessary for the injury, regardless of the patient's supplement use, strengthens the medical necessity argument. A prescriber who is aware of the patient's kratom use and still prescribes injury medications has made a clinical judgment that those medications are needed.

Emphasize Medication Compliance

The MERIT report shows that the plaintiff filled and maintained prescribed medications on schedule. This adherence evidence demonstrates that the plaintiff relied on medical professionals for treatment, not solely on unregulated supplements. For guidance on medication adherence documentation, the same principles apply.

The Pharmacy Lien's Role

The pharmacy lien through LienScripts serves an important evidentiary function in cases involving kratom use. It creates a clear, documented record of FDA-approved medications prescribed and dispensed by licensed healthcare professionals. This record:

• Establishes that the plaintiff sought and received professional medical treatment
• Documents medication compliance through verified dispensing records
• Provides pharmacist-signed documentation of the pharmaceutical treatment timeline
• Distinguishes regulated medical treatment from supplement use

For attorneys building comprehensive demand packages, the MERIT report provides the pharmaceutical evidence layer that withstands defense challenges about kratom or other supplement use.

Practical Guidance

Attorneys should ask clients about all substances they use, including kratom, at intake. Understanding the full picture allows proactive case management. Enroll clients in the LienScripts pharmacy lien for all injury-related prescribed medications, ensure the prescribed medication record is comprehensive, and prepare to address kratom use if it arises in discovery or deposition.