Liver injury associated with kratom, a popular opioid-like product: Experience from the U.S. drug induced liver injury network and a review of the literature

•Kratom has become a commonly used substance for its psychotropic effects.•Reports have surfaced linking Kratom to liver injury•US Drug Induced Liver Injury Network experience offers a description of the presentation and course of liver injury due to Kratom.•Practitioners must be aware of the potential for Kratom to induce liver injury. : Kratom is a botanical product used as an opium substitute with abuse potential. : Assessment of suspected cases of kratom-induced liver injury in a prospective US cohort. : Eleven cases of liver injury attributed to kratom were identified with a recent increase. The majority were male with median age 40 years. All were symptomatic and developed jaundice with a median latency of 14 days. The liver injury pattern was variable, most required hospitalization and all eventually recovered. Biochemical analysis revealed active kratom ingredients. : Kratom can cause severe liver injury with jaundice.