Can kratom be combined safely with other substances? In general, combining drugs can be risky. We recommend that kratom not be combined with yohimbine, cocaine, amphetamine-like drugs, or large doses of caffeine, because of the possibility of over-stimulation or increased blood pressure. We recommend that kratom not be combined with large amounts of alcohol, with benzodiazepines, opiates (other than possible use with red poppy tea—see below), or any other drugs that depress the nervous system. This is because of the possibility that such combinations might cause over-sedation or even possible respiratory depression (not breathing), We recommended that kratom not be combined with Syrian rue, Banesteriopsis caapi, or any other MAO inhibitor drug. Serious, even fatal, reactions can occur if MAO inhibitor drugs are combined with monoamine drugs. The combination of MAO inhibitor drugs with kratom, which contains monoamine alkaloids, has not been studied. (Text by "Sage Student" and Daniel Siebert)

Certain combinations have been reported by users to be pleasant and supposedly safe. Kratom can certainly be combined with ordinary tea without risk. It has been used with a tea made from red poppy flowers (Papaver rhoeas), which itself has an extremely mild narcotic effect, and with a sedating-euphoriant tea made from ‘blue lotus’ (Nymphaea caerulea). It has been safely combined with SMALL quantities of alcohol, however large quantities of alcohol must be avoided. Some people report they like to smoke tobacco or cannabis while under the influence of kratom. But anyone smoking under the influence of kratom must be very careful not to nod off and drop lit smoking materials. (Text by "Sage Student" and Daniel Siebert)