Kratom has been used traditionally and in recent years for its medicinal and therapeutic effects. In addition, it is increasingly being used as a recreational drug. Kratom can cause dependence and addiction, which can lead to withdrawal symptoms upon cessation. Some people may benefit from professional support when reducing and stopping kratom use.
- Kratom withdrawal symptoms can include stomach upset, shaking, aches, flu-like symptoms, agitation, low mood, and anxiety.
- Kratom withdrawal can emerge within 48 hours of the last use and may last for a week or so, although some psychological symptoms may persist for longer.
- Treatment options for kratom abuse and withdrawal can include therapy, support groups, and inpatient or outpatient rehab programs.
What is kratom withdrawal?
Kratom withdrawal occurs when kratom use is stopped after heavy and prolonged use. Kratom is a substance made from the leaves of Mitragyna speciosa, a plant native to Southeast Asia. It contains various chemical compounds that create sedative and stimulant effects and can lead to the development of dependence and withdrawal. [1]
Two of the most prominent chemical compounds found in kratom are mitragynine and 7-hydroxymitragynine. These chemicals activate opioid receptors in the brain in a similar way to opioids, such as heroin, morphine, and codeine, although to a lesser degree. When opioid receptors are activated, this has a sedative and analgesic effect, which can reinforce use and contribute to addiction. [2]
Kratom is also seen to impact other chemicals in the brain, including serotonin and dopamine. These neurotransmitters impact functions such as mood, behavior, sleep, and appetite. Dopamine is also associated with the development of addiction, as it is linked to the reward circuit in the brain. [3]
Prolonged use of kratom causes these effects to occur, changing brain function and leading to the development of physical dependence. If kratom use is then stopped, the brain must adapt to the sudden change in chemical activity, which can cause the physical and psychological effects of withdrawal. [4]
Withdrawal symptoms from kratom can be mild to moderate and tend not to be severe. However, the severity of withdrawal symptoms can vary depending on the individual, the duration and amount of kratom use, other substance use, and pre-existing mental and physical health conditions. [5][6]
Common kratom withdrawal symptoms
Kratom withdrawal can cause physical and psychological symptoms. Common physical kratom withdrawal symptoms can include: [4][6]
- Nausea
- Stomach pain
- Vomiting
- Diarrhea
- Fatigue and energy loss
- Jerky movements
- Loss of appetite
- Weight loss
- Runny nose
- Watery eyes
- Hot flushes
- Muscle aches and pains
- Insomnia
Common psychological kratom withdrawal symptoms can include: [4][6]
- Low mood
- Anxiety
- Agitation
- Restlessness
- Irritability
- Cravings
Severe kratom withdrawal symptoms
Kratom withdrawal symptoms tend not to be severe, although the severity of kratom withdrawal can vary from person to person. Withdrawal symptoms that may be severe or long-lasting can include: [4][6]
- Severe mood changes, which may impact functioning and cause suicidal ideation
- Persistent vomiting or diarrhea, leading to dehydration
- Intense cravings, which can cause a high risk of relapse or other substance use
Kratom withdrawal timeline
Typically, withdrawal symptoms emerge within 12-48 hours of the last kratom dose. They may be at their most severe within the first three days, after which they will begin to reduce. Some symptoms, particularly psychological symptoms such as depression and anxiety, may continue for several weeks. [2][6]
The duration and severity of kratom withdrawal symptoms can vary depending on several factors, including duration and amount of use, history of mental and physical health issues, the severity of addiction and dependence, and how quickly drug use is stopped.
During withdrawal, individuals are at a high risk of experiencing cravings and relapse, as they may wish to return to drug use to stop withdrawal symptoms. Gradual tapering can help prevent severe withdrawal symptoms and reduce the risk of relapse during this time. [4]
Kratom detox and withdrawal management
Drug detoxification, or detox, involves the removal of the substance from the body. On some occasions, people detox by stopping the drug completely, known as cold turkey. With professional support and monitoring, and sometimes with the use of medications, this can be the fastest way to detox. However, abruptly stopping a substance can cause more severe withdrawal symptoms.
Alternatively, people can gradually taper off the substance, slowly reducing their dosage. This can help reduce withdrawal symptoms.
Medications can be used to help alleviate kratom withdrawal symptoms, such as clonidine and lofexidine, which can reduce nausea and vomiting, mood changes, shaking, and insomnia. [7][8]
Medications commonly used for opioid withdrawal and abstinence maintenance, such as buprenorphine and methadone, are also found to be beneficial in kratom withdrawal. They can reduce cravings as well as withdrawal symptoms and can be used alongside or instead of clonidine and lofexidine. [7][8]
When to seek professional help for kratom withdrawal
Although kratom withdrawal is unlikely to cause severe effects, some people may find it beneficial to utilize professional support to reduce and stop kratom use. Professional help may be necessary for people who:
- Have used large doses of kratom for a prolonged period
- Have tried to reduce or stop kratom use several times unsuccessfully
- Have noticed increasing problems in their life or functioning because of kratom use
- Use other substances alongside kratom, particularly opioids or alcohol
- Have a history of mental health issues
Professionals can provide psychological and physiological treatments for kratom withdrawal symptoms, help reduce the risk of relapse, and teach coping strategies for associated mental health issues and triggers.
Using kratom for opioid withdrawal: Is it safe?
Kratom has been used in Southeast Asian traditional medicine to help with opioid withdrawal for many centuries. In recent years, it has become increasingly used in Western countries. Scientific research into the use of kratom for opioid withdrawal is limited, although there is some evidence for this and many anecdotal reports. [6][9][10]
Because kratom partially activates opioid receptors, it can be a helpful substitute for people with opioid use disorder during withdrawal. Its mechanism of action produces some of the same effects as opioids, which can prevent cravings during opioid withdrawal. However, it does not have the same level of impact on receptors and may cause fewer unpleasant side effects. [2]
Anecdotal reports of using kratom for opioid withdrawal suggest that it can reduce unpleasant withdrawal symptoms. However, kratom can cause side effects, such as vomiting, changes in blood pressure, seizures, and psychotic symptoms. [2][10] Additionally, there are some reported deaths associated with kratom use, although most involve multiple drug use. [11]
As kratom is not regulated in the US, people buying kratom products online or in stores cannot be certain of their content and safety. There are some reports of contaminated kratom products, which may contribute to additional risks. [3]
As such, kratom may not be safe to use, in medicinal or recreational contexts. The Food and Drug Administration (FDA) warns against its use. While its therapeutic benefits are recognized, more extensive research is required to determine its safety and risk profile in the treatment of opioid withdrawal. [1]
Treatment for kratom abuse
People regularly using kratom may require professional support to reduce and stop their use. Various treatment options are available to help with substance use issues, including:
- Therapy and counseling
- Support groups
- Inpatient rehab
- Outpatient treatment programs
- Medications, such as those used for opioid use disorder, may be beneficial in treating kratom withdrawal [7]
The Recovered directory can help with finding local rehabs and learning more about available treatments.