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Kratom Detox Guide: Symptoms, Timeline and Effects

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Kratom comes from the leaves of a tree (Mitragyna speciosa) which contains a chemical with dose-dependent, opioid-like effects.1 When kratom is used in smaller doses, it produces stimulant effects, such as increased energy and sociability.1 At higher doses it has effects similar to opioids such as morphine, oxycodone, and hydrocodone, which is why many people use it as an alternative treatment for the management of opioid withdrawal and to combat cravings.1 This somewhat unusual duality of effects makes Kratom unique as an “upper” at low doses, and a “downer” in high doses.

Kratom is sold as a gum, extract, or green powder in packets labeled “not for human consumption”.1 It is not currently an illegal substance but the Drug Enforcement Administration (DEA) lists it as a drug of concern due to health risks associated with use.2 Since it is not federally illegal, Kratom is relatively easy to obtain through online mail ordering and is sometimes sold under names such as:1

  • Thom.
  • Ithang.
  • Ketum.
  • Biak-biak.
  • Herbal Speedball.
  • Kahuam.

Kratom leaves can be chewed or used to make a tea. Others smoke it or add it to food.1 Kratom, like heroin and prescription painkillers, binds and activates certain opioid receptors in the brain—an interaction which results in reduced pain, euphoria, and sedation.1 Although kratom produces effects similar to opioids, it is not classified as an opioid because it is not derived or synthesized from the opium poppy (Papaver somniferum). Despite this, the chemical structure of the drug does have some activity as an exogenous opioid receptor agonist, as previously mentioned. This has raised the question as to whether a person can overdose on kratom similarly to opioid overdoses. Initially, kratom does not appear to be associated with fatal overdose. However, kratom is sometimes laced with other compounds, and there have been reported fatalities. Its use is associated with nausea, loss of appetite, increased sweating, seizures, and psychosis.1,2 Like opioid drugs, kratom has been reported to result in physical dependence, addiction, and withdrawal symptoms.1

What Are the Risks of Kratom Abuse?

As indicated above, kratom is unique because of its mix of stimulant and sedative effects. And while it has many desirable effects, such as euphoria, it’s important to be aware that there are many negative side effects and health risks associated with kratom use. Below is a list of the physical and mental risks associated with kratom abuse:2,4

  • Depression.
  • Nausea and vomiting.
  • Slowed breathing.
  • Irregular heart beat.
  • Muscle pain.
  • Liver damage.
  • Hallucinations.
  • Delusions.
  • Paranoia.
  • Aggression.
  • Hostility.
  • Seizures.
  • Coma.

Commercial forms of the drug are sometimes adulterated with other substances, a practice that can increase the risk of death in users.1 It appears that fatalities result from the additional drug(s) present along with the kratom, although there is some evidence that kratom itself can have deadly results.1,2

What Are the Signs and Symptoms of Addiction?

Kratom is popular amongst people who wish to use it as an alternative to standard medical treatments for opioid withdrawal. Many people believe that kratom is a safer option, perhaps because it is legal and natural, but there are increasing reports of individuals developing a dependence on and addiction to kratom. Dependence occurs with chronic kratom abuse, as the body adapts to the presence of the drug and requires it to function optimally. Those who are dependent on kratom will likely experience unpleasant withdrawal symptoms when they try to quit. Kratom addiction, which almost always is accompanied by dependence, is a complex condition in which the person compulsively uses the substance regardless of harmful effects and impairment in life functioning. It’s important to be aware of the signs and symptoms of a kratom addiction so that you can get the help you or a loved one needs to begin on the road to recovery. Signs and symptoms may include:7

  • Persistent lack of control over use.
  • Continued use despite social or interpersonal problems caused by kratom.
  • Risky kratom use, such as while driving.
  • A strong urge to use kratom.
  • Continued use despite physical or psychological problems caused or exacerbated by kratom.
  • Neglect of previously enjoyed hobbies.
  • Withdrawal symptoms with cessation of use.

Additionally, some signs of chronic kratom use specific to the substance include:4

  • Lack of sex drive.
  • Hyper-pigmentation of the cheeks and face.
  • Severe weight loss.
  • Anorexia.

Given the unpleasant symptoms sometimes seen in those suddenly quitting kratom, someone who struggles with kratom addiction may benefit from detox to help them to comfortably withdraw and manage cravings. They may also benefit from formal treatment programs to help address the psychological and social issues associated with addiction.

Kratom Withdrawal Symptoms Explained

Kratom withdrawal symptoms result when an individual is physically dependent on the substance and abruptly discontinues or significantly reduces use. These symptoms can range from mildly unpleasant to extremely distressing.

Potential withdrawal symptoms associated with kratom abuse include the following:2,4,5

  • Nausea.
  • Diarrhea.
  • Fever and hot flashes.
  • Tearing of the eyes and runny nose.
  • Insomnia.
  • Hostility.
  • Aggression and anger.
  • Irritability.
  • Sadness.
  • Restlessness.
  • Mood swings.
  • Joint pain.
  • Muscle aches.
  • Jerky limb movements.

Because withdrawal is physically and psychologically very uncomfortable, chronic kratom users often feel compelled to return to drug use in order to avoid the withdrawal effects. This frequently causes the person to relapse. Remember that addiction is a chronic condition, and relapse can happen even with the best of intentions. That does not mean a person is a failure. Rather, it is a reminder that recovery is a journey and not a finite event.

How Long Do Withdrawal Symptoms Last?

The timeline for kratom withdrawal varies from person to person and depends on several factors, including

  • Average dose of kratom.
  • Frequency of use.
  • Length of use.
  • The presence of psychoactive additives in the kratom.
  • The presence of a co-occurring mental health condition.
  • Individual physiology.
  • General physical health.
  • Age.

More research needs to be conducted to ascertain a specific timeline for kratom withdrawal. That being said, since kratom has an affinity for opioid receptors and elicits similar effects to opioids, the timeline has potential to be similar to that of opioid withdrawal. The following is a general timeline for withdrawal from opioids:6

  • Withdrawal symptoms may emerge about 6-12 hours after the last dose.
  • Symptoms may peak between 1 and 3 after the last dose.
  • Acute symptoms typically subside within about 5-7 days.

What Does Kratom Detox Entail?

It takes courage for someone to admit that they have a drug problem and need help. The next step after acknowledging that you have a kratom addiction is to seek detox services. During a medical detox, you can expect to be treated with compassion in the most professional manner by highly skilled medical staff. These healthcare professionals will do everything they can to make you feel comfortable, providing safe and humane treatment throughout the withdrawal process.

Detox, or detoxification, is comprised of multiple interventions that aim to manage acute intoxication and withdrawal symptoms. The goal of detox is to remove kratom and other harmful substances from the body, while minimizing the physical damage caused by the drug abuse.8

There are 3 components to the detox process:8

  • Evaluation: This part of the process entails screening for the levels of kratom and other substances in the bloodstream. It also involves an assessment of general health, including an evaluation for the presence of any mental and physical conditions.
  • Stabilization: This stage of detox involves helping a person through the process of withdrawal by providing medical care (including medications) as needed, as well as emotional support to assist in helping to reach a medically stable and drug-free state. It is also a time when a doctor may elaborate on what a person can expect in a treatment program, including the benefits of involving family in the recovery process. This is done in cooperation with the patient and upon release of confidentiality.
  • Fostering entry into treatment: This involves preparing a person to enter a treatment program, stressing the need for ongoing help with recovery.

Detox should be viewed as the first step on the continuum of addiction treatment. Recovery from addiction involves a lot more than just ridding your body of kratom. While detox is an important first step, it cannot help you deal with the long-term goals of your recovery, such as improvements in employment, family, or other interpersonal relationships, and your mental and physical wellbeing. It takes time to heal relationships affected by addiction or to get back to work. Co-occurring psychiatric disorders, such as depression or anxiety, may need treatment as well. Left unattended and untreated, these issues can cause great emotional stress and can lead to relapse. A treatment program will offer you the tools to effectively handle these important issues and also offer coping skills to help prevent relapse.

What Are My Detox Options?

Detox can take place in a number of settings, depending on medical needs, the extent and nature of the addiction, as well as practical considerations such as work and family obligations:8

Having completed this critical part of the recovery process, the individual is now over the acute withdrawal phase associated with quitting the drug. The next phase is where they start to build on the success they achieved in detox.

Kratom Addiction Treatment Programs

Once you’ve completed detox, the next step towards a healthier and happier life is to seek out a comprehensive substance abuse treatment program where you can build relapse prevention skills and address the underlying issues that drove you to abuse kratom in the first place. There are several different types of addiction treatment, each with its own strengths and weaknesses. When choosing a recovery program that is appropriate for you, you will want to consider your own needs, priorities in a program, and treatment philosophy.

Addiction treatment programs vary in treatment philosophy. For example, some programs are faith-based while others utilize a secular approach to recovery. Likewise, many treatment programs prefer using a traditional treatment approach while some incorporate more holistic or alternative methods for recovery. There are even recovery centers that specialize in treating specific populations.

There are many things you should consider when researching a treatment program, such as:

  • Location.
  • The visitor policy.
  • The amenities and services offered.
  • Price range.
  • What insurance they take.
  • Treatment philosophy (holistic vs. traditional).
  • The level of support you need.
  • Experience in treating dual diagnosis.
  • The credentials of the staff members.
  • The types of rooms offered.

The various types of kratom abuse treatment programs available include:

  • Inpatient: This may be recommended if the extent of your addiction and related medical problems warrant 24/7 care. Inpatient programs can last from 30-90 days, although lengths of stays should be flexible and individualized to meet a patient’s needs.
  • Outpatient: This may be a good option for those who are in the early stages of readiness to change, committed to full recovery, and are compliant with a treatment plan.
  • Luxury: These facilities cater to those patients who expect a high level of comfort and customer service. Amenities may include activities such as golf, equine therapy, aromatherapy, acupuncture, and spa treatments.
  • Executive: These treatment centers are specially designed for CEOs and executives who require addiction treatment with a minimal impact on their professional and personal lives.
  • Holistic: These programs address the entire person—mentally, physically, and spiritually—and utilize alternative and complementary recovery methods, such as meditation or yoga.
  • Population-specific programs: These treatment programs are appropriate to specific populations with unique treatment needs, such as women-only, men-only, the elderly, LGBT, veterans, and teens.
  • 12-Step programs: The emphasis in these programs is peer support and encouragement while the person follows the 12 steps of recovery and receives guidance from a sponsor.
  • Non-12 Step programs: Many of these programs adhere to a more secular approach to recovery and utilize evidence-based practices while focusing on empowerment.

Each of these programs functions differently. What works for one individual may not be suitable for another, since everyone has varying treatment needs. You can find the best treatment program for yourself or a loved one by consulting with medical and other support professionals during the detox phase.

Sources

  1. National Institute on Drug Abuse. (2016). What is kratom?
  2. Fluyau, D., and Revadigar, N. (2017). Biochemical Benefits, Diagnosis, and Clinical Risk Evaluation of KratomFront Psychiatry 8:62.
  3. Prozialeck, W.C., Jivan, J.K., & Andurkar, S.V. (2012). Pharmacology of Kratom: An Emerging Botanical Agent With Stimulant, Analgesic and Opioid-Like Effects. The Journal of the American Osteopathic Association 112, 792-799.
  4. Chang-Chien, G.C., Odonkor, C., and Amorapanth, P. (2017). Is Kratom the New ‘Legal High’ on the Block?: The Case of an Emerging Opioid Receptor with Substance Abuse PotentialPain Physician 20(1) E195-E198.
  5. Singh, D., Müller, C.P., and Vicknasingam, B.K. (2014). Kratom (Mytragyna speciosa) Dependence, Withdrawal Symptoms, and Craving in regular users. Drug and Alcohol Dependence, 139: 132-7
  6. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  7. Substance Abuse and Mental Health Services Administration. (2010). Substance Abuse Treatment Advisory: Protracted Withdrawal.
  8. Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series No. 45HHS Publication No. (SMA) 15-4131.  Rockville, MD: Center for Substance Abuse Treatment, 2006.

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