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
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
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
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
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
Additionally, some signs of chronic kratom use specific to the substance include:4
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 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
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.
The timeline for kratom withdrawal varies from person to person and depends on several factors, including
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
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
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.
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.
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:
The various types of kratom abuse treatment programs available include:
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.