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A guide to kratom withdrawal symptoms and how to find a detox treatment program

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Kratom has become a widely used substance across the globe. The leaves of the namesake kratom tree have long been used in areas where the plant grows, while herbal products and other substances containing kratom have been sold in the United States for some time. The market availability of kratom is ample because the substance is not a federally banned drug. This has led many to turn to it in low doses for stimulant effects and psychoactive properties; and in high doses for effects similar to opioids.

However, despite the fact kratom is not on the federal drug schedule, many foreign countries and American states have taken legal action to limit or ban its use. This is because the drug can have negative neurological and cardiovascular side effects, in the worst cases turning fatal. Kratom can also be abused, which can leave users physically and mentally dependent on the drug. While this danger is not as well known, U.S. enforcement agencies have doubled down on targeting kratom at a federal level.

Increasing awareness about what kratom is, how it can be harmful and what treatment programs exist is important. Continue reading for more vital information on the drug, its risks, kratom withdrawal symptoms, and how to find help for you or a loved one.

What is kratom?

Mitragyna speciosa, the scientific name for the kratom tree, is indigenous to Southeastern Asia and common to places like Thailand, Malaysia, Indonesia, and Papua New Guinea. According to the National Institutes of Health (NIH), there are two compounds contained within the plant’s leaves which are sometimes used in marketing for botanical substances and products containing kratom extract.1 These chemical compounds are mitragynine and 7-α-hydroxymitragynine, which interact with opioid receptors in the brain and produce sedation, pleasure, and decreased pain. Mitragynine has also been observed to interact with other neuroreceptor systems in the brain that lead to stimulant effects.

Compounds in Kratom

Because kratom produces effects similar to opioids, local populations in Southeastern Asia have traditionally used the plant as a homeopathic pain reliever. For example, laborers have been known to chew kratom leaves to treat aches and pains. Used in higher doses, however, it can produce sedative and euphoric effects that resemble morphine or prescription painkillers like oxycodone and hydrocodone. It is not classified as such. However, the links were reinforced with research from the U.S. Food and Drug Administration (FDA). Using advanced computer modeling that analyzes chemical structures, the FDA found that of the 25 most prevalent compounds in kratom, all shared similarities with controlled opioids. Further, 22 of the 25 are bound to mu-opioid receptors, and 2 of the top 5 most-prevalent (including mitragynine) activate opioid receptors.2

Yet kratom users can also experience opposite effects from those opioids when ingesting the drug. At low doses, kratom can produce stimulant effects that increase alertness, concentration, and energy; some even take it to improve sociability or for recreational purposes.

How is kratom used

Traditional use entails chewing kratom, but the dried leaf can also be brewed with tea or coffee. The leaf may also be smoked, similar to marijuana. Powdered leaf can also be used as an additive. More commonly found in Western countries are the pill and capsule forms that contain the extract, and which are easily ordered over the internet or purchased in stores. Typically, the effects of the drug are felt within minutes, depending on the method of use.

A major problem with kratom products that are legally available is lack of regulation. Discrepancies between doses listed and what’s actually in the product can lead to overuse, which aggravates negative side effects. Using kratom products that are secretly laced with other substances can lead to death. There was even an outbreak of salmonella in kratom products that caused an FDA investigation in 2018.3

What are kratom side effects?

While some users may hail kratom for therapeutic qualities, names like “herbal speedball” indicate that kratom is no different from any other type of drug. While users may expect to gain energy at low doses or euphoric bliss and pain relief at high doses, the likelihood is that whatever experience follows can often be negative or physically damaging, even lethal.2 Some of the common outcomes of ingesting kratom, as outlined by NIH, include:

  • Nausea.
  • Itching.
  • Elevated heart rate.
  • Sweating.
  • Aggressive behavior.
  • Dry mouth.
  • Constipation.
  • Increased urination.
  • Loss of appetite.

Using kratom can also have more severe negative outcomes, such as liver damage, development of an eating disorder, chronic respiratory difficulty, psychological delusions, seizures, hallucinations, extreme weight loss, and insomnia. At worst, kratom use can affect or damage cardiovascular and neurological functions, resulting in conditions like an irregular heart beat or psychosis. Abuse of the drug can turn fatal, though in most cases death is a result of using tainted kratom or interference with other medications or substances being taken, like alcohol and opioids. The FDA has recognized 44 cases of death involving the drug.

Exposure to kratom risks is increasing across the nation, and exponentially so. Research released in early 2019 found calls to state poison control centers involving kratom grew 50-fold from 2011 to 2017, from 13 incidents annually to 682. Of the 1,807 calls analyzed during that period, nearly two-thirds occurred between 2016 and 2017.4

Why is it used to self-treat opioid withdrawal?Effects of Kratom

Some individuals who have struggled with or currently suffer from opioid addiction turn to kratom as an aid. This is because of the effects it produces, as well as the general perception that kratom is a beneficial and healthy substance. As such, many turn to kratom when trying to self-treat an opioid dependency, either for prescription drugs, illicit substances like heroin, or synthetics such as fentanyl.

But the misconception that kratom is a safe alternative can push users further into opioid and substance abuse. The reality is this may only exacerbate cravings for opioids or kratom, or lead to taking increasingly higher doses or mixing drugs to get the same intensity of effect.

Is kratom addictive?

Proponents of kratom contend that the botanical substance is largely benign. Yet the data would say otherwise, as would the actions of legal authorities around the world. Chronic abuse can lead to addiction, a disease manifested by physical and mental dependence on a drug. The risk of addiction is real despite the objections of supporters. The U.S. Drug Enforcement Agency (DEA) in 2016 attempted to classify kratom as a schedule I controlled substance but was rebuffed by support.3

In Malaysia, where kratom has traditional cultural use, the drug is considered a controlled substance and addiction to it is common. One study monitoring daily kratom use among Malaysians found more than half of regular users developed severe kratom dependence problems.5

The same FDA research that modeled and examined kratom chemical compound structures showed it can be as potent as comparable opioids. In addition to binding to the same receptors as opioids, kratom’s bind was of a similar strength, indicating its addictive qualities. What it means is kratom can affect brain chemistry the same way as opioids can, which may lead to addiction.

Potential warning signs of an addiction to kratom include:

  • Using kratom as a crutch to get through the day or other events.
  • Lack of self-control over use or neglecting obligations in order to use.
  • Continued use despite physical or psychological side effects.
  • Risky or dangerous use of kratom, like while driving.
  • Social withdrawal and inability to find joy in hobbies.
  • Increasing need for higher dosages to achieve desired effects.

What is kratom withdrawal?

Attempting to quit any substance after a prolonged period of regular use is often an uncomfortable and difficult time. The same is true for kratom; withdrawal syndrome associated with the drug is commonly experienced by users who try to kick the substance cold turkey.

However, sustained physical and psychological dependence is not easy to quash, and users will likely feel a number of kratom withdrawal symptoms. These may include, but aren’t limited to:

  • Mood swings and irritability.
  • Aching limbs and joints.
  • Runny nose and itchy eyes.
  • Nausea and diarrhea.
  • Aggression and hostility.
  • Muscle spasms or jerky movements.
  • Restlessness and sadness.
  • Fever or hot flashes.
  • Difficulty with sleep.
  • Decreased appetite.

Kratom Withdrawal Symptoms

How long does it take to recover from kratom withdrawal?

Going through the stages of kratom withdrawal can take some time. Importantly, severity and duration of symptoms are related to the use behavior, biology, and mental health of the specific individual. There is much research being done into kratom effects and addiction, as there is still a relatively low understanding of the substance. However, the timeline of kratom withdrawal tracks along with opioid withdrawal. In general, symptoms:

  • May appear in 6 to 12 hours after quitting cold turkey.
  • Peak in severity at 72 hours after last dose.
  • Subside after around 5 or 7 days (acute symptoms only).

These stages are not fixed in time, as other factors may affect the situation. These variables include:

  • History of substance abuse.
  • Frequency of use.
  • Personal medical history, like preexisting conditions.
  • Age and individual physiology.
  • Presence of another substance—i.e., if kratom is used when mixed with another drug.

What is kratom detox?

Those suffering from kratom addiction or withdrawal symptoms can find relief and help in addressing their use. The entry stage to seeking such recovery is usually detoxification; and there are professional medical detox options for cases specifically related to kratom. Overall, these programs are available to help care for acute symptoms of withdrawal, as well as sketch out a course for rehabilitation, if the individual continues with sobriety.

The process basically entails a gradual weaning off kratom — which can be a difficult proposition with any drug, as chemical dependence alters how the brain may function. The primary benefits of detox, beyond the physical and psychological cleansing, is personalized care and treatment.

Each patient will undergo an evaluation that is then used to inform their detox progression, as well as potential next steps to stay clean from kratom.

What treatment options are available?

Individuals seeking to detox or looking for further assistance in beating substance abuse can find a program that works for their personal and recovery needs. Primarily, there are three types of detox settings:

  • Inpatient: This includes entering a treatment facility full time so care staff and help are accessible around the clock.
  • Outpatient: Which extends detox services to you in residence, allowing you to live your life, whether that’s going to work or taking care of family.
  • Hospitalization: Usually reserved for the most severe cases, or emergencies such as overdoses, hospitalization means being admitted.

It’s important to note detox programs also differ in other respects, from location and pricing to visiting hours policy and level of care offered. If you or a loved one needs help understanding their treatment options, contact American Addiction Centers today.

References

  1. National Institute on Drug Abuse. (2018). Kratom.
  2. U.S. Food & Drug Administration. (2018). Statement from FDA Commissioner Scott Gottlieb, M.D., on the agency’s scientific evidence on the presence of opioid compounds in kratom, underscoring its potential for abuse.
  3. National Center for Complementary and Integrative Health. (2018). In the News: Kratom (Mitragyna speciosa).
  4. Post S., Spiller H., Chounthirath T., & Smith G. (2019). Kratom exposures reported to United States poison control centers: 2011–2017, Clinical Toxicology, DOI: 10.1080/15563650.2019.1569236
  5. Singh D., Müller C., Vicknasingam B. (2014). Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users, Drug and Alcohol Dependency, DOI: 10.1016/j.drugalcdep.2014.03.017

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