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Addiction: Kratom

Kratom is an herbal substance made from the leaves of Mitragyna speciosa, a tree native to Southeast Asia. In the United States, kratom products are commonly sold as powders, capsules, teas, and liquid extracts. Many people report using kratom for pain, fatigue, anxiety, depression, or to manage opioid withdrawal symptoms, but kratom has not been approved by the U.S. Food and Drug Administration as safe and effective for any medical use.

Kratom can produce stimulant-like effects, such as increased energy and alertness, as well as opioid-like effects, such as relaxation, pain relief, sedation, and euphoria. These effects help explain why some people find kratom appealing, but they also contribute to the risk of dependence, withdrawal, and substance use disorder.

Dependence can develop when a person feels unable to function normally without kratom or experiences withdrawal symptoms when they reduce or stop use. Addiction involves a broader pattern that may include cravings, loss of control, continued use despite harm, and difficulty meeting responsibilities at work, school, or home.

Kratom contains bioactive alkaloids, including mitragynine and 7-hydroxymitragynine. These compounds can interact with opioid receptors in the brain, which are involved in pain relief, reward, and mood regulation. With repeated use, the body may adapt to kratom’s effects. A person may then need larger amounts or more frequent doses to feel the same effect, a pattern known as tolerance.

Common Warning Signs

Using kratom more often or in larger amounts than intended
Needing kratom to start the day, sleep, work, or manage emotions
Spending significant time buying, using, or recovering from kratom
Trying unsuccessfully to cut back or stop
Experiencing cravings or anxiety when kratom is unavailable
Continuing to use kratom despite health, relationship, financial, or legal problems
Combining kratom with alcohol, opioids, benzodiazepines, antidepressants, or other substances

Withdrawal Symptoms

People who use kratom regularly may experience withdrawal when they stop or reduce their intake. Reported symptoms include muscle aches, joint pain, runny nose, watery eyes, yawning, sweating, chills, diarrhea, nausea, loss of appetite, insomnia, restlessness, irritability, anxiety, depressed mood, and strong cravings. Withdrawal can vary from mild to severe depending on dose, frequency of use, product strength, duration of use, and whether other substances are involved.

Health Risks and Safety Concerns

Although many kratom users believe “natural” means safe, kratom products can still carry serious risks. Reported adverse effects include nausea, constipation, rapid heart rate, confusion, drowsiness, liver problems, seizures, hallucinations, breathing problems, and, rarely, death. The risk may be higher with concentrated extracts, high-potency products, contaminated products, or polysubstance use.

Another concern is the variability of kratom products. Because kratom is often sold outside the prescription-drug system, consumers may not know the exact dose, potency, purity, or presence of additional substances. Liquid extracts and products enriched with 7-hydroxymitragynine may be especially concerning because they can be more potent than traditional leaf preparations.

For women, kratom addiction may be shaped by overlapping health, social, and reproductive factors. Some women use kratom to cope with chronic pain, anxiety, depression, fatigue, or opioid withdrawal, which can make dependence harder to recognize until daily functioning is affected.

During pregnancy or breastfeeding, kratom use raises additional concerns because limited case reports and reviews have described maternal dependence, withdrawal, and newborn withdrawal after prenatal exposure.

WHEN TO SEEK HELP

Anyone who feels unable to reduce kratom use, experiences withdrawal, uses kratom with other substances, or has worsening mental or physical health symptoms should consider speaking with a healthcare professional. Medical guidance is especially important for people with a history of opioid use disorder, pregnancy, liver disease, heart problems, seizures, or use of medications that affect the nervous system.

Treatment and Recovery Options

There is no single standard treatment protocol for kratom use disorder, but clinicians may use approaches similar to those used for other substance use disorders. Treatment may include a medically supervised taper, management of withdrawal symptoms, counseling, behavioral therapy, peer support, and treatment for co-occurring conditions such as anxiety, depression, chronic pain, or opioid use disorder. In some cases, medications used for opioid use disorder may be considered by qualified clinicians.

Recovery is often more successful when it addresses the reasons a person began using kratom in the first place. For example, someone using kratom for pain may need safer pain-management strategies, while someone using it for mood or stress may benefit from therapy, medication evaluation, sleep support, exercise, and social connection.

Reducing Harm

For people not ready to stop, harm reduction can still lower risk. Avoid mixing kratom with alcohol, opioids, benzodiazepines, or other sedating substances. Be cautious with extracts and high-potency products. Track frequency and amount used, avoid escalating doses, and seek medical support rather than abruptly stopping if withdrawal symptoms are significant. Friends and family can help by responding with concern rather than judgment and encouraging professional care.

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