Kratom withdrawal has become an increasing concern in the United States as more people turn to this unregulated herbal supplement for pain relief, mood enhancement, or even to self-manage opioid withdrawal. Known scientifically as Mitragyna speciosa, kratom contains active compounds that act on the brain’s opioid receptors, making its effects strikingly similar to those of opioids when taken in higher doses.
Because of this pharmacological overlap, regular use can quickly lead to physical dependence, cravings, and a challenging withdrawal syndrome when someone tries to stop. Many people underestimate the symptoms of kratom withdrawal, assuming that because it is marketed as “natural,” it must also be safe. Unfortunately, countless case reports and clinical experiences demonstrate otherwise.
This comprehensive guide explores the effects of kratom, why withdrawal occurs, common withdrawal symptoms, the timeline, treatment options, and strategies for recovery. It also examines the pharmacology of kratom, its impact on mental health, and the role of professional treatment centers in supporting recovery.
The National Institute on Drug Abuse (NIDA) explains kratom (Mitragyna speciosa) is a tropical evergreen tree in the coffee family, native to Southeast Asia. Its leaves have been used traditionally for centuries. In countries like Thailand and Malaysia, farmworkers and laborers chewed kratom leaves or brewed them into teas to fight fatigue, relieve chronic pain, and improve productivity.
When introduced into Western markets, kratom was often sold in powdered form, capsules, extracts, or teas. In the U.S., kratom is largely unregulated, creating major safety concerns. Products can vary widely in potency, may contain contaminants, and often provide no clear dosage guidelines.
Kratom’s active alkaloids include:
Because of these compounds, kratom is capable of producing pain relief, euphoria, and sedation similar to opioids. However, its use comes with risks of kratom dependence, substance abuse, and a difficult withdrawal process.
While kratom has been part of Southeast Asian culture for centuries, its use there looks very different than in the United States. In Thailand, Malaysia, and Indonesia, farmers traditionally chewed fresh kratom leaves or brewed them into tea to sustain energy during long hours of labor in the fields. In some villages, kratom was also used in social or spiritual rituals, where its effects were considered both medicinal and cultural.
In the U.S., however, kratom use has taken on a more commercial and unregulated form. The plant is typically dried, ground into powder, and sold in capsules, concentrated extracts, or even energy drinks. Unlike traditional use, which involved relatively small amounts, many Western consumers take high-potency products daily, increasing the risk of dependence and withdrawal.
According to surveys, between 1–3 million Americans report using kratom, often for pain relief or as a self-treatment for opioid withdrawal. The FDA has documented rising reports of adverse reactions, and U.S. poison control centers have recorded thousands of calls related to kratom exposure. This dramatic difference in usage patterns highlights why kratom poses unique risks today.
Understanding the pharmacology of kratom is crucial in appreciating why withdrawal occurs.
Kratom’s alkaloids act on opioid receptors in the brain and spinal cord, particularly the mu receptor, which also mediates the effects of morphine, oxycodone, and heroin. The result is that kratom use can trigger the same mechanisms of tolerance, drug dependence, and withdrawal seen in traditional opioids.
Additional pharmacological insights:
Unlike opioids, kratom is not currently classified as a controlled substance at the federal level in the United States. However, the FDA has issued warnings about its risks, and several states have banned it.
To understand withdrawal, it helps to know how kratom’s alkaloids interact with the body. Research published in PubMed states that Mitragynine, the most abundant alkaloid, is considered a partial agonist at opioid receptors. This means it stimulates the receptors but not to the same full intensity as drugs like heroin or oxycodone. At low doses, this can create a sense of stimulation and alertness. At higher doses, however, the effects shift toward sedation, pain relief, and euphoria.
The second major alkaloid, 7-hydroxymitragynine, is much more potent. Even in small amounts, it binds strongly to mu-opioid receptors, creating opioid-like effects and contributing heavily to dependence and withdrawal.
Kratom is metabolized in the liver, primarily through CYP3A4 enzymes, and its half-life is estimated at 7–24 hours. This relatively long half-life means withdrawal symptoms may take a while to emerge, but once they do, they can linger for days. Kratom also interacts with adrenergic and serotonergic receptors, which helps explain why users report changes in mood, anxiety, and energy levels.
When a person uses kratom consistently, the brain adapts to the presence of its alkaloids. The nervous system adjusts receptor activity to balance the constant stimulation. Over time, this leads to physical dependence.
When kratom use stops suddenly, the body is thrown into imbalance. This is what produces a withdrawal syndrome. Symptoms can affect both body and mind, often resembling opioid withdrawal.
Unlike FDA-approved treatments for opioid use disorder, there are currently no medications specifically approved for kratom withdrawal. This lack of regulation and oversight makes the withdrawal process unpredictable and risky.
The symptoms of kratom withdrawal can range from mild discomfort to severe physical and psychological distress. People who take higher doses or use kratom multiple times a day are at greater risk of experiencing significant withdrawal.
While kratom withdrawal is often considered less severe than opioid addiction withdrawal, it is still significant and can disrupt daily functioning, work, and relationships.
Although kratom withdrawal is sometimes downplayed as “mild,” many users describe it as profoundly uncomfortable. A typical day during withdrawal might begin with restlessness, chills, and an inability to focus. As the hours pass, muscle aches and gastrointestinal upset can make even simple tasks feel overwhelming. Many report restless legs at night, making sleep almost impossible, which worsens irritability and fatigue the next day.
Cravings can be relentless, often triggered by routine situations like driving past a store that sells kratom or scrolling social media where products are advertised. Psychological distress is often underestimated — people describe sudden mood swings, panic attacks, or a crushing sense of hopelessness. For those with pre-existing anxiety or depression, these symptoms can be especially destabilizing.
Not everyone experiences kratom withdrawal the same way. For people who began using kratom to manage chronic pain, withdrawal can be especially challenging. The pain relief they relied on is suddenly gone, and symptoms often include a “rebound effect,” where pain feels more severe than before.
Individuals who transitioned to kratom after opioid use disorder face another layer of complexity. Because their brain has already adapted to opioids, switching to kratom doesn’t erase dependence — it simply replaces one opioid-like substance with another. For these individuals, withdrawal may feel just as disruptive as coming off prescription opioids.
Age and health also matter. Younger users may experience stronger psychological symptoms, such as irritability, mood swings, and cravings, while older adults may face more intense physical symptoms like blood pressure spikes or gastrointestinal distress. Additionally, those with co-occurring conditions such as anxiety, PTSD, or alcohol dependence often report that kratom withdrawal magnifies their existing struggles.
Recognizing how withdrawal manifests across different populations is crucial for tailoring treatment and ensuring that individuals receive the right type of medical and psychological support.
The course of kratom withdrawal depends on the frequency, amount, and duration of use. A typical kratom withdrawal timeline may look like this:
Understanding the withdrawal timeline helps both patients and healthcare providers anticipate what to expect and plan appropriate support.
Because kratom acts on opioid receptors, its withdrawal syndrome is often compared to opioid withdrawal. The similarities include muscle aches, insomnia, anxiety, and cravings. However, many report that kratom withdrawal is shorter in duration and slightly less intense.
That said, the risk is significant because:
It’s essential not to underestimate kratom withdrawal. For some, it can be as disruptive as traditional opioid withdrawal and requires professional support.
Many people attempt to quit kratom without medical supervision, but doing so can be risky.
For these reasons, professional detox and treatment is the safest choice.
There is no single treatment pathway for kratom dependence, but evidence-based treatment programs are highly effective.
The safest first step is often a medical detox, where clinicians can:
Residential or inpatient care provides a structured environment, particularly valuable for individuals with severe kratom addiction or co-occurring mental health conditions.
Outpatient programs are best for those with strong family support and milder withdrawal symptoms. They allow patients to attend therapy sessions while living at home.
Effective addiction treatment incorporates therapy:
While medical detox and structured treatment programs remain the gold standard, there are additional strategies worth highlighting. Tapering is one method some people try on their own — gradually reducing the amount of kratom taken instead of stopping abruptly. This approach can ease the shock to the nervous system, though it requires discipline and professional oversight to prevent relapse.
Complementary approaches can also play a supportive role. Practices such as yoga, mindfulness meditation, and acupuncture have been reported to reduce stress, improve sleep, and ease anxiety during withdrawal. Nutritional support is another critical but overlooked element: staying hydrated, eating balanced meals, and supplementing with vitamins can help stabilize the body as it adjusts.
In some treatment centers, clinicians also encourage structured daily routines that include exercise, journaling, or peer support meetings. These activities may not eliminate withdrawal symptoms, but they provide healthier coping outlets. When paired with therapy and medical monitoring, these holistic strategies help individuals move through withdrawal with greater resilience and reduced risk of relapse.
Consider a typical patient scenario:
A 34-year-old man begins using kratom to manage chronic pain after an injury. Over time, he escalates to higher doses, believing it to be safer than prescription opioids. Soon, he develops kratom dependence, experiencing cravings and withdrawal when he misses a dose.
When he decides to quit, he experiences insomnia, depression, and physical symptoms. He enters a treatment center, beginning with medical detox. His care team monitors his blood pressure, addresses muscle aches, and provides medications for nausea and sleep.
Following detox, he transitions into an inpatient program, where therapy helps him explore underlying mental health struggles and build coping strategies. After 30 days, he steps down to an outpatient program for continued therapy and relapse prevention.
This trajectory illustrates how professional care addresses both the withdrawal syndrome and long-term recovery needs.
Detox is only the beginning. Long-term recovery involves addressing the psychological side effects of kratom use and building new habits.
Recovery doesn’t end after withdrawal symptoms fade. The biggest challenge for many people is staying off kratom in the long term. This requires building a lifestyle that supports both physical health and emotional stability.
Relapse prevention planning is essential: identifying triggers (such as stress, boredom, or pain flare-ups) and developing practical coping tools to deal with them. Establishing new routines, engaging in regular physical activity, and practicing sleep hygiene can help restore balance.
Peer and family support also play a critical role. Attending support groups like SMART Recovery or 12-step meetings can provide accountability and encouragement. Many treatment programs also emphasize addressing co-occurring conditions like depression or PTSD, which, if left untreated, can lead to relapse.
Currently, kratom is not federally scheduled as a controlled substance in the U.S., but several states have banned or restricted it.
They include muscle aches, runny nose, anxiety, depression, sweating, gastrointestinal upset, and strong cravings.
Yes. Gradual tapering may reduce discomfort, but medical supervision is still advised.
Most people experience withdrawal symptoms for 5–7 days, but cravings and mood issues may persist for weeks.
While usually milder, kratom withdrawal can mirror many features of opioid withdrawal, including cravings, pain, and psychological distress.
Despite being marketed as natural, kratom can cause substance abuse, drug dependence, and toxicity.
Yes. Buprenorphine and other supportive medications have been used in case reports to reduce symptoms, though none are FDA-approved for kratom.
Not for everyone. Mild cases may be managed with outpatient care, but inpatient programs provide greater safety and structure for severe dependence.
Yes. Anxiety, depression, and cravings can intensify, particularly in those with preexisting mental health conditions.
No. Unlike treatments for opioid use disorder, there are no FDA-approved medications specifically for kratom withdrawal. However, some medications are used off-label to ease symptoms.
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Myth: Kratom is safe because it’s natural.
Fact: Many natural substances — like tobacco, opium, or poisonous plants — are addictive or harmful. Kratom is no exception.
Myth: Kratom isn’t addictive.
Fact: Research and clinical reports clearly document patterns of dependence, tolerance, and withdrawal in regular kratom users.
Myth: You can quit kratom easily without help.
Fact: While some manage withdrawal alone, many relapse due to cravings or experience complications like dehydration or depression. Professional support significantly increases success rates.
Myth: Kratom is safer than prescription opioids.
Fact: Although often marketed as a safer alternative, kratom carries its own risks, including toxicity, dependence, and unpredictable withdrawal. Safer, FDA-approved treatments exist for pain and opioid recovery.
Kratom (Mitragyna speciosa) is not as harmless as many believe. Its active compounds, mitragynine and 7-hydroxymitragynine, act on opioid receptors and can cause physical dependence, withdrawal, and long-term health consequences.
The symptoms of kratom withdrawal can be physically and emotionally distressing. Fortunately, evidence-based addiction treatment — including medical detox, inpatient care, outpatient therapy, and long-term support — provides a safe path forward.
If you or a loved one is struggling with kratom use, reach out to a trusted treatment center today. Professional support is the key to recovery and a healthier future.
If you or a loved one is struggling with kratom withdrawal, you don’t have to go through it alone. AM Health Care offers medical detox, residential treatment, outpatient programs, and ongoing recovery support to help you every step of the way.
👉 Call us at 866-352-6898 today or Verify Your Insurance online to start your recovery journey.
