Is Kratom Addictive?

What is Kratom?

Kratom commonly refers to an herbal substance that can produce stimulant effects (increased alertness and energy) or opioid-like effects (pain relief).¹ Kratom and kratom-based products are legal in many areas, though agencies in the United States continue to review and evaluate emerging evidence to inform policy.¹ While the National Institute on Drug Abuse (NIDA) supports research on the potential medicinal uses of kratom, the Food and Drug Administration (FDA) has not yet approved any.¹

Kratom comes from the plant Mitragyna speciosa, a tree found in Southeast Asia.¹ Individuals generally brew the leaves as a tea, ingest it in a tablet or powder form—mixing it into food or drinks—or take it as a liquid extract.¹

Unfortunately, kratom misuse appears to be on the rise in the United States. While large-scale studies assessing the prevalence of kratom use are scarce, recent data indicates that in the 7-year period between 2011 and 2017, more than 1,800 calls relating to kratom ingestion were made to poison centers around the country.² The Drug Enforcement Administration (DEA) lists kratom as a “drug of concern” in the United States.³

Kratom Dependence and Addiction

Research continues to better understand how kratom and kratom’s compounds affect the body in the short and long term.¹ Like most other drugs, kratom’s effects may depend on the amount taken, the potency, the formulation of the product, the way it was ingested, co-occurring health and mental health conditions, an individual’s history with substance use, and more.¹ There is convincing evidence that kratom has significantly less potential for dependence and overdose than other stimulants and traditional opioids.² 

Kratom Withdrawal Symptoms

Studies suggest that some people may experience mild to moderate withdrawal symptoms when they stop taking kratom.¹ One case report noted that individuals who visited hospitals due to kratom withdrawal typically showed symptoms that included:⁴

• Nausea.
• Insomnia.
• Irritability.
• Restlessness.
• Mood swings.
• Diarrhea.
• Runny nose.
• Muscle pain.
• Joint stiffness.

Risk of Kratom Dependence

Research indicates that those who use kratom regularly may risk becoming dependent.⁵ This can occur because the body naturally adapts to regular exposure to kratom.⁶ When someone stops taking it, withdrawal symptoms can emerge as the body adjusts to no longer having the substance.⁶ Physical dependence can lead to cravings to relieve these symptoms.⁶

The risk of dependance development seems to be highest for individuals who frequently consume higher doses (more than 5 grams per day and more than 3 times per day).⁷

Signs of Kratom Addiction

To be diagnosed with a substance use disorder, an individual must meet specific diagnostic criteria for the continued, compulsive substance use despite its negative effects. According to the “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or DSM-5, a reference text published by the American Psychiatric Association, these criteria include:⁶

• Lacking control over the amount of the substance taken or the frequency with which it is used.
• An inability to stop using the drug despite multiple attempts to do so.
• Neglecting responsibilities and relationships.
• Lacking interest in social, recreational, or other activities that used to be important.
• Decreasing productivity at home, school, or work.
• An increase in risk-taking behaviors.
• Continuing to use the drug in full awareness of problems its use may create.
• Needing to take more of the drug to feel its effects, which is also known as tolerance.
• Experiencing withdrawal symptoms when the substance is not used.

There is currently no specific diagnosis related to kratom use.¹

How Addictive is Kratom?

While research continues on kratom and its use, effects, drug interactions, and therapeutic possibilities, some experts worry about kratom’s addictive potential because the main kratom compounds—mitragynine and 7-hydroxymitagynine—partially activate the same receptors in the brain that drugs with known addictive properties activate.¹ On the other hand, research also indicates that the manner in which kratom activates these receptors might actually reduce the potential for addiction when compared to opioids.¹ In fact, early studies have discovered that some people actually use kratom to reduce cravings and withdrawal symptoms associated with opioids and stimulants.¹ Therefore, the National Institute on Drug Abuse and the National Institutes of Health’s HEAL (Helping End Addiction Long-Term) initiative support research that works to develop new medications for the treatment of chronic pain, opioid withdrawal, and opioid use disorder, including kratom-derived products.¹

Kratom Addiction Treatment

There are currently no proven medical therapies approved to treat withdrawal symptoms that might be associated with kratom use.¹ Limited evidence—in the form of very small studies of individuals who used kratom regularly—suggests that buprenorphine and combination buprenorphine-naloxone products might be effective for those who use kratom compulsively.⁵ Another case study found clomipramine helpful for an individual who had developed withdrawal symptoms after stopping the regular use of kratom.⁸ However, robust clinical trials are still needed to evaluate the effectiveness of pharmacological agents and other therapies for the treatment of kratom dependence.

Effective treatment looks different for everyone but might include detoxification if you’re experiencing withdrawal symptoms. During detox, the body rids itself of the substance and toxins, while the healthcare support team manages the symptoms and keeps you safe and as comfortable as possible. While detox is an important step, it’s typically not enough to support long-term recovery. Evidence-based therapies help you understand the emotions, thoughts, and behaviors that led to the addiction in the first place. Therefore, after detox, treatment may involve inpatient or outpatient services, various therapy modalities, and aftercare to help support your long-term recovery from drug addiction.

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