Kratom Withdrawal: Signs, Symptoms, and Treatment Options
Kratom is a substance that has seen an increase in abuse in recent years.1 It’s not controlled under the Controlled Substances Act (though some states may have regulations against the possession and use of it), the Food and Drug Administration (FDA) has not approved any medical use for it, and the Drug Enforcement Administration (DEA) listed it as a drug of concern.1
What Is Kratom and What Does It Do?
Kratom is derived from the plant Mitragyna speciosa and is commonly marketed in tablet or powder form as a dietary supplement or sold in head shops as incense. However, for the last several years, the FDA has ordered the seizure and destruction of kratom and kratom-containing supplements and warmed consumers not to use any products labeled as containing kratom. This is due to concerns over the toxicity of kratom in the human body—which, in rare instances has led to seizures—and the potential for abuse.2,3
As with all drugs, the effects of kratom vary widely and depend on the amount taken, the concentration, how kratom was ingested, and any underlying medical conditions an individual may have.4 Individuals who use kratom in smaller doses report stimulant-like effects that may increase energy levels and alertness and combat fatigue.4 In higher doses, those who take kratom report opioid-like sedative effects and psychotic symptoms.4
At American Addiction Centers, we provide 24-hour medical detox and utilize FDA-approved medications to help our patients manage withdrawal in a safe and supportive environment. If you’re struggling with a substance use disorder (SUD), a medical condition defined by the compulsive use of kratom or other substance despite its negative consequences, please reach out to one of our admissions navigators at
To be diagnosed with a substance use disorder, a medical condition defined by the compulsive use of a substance despite negative consequences, an individual must meet specific diagnostic criteria. The criteria that doctors and other healthcare professionals use, “The Diagnostic and Statistical Manual of Mental Disorders, Fifith Edition (DSM-5)” does not include a specific diagnosis for kratom.4 However, some experts still worry about the addictive potential of the drug because the main kratom compounds—mitragynine and 7-hydroxymitragynine—partially activate the same receptors in the brain as other drugs with known addictive properties.4 Other researchers report observing that the way in which kratom affects these receptors may reduce the potential for addiction.4
Some individuals report using kratom to reduce the withdrawal symptoms and cravings associated with other drugs—specifically, opioids.4 However, there is no scientific evidence to substantiate these claims, so at this stage, these claims are purely anecdotal.
Signs and Symptoms of Kratom Withdrawal
Studies suggest that individuals may experience mild to moderate withdrawal symptoms when they stop regular kratom use.4 Research shows that kratom withdrawal is different for everyone. In one study, individuals who had developed moderate to severe kratom dependence, commonly experienced withdrawal symptoms, including:5
- Jerky movements of the limbs.
- Disturbed sleep.
- Loss of appetite.
- Abdominal pain and cramping.
- Watery eyes.
- Runny nose.
- Hot flashes.
- Depressed mood.
Death from kratom misuse is extremely rare. A 2019 report linked 11 U.S. deaths (between 2011 and 2017) to kratom.4 Only two of those were from kratom alone.4 Additionally, polysubstance misuse (other drugs or alcohol)—that also involves kratom—has been associated with severe adverse effects, including liver problems and death.4
How Long Does Kratom Withdrawal Last?
The duration of withdrawal may be closely related to the level of dependency to kratom, which is likely influenced by several factors. Biology, genetics, and history of addiction play a role in the level of drug dependence, as do the manner, amount, and length of time abusing the drug. Other medical or mental health issues, any polysubstance abuse, and certain environmental factors, such as trauma or chronic stress, may also impact the severity of drug dependence and therefore the timeline for withdrawal.
Research suggests that for those who experience kratom withdrawal, symptoms generally appear within 12 to 48 hours of stopping kratom use.6 The symptoms generally last 1 to 3 days, though in some instances, individuals experienced withdrawal symptoms for more than 3 days and up to a week.5
Kratom Detox and Tapering
Detox is defined as the removal of toxins from the body. With many types of psychoactive and addictive substances, dosages can be lowered slowly over a period of time in order to minimize withdrawal symptoms and cravings. This is called tapering, or weaning off the substance. The goal is to slowly work on rebalancing brain chemistry over time instead of shocking it by suddenly removing the drug.
When a drug like kratom is stopped suddenly after a person has developed a dependence, the brain may suffer a kind of rebound effect, where it tries to restore balance quickly, causing significant withdrawal symptoms. Tapering the dosage down slowly can smooth out the potential side effects of withdrawal, as the drug remains active in the brain for longer, giving the brain’s chemistry a chance to slowly regain its natural balance.
Should I Detox from Kratom at Home?
Some individuals may be tempted to detox from kratom at home by using over-the-counter pain, sleep, and other medications—or even going cold turkey. While these drugs may alleviate some of the symptoms, particularly if the withdrawal is not severe, the most effective way to come off kratom is under medical supervision.
The biggest concern with detoxing at home are relapse and medical or psychiatric complications. When withdrawal becomes painful or uncomfortable, the urge to use again to relieve the symptoms can become unbearable. The risk of relapse is greatly reduced or even eliminated in a rehabilitation program, where healthcare providers can treat the physical and mental health symptoms associated with kratom withdrawal.
Benefits of Medical Detoxification for Kratom
Performed in a specialized facility that can provide around-the-clock supervision and access to medical and mental health professionals, medical detox rids the body of kratom (and any other substances) while keeping the individual safe and as comfortable as possible.
Kratom Withdrawal Medications
There are currently no medical therapies approved in the United States for kratom withdrawal.4 However, in Europe, inpatient detoxification may include a combination of dihydrocodeine (used to treat moderate to severe pain) and lofexidine (a medication used to treat high blood that also seems to be beneficial in reducing symptoms of opioid withdrawal when used off-label during medical detox), antidepressants, anxiolytic (anti-anxiety medications), and/or non-steroidal anti-inflammatory drugs.7
If other substances are also being abused, medications may need to be altered to avoid complications or undesirable drug interactions. Since kratom is not a controlled substance, it is often not included in regular toxicology screenings that may be performed upon entrance into a detox program. It is important, therefore, to indicate to treatment providers if kratom is in your system, as well as any other drugs or substances, so that medications used during medical detox are safe and effective.
There is little evidence to determine how kratom use might affect someone over time.4 However, there are a handful of case studies that suggest that long-term, regular use of large amounts of kratom may be associated with serious liver damage, drug-induced hepatitis, seizures, kidney injury, and cardiovascular events.4,8 Since there are no treatment guidelines specifically for kratom, treatment regimens often mimic the treatment protocol for individuals who have opioid use disorder, the clinical term for opioid addiction, which has reportedly been successful.8
Is Kratom Treatment Covered by Insurance?
Find out instantly if kratom treatment may be covered or at least partially covered by your insurance provider.