Kratom Withdrawal Symptoms and Treatment
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Kratom Withdrawal Symptoms and Treatment
Kratom is extracted from the leaves of Mitragyna speciosa, a tree native to Southeast Asia. The leaves are crushed then smoked, brewed, or placed in capsules.1, 2, 3
Kratom produces stimulant effects in low doses. These include increased energy, alertness, talkativeness, and sociability. In higher doses, it produces sedative and opioid-like effects like relaxation, euphoria, and pain relief.1, 3, 4
Kratom’s effects occur within 5 to 10 minutes of ingestion. The effects last 2 to 5 hours.3
In the U.S., kratom is sold as a dietary supplement. It’s not a controlled substance, but the Drug Enforcement Agency (DEA) listed it as a “drug of concern.” This is due to concerns about kratom withdrawal and addiction.1, 4
In 2021, the U.S. Food and Drug Administration (FDA) ordered the seizure and destruction of kratom-containing products. The FDA also warned consumers not to use them.2
Kratom is on the list of substances under surveillance by the World Health Organization’s (WHO) Expert Committee on Drug Dependence (EDCC).4
In Asia, people have used kratom as an anti-diarrheal, antidiabetic, cough suppressant, intestinal dewormer, and wound dressing. It’s also used to wean users off heroin.5
Thai and Malaysian farmers and laborers chewed kratom leaves to overcome fatigue. Thai natives used kratom as a substitute for opium. It has also been used to manage opioid withdrawal.3
In the West, people have used kratom to treat chronic pain, mood swings, cravings, and withdrawal symptoms from prescription and illicit opioids.4, 5, 6, 7
Side Effects of Kratom
Kratom use may lead to some side effects like:1, 2, 3
- Dry mouth
- Loss of appetite
- Weight loss
- Increased urination
- Rapid heart rate
- Respiratory depression
- Liver damage
Kratom misuse may cause death, although it’s infrequent. There were 11 kratom-related deaths in the U.S. between 2011 and 2017. Only two were from kratom alone.4
Moreover, co-occurring use of kratom and drugs or alcohol has been linked to severe adverse effects like liver problems and death.4
Can You Use Kratom for Opioid Withdrawal?
In Asia, kratom has been used to treat opioid withdrawal.
This ability comes from kratom’s two psychoactive compounds: mitragynine and 7-hydroxymitragynine. Both substances partially bind to the same receptors opioids bind to in the brain.1, 4, 6, 8
This action is similar to buprenorphine, an opioid for treating opioid withdrawal. It partially binds to opioid receptors to curb cravings and lower addictive potential.
Why Does Kratom Cause Withdrawal Symptoms?
Kratom’s partial affinity to opioid receptors has positive and negative aspects. While it provides kratom the ability to treat opioid withdrawal, it can also lead to addiction and withdrawal.
There are reports of people experiencing mild to moderate withdrawal symptoms when they stop using kratom. However, the extent of developing an addiction to kratom needs further research.4
Kratom Withdrawal Symptoms
Kratom withdrawal happens when people who have used kratom for a long time stop suddenly. It includes physical and psychological symptoms.
Physical symptoms of kratom withdrawal include:2, 3, 5, 7, 9, 10
- Lack of appetite
- Excessive sweating
- Muscle and bone pain
- Jerky movements
- Runny nose
- Watery eyes
- Hot flashes
Psychological symptoms of kratom withdrawal include:2, 3, 5, 7, 9, 10, 11
- Anger, hostility, or aggression
- Sleep disturbances
Kratom Withdrawal Timeline
The anticipated duration of kratom withdrawal is based on several studies and observations. But generally, the timeline is:7, 9
- 12 to 48 hours: Withdrawal symptoms start during this period.
- 1 to 3 days: Most kratom users experience physical withdrawal symptoms.
- 4 days to more than a week: Most users experience at least five psychological withdrawal symptoms. Some may still have lingering physical symptoms.
How to Cope or Find Relief From Kratom Withdrawal
There are currently no approved treatments for kratom withdrawal. However, people can find relief by addressing individual withdrawal symptoms:
- Take over-the-counter (OTC) pain medications (like acetaminophen, aspirin, or ibuprofen) for muscle aches and fever
- Take a hot bath or use heating pads and ice to relieve muscle aches
- Drink plenty of fluids to replenish lost fluids from vomiting, diarrhea, and sweating
- Take an OTC antidiarrheal drug to reduce or prevent diarrhea
- Take an OTC antiemetic drug for nausea and vomiting
- Ginger tea and candied ginger may also help soothe stomach discomfort
- Eat small, frequent meals and stick to a bland diet to help with nausea, vomiting, and stomach discomfort
- Get enough sleep to lower anxiety and irritability
- Practice breathing exercises, meditation, yoga, and other relaxation techniques to reduce pain, anxiety, and insomnia
- Talk to a friend or family member for emotional support
- Seek professional help to manage withdrawal symptoms and decrease the risk of relapse
Since kratom can affect everyone differently, it’s important to contact a healthcare provider. They can provide an individualized evaluation and plan.
Long-Term Treatment for Kratom Addiction and Withdrawal
There are no treatment guidelines for kratom addiction and withdrawal. The methods are usually patterned after opioid addiction treatment.4, 12
Here are some treatment approaches that were successful in experiments or limited cases:
- Medications like buprenorphine-naloxone, clomipramine, and dihydrocodeine-lofexidine
- Emergency use of antipsychotics in a hospital setting
- Inpatient detox involving dihydrocodeine and lofexidine, antidepressants, anti-anxiety medications, or non-steroidal anti-inflammatory drugs (NSADs), a method used in Europe
- Contingency management (CM) program with medication-assisted treatment (MAT) using buprenorphine
Here are other options for opioid addiction treatment that may help against kratom:
- Tapering the dosage to smooth out potential withdrawal
- Cognitive behavioral therapy (CBT) to help people recognize triggers and develop coping skills
- Addressing medical conditions, mental health disorders, and environmental factors contributing to kratom dependency
Counseling, support groups, and 12-step programs
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- “Kratom.” Drug Enforcement Administration (DEA). April 2020.
- “FDA Announces Seizure of Adulterated Dietary Supplements Containing Kratom.” U.S. Food and Drug Administration (FDA). May 21, 2021.
- “KRATOM (Mitragyna speciosa korth).” Drug Enforcement Administration (DEA). November 2019.
- “Kratom.” National Institute on Drug Abuse (NIDA).
- “Kratom drug profile.” European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).
- Afzal, Hasnain, Michael Esang, and Sabreen Rahman. “A Case of Kratom-induced Seizures.” Cureus vol. 12,1 : e6588.
- Veltri, Charles, and Oliver Grundmann. “Current perspectives on the impact of Kratom use.” Substance abuse and rehabilitation vol. 10 : 23-31.
- Vento, Alessandro et al. “Case Report: Treatment of Kratom Use Disorder With a Classical Tricyclic Antidepressant.” Frontiers in psychiatry vol. 12 ; 640218.
- Singh, Darshan, Christian Müller, and Balasingam Vicknasingam. “Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users.” Drug and Alcohol Dependence vol. 139 : 132-137.
- McWhirter, Laura, and Siobhan Morris. “A case report of inpatient detoxification after kratom (Mitragyna speciosa) dependence.” Eur Addict Res vol. 16,4 : 229-31.
- Bestha, Durga. “KRATOM AND THE OPIOID CRISIS.” Innovations in clinical neuroscience vol. 15,5-6 : 11.
- Eastlack, Steven, Elyse Cornett, and Alan Kaye. “Kratom-Pharmacology, Clinical Implications, and Outlook: A Comprehensive Review.” Pain and therapy vol. 9,1 : 55-69.
- Weiss, Stephanie, and Heather Douglas. “Treatment of Kratom Withdrawal and Dependence With Buprenorphine/Naloxone: A Case Series and Systematic Literature Review.” J Addict Med vol. 15,2 : 167-172.
- Kalin, Seth, Salaahuddin Dakhlalla, and Saurabh Bhardwaj. “Treatment for kratom abuse in a contingency-management-based MAT setting: A case series.” J Opioid Manag vol. 16,5 : 391-394.