Kratom Addiction: Symptoms, Causes, Effects, and Treatment

Kratom addiction is a condition where individuals develop a dependency on Mitragyna speciosa, a plant commonly used for pain relief, mood enhancement, and energy boosts. This dependency leads to compulsive use despite negative consequences. According to Schimmel et al. (2020), in their study ‘Prevalence and description of kratom (Mitragyna speciosa) use in the United States: a cross-sectional study,’ the prevalence of kratom use among U.S. adults in 2018–2019 was estimated at 0.8%, representing approximately 2 million individuals. The lifetime prevalence of kratom use was found to be 1.3% or about 3,353,624 adults. These statistics highlight the widespread use of kratom in the U.S., which contributes to the growing concern over kratom addiction and its associated risks.

Symptoms of kratom addiction include physical signs like nausea, constipation, and fatigue, as well as psychological symptoms such as anxiety, mood swings, and cravings. Over time, individuals experience withdrawal symptoms like muscle aches, irritability, and insomnia when they try to reduce or stop usage.

The causes of kratom addiction stem from its opioid-like effects. Regular use alters brain chemistry, leading to tolerance and dependence. Psychological factors, such as using kratom to manage stress, pain, or emotional issues, contribute significantly to addiction. Garcia-Romeu et al. (2020), in their study “Self-reported prevalence and severity of opioid-like withdrawal symptoms among kratom (Mitragyna speciosa) users,” found that 9.5% of regular users met the DSM-5 criteria for moderate or severe kratom use disorder, highlighting the addiction potential associated with regular use.

The effects of kratom addiction range from physical health problems, including liver damage and seizures, to psychological issues like depression and confusion. Long-term use also leads to social and occupational decline, as individuals prioritize drug use over responsibilities. Studies such as Schimmel et al. (2020) report that kratom use prevalence in the U.S. was around 0.8% of adults, indicating a significant population at risk of the physical and psychological effects of long-term use.

Treatment for kratom addiction involves a combination of behavioral therapy and medical intervention. Detoxification is the first step, often managed under medical supervision to handle withdrawal symptoms. Stanciu et al. (2019), in their study “Kratom: A Controversial Substance or an Amazing Therapeutic Agent?” suggest that medication-assisted treatments like buprenorphine-naloxone, combined with cognitive-behavioral therapy (CBT), are effective in treating kratom addiction by addressing both the physical cravings and the psychological aspects of dependence.

What Is Kratom Addiction?

Kratom addiction is characterized by the compulsive use of Mitragyna speciosa, a tropical tree whose herbal substance is known for its stimulant effects at low doses and mind-altering properties at higher doses. This addiction develops as users seek the pain-relieving, mood-enhancing, and sedative effects of the substance, often escalating their intake despite negative consequences. Like opioids, kratom causes dependency, leading to physical and psychological cravings that disrupt everyday life.

Kratom comes from Mitragyna speciosa, a tropical tree native to Southeast Asia, particularly in countries like Thailand, Malaysia, and Indonesia. This herbal substance has been used traditionally in these regions for centuries due to its medicinal and energizing properties.

People use kratom’s leaves primarily for their stimulant effects at low doses and mind-altering effects at higher doses. These leaves are consumed to alleviate pain, enhance mood, and boost energy, with users chewing the leaves, brewing them into tea, or taking them in capsule form.

Kratom has become increasingly common, especially in the United States, where its use has surged as an alternative to opioids. While it is still considered a niche herbal substance, its availability in smoke shops, online, and in some states without regulation has contributed to its rising popularity. According to Diep et al. (2023), in their study “Kratom Availability in Vape Shops in California,” kratom was available in 62.4% of observed vape shops in California. The study also found that 81.1% of vape-and-smoke shops carried kratom products, compared to only 11.5% in vape-only shops. Despite a ban on kratom sales in San Diego City, 46.2% of stores were still found selling kratom. These figures highlight the widespread availability of kratom, even in areas with legal restrictions.

The FDA’s stance on kratom is firm, warning that it is not approved for any medical use. The FDA has raised concerns about the potential for addiction, abuse, and serious side effects, including withdrawal symptoms and death, urging consumers to avoid kratom use.

Kratom’s effects are similar to opioids because it binds to the brain’s opioid receptors, producing pain relief and a sense of euphoria. This interaction makes it addictive, as kratom use leads to mind-altering effects at high doses, mimicking the sedative properties of opioids and triggering withdrawal symptoms like irritability, muscle aches, and cravings.

According to Garcia-Romeu et al. (2020), a study involving 2,798 kratom users revealed that 56 individuals (2%) met the criteria for moderate to severe kratom-related substance use disorder (SUD). Despite its risks, the study showed that most users expressed low concern about their kratom use, with an average rating of 3.2 out of 100. The study also highlighted kratom’s withdrawal symptoms, which closely mimic those of opioids, underscoring the potential for addiction.

Is Kratom Addictive?

Yes, kratom is addictive. The plant’s active compounds, particularly mitragynine and 7-hydroxy mitragynine, engage with the brain’s opioid receptors, much like traditional opioids. These compounds create feelings of euphoria, pain relief, and relaxation, which lead to regular use and, eventually, addiction.

The primary alkaloid, mitragynine, produces stimulant effects at low doses, increasing alertness and energy, while 7-hydroxy mitragynine is more potent and responsible for the stronger, sedative, and mind-altering effects at higher doses, similar to the calming sensations of opioid medications. With repeated use, the body develops a tolerance, requiring more of the substance to achieve the same effects, which often leads to dependency.

A study by Garcia-Romeu et al. (2022), titled “Assessment of Kratom Use Disorder and Withdrawal among an Online Convenience Sample of US Adults,” published in the Journal of Addiction Medicine, found that 29.5% of respondents met the criteria for Kratom Use Disorder (KUD). This disorder involves symptoms like increased consumption, failed attempts to quit, and cravings, with 8.5% experiencing severe addiction. In this study, users reported typical signs of withdrawal, such as irritability, anxiety, and muscle pain, when they tried to stop, much like traditional opioid addiction. 

What Are the Symptoms of Kratom Addiction?

The symptoms of kratom addiction are cravings, weight loss, depression, mood swings, and neglecting responsibilities. These symptoms affect individuals in various ways, including physical changes like fatigue and muscle pain, psychological struggles such as anxiety and depression, and behavioral issues like social withdrawal and risky behaviors. Over time, these effects lead to a significant decline in health, emotional well-being, and social relationships.

The physical symptoms of kratom addiction include:

• Weight loss: Many users experience significant weight loss due to reduced appetite and poor nutrition. This leads to physical weakness and other health complications.
• Fatigue: Chronic tiredness is common, leaving individuals feeling drained and unable to complete daily tasks. This often exacerbates their dependency on kratom.
• Muscle aches: Regular kratom users often suffer from muscle pain, particularly during withdrawal periods. This discomfort affects mobility and overall physical health.
• Nausea: Frequent nausea and digestive issues are typical, especially when the body becomes dependent on kratom. This leads to dehydration and malnutrition.
• Insomnia: Difficulty sleeping or maintaining a regular sleep pattern is another common symptom. Insomnia worsens during withdrawal, further affecting recovery.

The psychological symptoms of kratom addiction include:

• Cravings: Intense, uncontrollable cravings for kratom make it difficult for users to cut back or quit. These cravings often lead to increased consumption.
• Depression: Many experience feelings of sadness and hopelessness. This is particularly intense during withdrawal or when kratom is unavailable.
• Anxiety: Heightened anxiety becomes a persistent issue, often manifesting as excessive worry or panic attacks. This worsens as users attempt to reduce their intake.
• Poor concentration: Kratom users often struggle with concentration, making it difficult to focus on work, studies, or personal tasks. This leads to decreased productivity and frustration.
• Mood swings: Addicted individuals frequently experience unpredictable mood swings. These range from euphoria to irritability or deep sadness, often without a clear cause.

The behavioral symptoms of kratom addiction include:

• Social withdrawal: Users begin to isolate themselves from family and friends, avoiding social interactions. This withdrawal is often motivated by shame or the desire to hide their addiction.
• Neglecting responsibilities: People tend to neglect work, school, and family duties as their focus shifts toward obtaining and using kratom. This leads to problems in personal and professional life.
• Increased isolation: As addiction worsens, users further withdraw from their social circles. This isolation reinforces their reliance on kratom as a coping mechanism.
• Risky behaviors to obtain kratom: Some individuals engage in risky or illegal activities to acquire the substance. These behaviors have legal or financial consequences.
• Unsuccessful attempts to quit: Despite repeated efforts, many users are unable to stop using kratom. These failed attempts increase frustration and deepen their dependence.

According to Singh et al. (2014) in their study “Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users,” regular users showed clear signs of addiction, including cravings, withdrawal symptoms, and an inability to quit. The study shows the wide-ranging effects of kratom addiction on physical health and mental well-being.

What Are the Causes ?

The causes of kratom addiction, such as genetic vulnerability to substance abuse, brain changes from repeated use of the drug, emotional reliance on it to manage stress, and co-occurring mental health conditions like anxiety or depression, are critical factors in its dependency. The common causes of kratom addiction include:

• Biological factors: Individuals with a family history of addiction are more susceptible to developing substance dependence. For example, someone genetically predisposed to substance abuse may develop tolerance to kratom faster. According to Dick (2022), in the study “Rutgers Researchers Delve Deep Into the Genetics of Addiction,” more than half of addiction likelihood is influenced by DNA variations, with addiction to certain substances being up to 70 percent heritable, highlighting the strong role genetics plays in addiction risk.
• Neurological factors: Repeated use of kratom alters the brain’s opioid receptors, leading to dependency. The brain starts to rely on the drug to maintain normal functioning, causing physical cravings and withdrawal symptoms when kratom is unavailable.
• Psychological factors: Many people use kratom to cope with anxiety, stress, or depression. For instance, someone using kratom to alleviate daily stress develops an emotional reliance, making it increasingly difficult to quit as their psychological cravings intensify.
• Social and environmental factors: Easy access to kratom and environments where drug use is normalized contribute to addiction. In communities where kratom is widely available, individuals are more likely to try it recreationally, eventually developing a regular habit.
• Co-occurring mental health disorders: Individuals with mental health conditions such as PTSD or severe depression use kratom as a form of self-medication. For example, someone struggling with anxiety might rely on kratom to calm their symptoms, which leads to a deepening dependency over time.

What Are the Effects of Kratom Addiction?

The effects of kratom addiction are cravings for higher doses, withdrawal symptoms like anxiety and irritability, and long-term physical and psychological damage, such as muscle pain, weight loss, and depression. In the short term, kratom provides euphoria, increased energy, and pain relief by interacting with opioid receptors. However, as tolerance builds, users need larger amounts to achieve the same effects, making the addiction more severe. In some cases, users may turn to other, stronger substances when kratom’s effects are no longer sufficient. Long-term effects include heightened anxiety, severe withdrawal symptoms, and physical deterioration, such as liver damage and chronic fatigue, with symptoms persisting for extended durations after cessation.

According to Hemby and McMahon (2021), in their study “The Pharmacology of Kratom and Its Potential for Abuse,” kratom’s interaction with opioid receptors creates both short-term therapeutic benefits and long-term risks of dependence. The study outlines how repeated use leads to behavioral changes, addiction, and significant physiological harm over time.

Physical Health Effects of Kratom Addiction

The physical health effects of kratom addiction are severe, ranging from digestive issues like nausea and constipation to more serious conditions such as weight loss and cardiovascular problems. Regular users often experience a deterioration in their overall physical health, with prolonged use leading to long-term damage to multiple body systems.

The physical health effects of kratom addiction include:

• Gastrointestinal problems: Chronic kratom use frequently leads to digestive issues such as nausea, constipation, and vomiting. These problems cause dehydration and malnutrition if left untreated, further weakening the body.
• Weight loss: Kratom suppresses appetite in many users, leading to significant and unhealthy weight loss over time. This weight loss leads to a weakened immune system and an overall decline in physical health.
• Cardiovascular problems: Kratom increases heart rate and elevates blood pressure, putting strain on the cardiovascular system. Over time, these changes lead to more serious heart conditions, including an increased risk of heart attack or stroke.
• Respiratory issues: In higher doses, kratom causes respiratory depression, slowing breathing and potentially leading to life-threatening complications. This risk is especially high when kratom is combined with other substances that also depress the respiratory system.

Psychological Effects of Kratom Addiction

The psychological effects of kratom addiction range from mild anxiety, where users feel nervous or uneasy, to severe cognitive impairment, such as difficulty remembering tasks, and even psychosis, where individuals experience hallucinations or delusions. According to Eltri and Grundmann (2019), in their study “Current perspectives on the impact of Kratom use,” these effects become more severe over time, especially with prolonged use or higher doses, significantly impacting mental health.

The psychological effects of kratom addiction include:

• Anxiety and Depression: Users start with mild restlessness, but as addiction worsens, it often leads to chronic anxiety and depression. For example, a user feels anxious without reason or experiences prolonged sadness when unable to access kratom.
• Mood Swings: People frequently experience sudden mood changes, from brief euphoria to intense irritability or sadness. A person might feel elated after using kratom but quickly become upset when the effects fade.
• Cognitive Impairment: Long-term kratom use impairs concentration and memory. Initially, users might feel more focused, but over time, they struggle with everyday tasks, like remembering appointments or maintaining attention at work.
• Psychosis: In severe cases, kratom addiction results in psychosis, with symptoms like hallucinations or delusions. For example, users see or hear things that aren’t there or believe in false ideas, especially when consuming high doses.

Social Effects of Kratom Addiction

The social effects of kratom addiction severely damage personal relationships, such as causing conflicts with family or friends, harming financial stability through mounting debt from kratom purchases, and jeopardizing legal standing with potential arrests or fines. As individuals become increasingly dependent on kratom, their ability to maintain responsibilities and engage socially deteriorates. According to Singh et al. (2014) in their study “Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users,” kratom addiction leads to significant social consequences, including isolation and neglect of duties, further complicating the lives of those affected.

The social and relationship effects of kratom addiction include:

• Neglect of Responsibilities: Individuals addicted to kratom often start neglecting work, family, and social obligations. This leads to strained relationships and a decline in personal and professional performance.
• Social Isolation: As addiction worsens, users tend to withdraw from social circles, avoiding friends and family. This isolation deepens their dependence on kratom, as they prioritize drug use over maintaining relationships.
• Financial Problems: The cost of maintaining a kratom habit leads to significant financial strain. People prioritize buying kratom over essential expenses, leading to debt or inability to cover basic needs.
• Legal Issues: In regions where kratom is restricted or illegal, users face legal consequences for possession or distribution. This results in fines, arrests, or even imprisonment, further complicating their social and financial situation.

What Are the Treatments for Kratom Addiction?

The main treatments for kratom addiction are medication-assisted therapy, such as using buprenorphine to manage withdrawal symptoms, behavioral therapy like Cognitive Behavioral Therapy (CBT) to address psychological dependence, and supportive care, including counseling and peer support groups for ongoing recovery. According to Diep et al. (2018) in their study “Kratom, an Emerging Drug of Abuse: A Case Report of Overdose and Management of Withdrawal,” medications like buprenorphine are commonly used to help reduce cravings and stabilize the patient during withdrawal. Behavioral therapies help individuals modify their relationship with kratom, addressing the underlying emotional triggers. Supportive care, through counseling and community groups, offers long-term support to prevent relapse and promote sustained recovery.

Medical Detoxification

Medical detoxification is a structured process that helps individuals safely withdraw from kratom under medical supervision. This treatment includes detoxification, where the body is cleansed of kratom and the use of medications like buprenorphine and naltrexone to manage withdrawal symptoms and reduce cravings. According to Stanciu et al. (2019) in their study “Kratom: A Controversial Substance or an Amazing Therapeutic Agent?”, although there are no FDA-approved medications specifically for kratom addiction, approaches similar to those used for opioid use disorder, such as buprenorphine-naloxone, have shown promise in managing withdrawal symptoms and cravings. 

Medical detoxification is particularly effective for kratom addiction because it addresses the physical dependence on the drug. Additionally, during detox, group therapy is often incorporated to provide emotional support and begin addressing the psychological aspects of addiction. This combination of medical and psychosocial interventions forms a comprehensive approach to recovery.

Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) involves the use of medications, such as buprenorphine and naltrexone, to help individuals recover from kratom addiction by reducing cravings and managing withdrawal symptoms. MAT is particularly effective because it addresses the physical dependence on kratom, allowing individuals to focus on recovery without being overwhelmed by cravings. This treatment is most effective when combined with psychosocial interventions, ensuring a comprehensive approach to recovery.

Support Groups

Support groups offer individuals recovering from kratom addiction a space to connect with others experiencing similar challenges. These groups provide emotional support and reduce feelings of isolation. Sharing experiences and coping strategies within a group setting helps participants build a sense of community and accountability. Support groups complement other treatments like Medication-Assisted Treatment (MAT) and behavioral therapies, offering a well-rounded support system important for sustained recovery. According to Maglione et al. (2018), MAT reduces the risk of death from substance abuse by more than 50%,  highlighting its life-saving potential when combined with support groups and behavioral interventions in treating substance use disorders like kratom addiction.

Behavioral Therapies

Behavioral therapies, such as Cognitive Behavioral Therapy (CBT), play a critical role in treating kratom addiction by addressing the psychological aspects of dependency. These therapies help individuals understand and modify the negative thought patterns and behaviors that contribute to their addiction. By focusing on coping strategies and relapse prevention, Behavioral Therapies support long-term recovery, helping patients manage the emotional challenges of addiction alongside the physical ones.

Is Kratom Legal?

No, kratom is not fully legal across the United States. Kratom’s legal status varies by state and local regulations, with some states like Alabama, Arkansas, and Wisconsin banning its use, while others allow it with restrictions. The FDA has raised concerns over kratom’s safety, warning against its use due to its potential for addiction and harmful side effects. Despite these concerns, kratom remains available in many states, sold in smoke shops or online without federal oversight. However, the U.S. Drug Enforcement Administration (DEA) has considered listing kratom as a Schedule I substance, which would place it alongside drugs like heroin and LSD.

The World Health Organization (WHO) has evaluated kratom but has not yet classified it as a controlled substance globally. WHO’s 2021 review acknowledged kratom’s potential for misuse and addiction but determined that more evidence is needed before recommending an international ban.

According to Hemby and McMahon (2021) in their study “The Pharmacology of Kratom and Its Potential for Abuse,” kratom’s growing use raises concerns due to its interactions with opioid receptors, highlighting the need for more research and regulation to ensure safe administration.

Can Kratom Addiction Cause Liver Damage?

Yes, kratom addiction causes liver damage. Several case studies and reports have linked chronic kratom use to liver toxicity, with symptoms including jaundice, dark urine, and elevated liver enzymes. These symptoms emerge after prolonged and high-dose use of kratom. According to a study published in the Journal of Medical Toxicology, regular kratom users exhibited signs of liver injury similar to drug-induced liver damage, including hepatitis-like symptoms. This suggests that kratom, especially in high doses, places a strain on the liver and leads to serious health issues.

Can Kratom Affect Pregnancy?

Yes, kratom effects pregnancy. While research is still limited, there are concerns that kratom use during pregnancy leads to negative outcomes such as neonatal abstinence syndrome (NAS), a condition where newborns experience withdrawal symptoms after birth. A study published in Obstetrics & Gynecology reported cases of infants exposed to kratom in utero showing symptoms like tremors, irritability, and poor feeding after birth, similar to opioid withdrawal. The lack of conclusive data makes it unsafe to use kratom during pregnancy, as its opioid-like effects harm both the mother and the developing fetus.

What Are the Withdrawal Symptoms of Kratom?

The withdrawal symptoms of kratom are anxiety, irritability, muscle aches, nausea, and cravings. These symptoms resemble those of opioid withdrawal due to kratom’s interaction with the brain’s opioid receptors. Withdrawal begins within 12-24 hours after the last dose and lasts anywhere from 3 to 7 days, depending on the level of dependence and duration of use.

The withdrawal symptoms of kratom include:

• Anxiety
• Irritability
• Muscle aches
• Nausea
• Insomnia
• Sweating
• Diarrhea

These symptoms occur because kratom, like opioids, activates similar pathways in the brain, causing dependency and withdrawal once the drug is discontinued.

Can Kratom Be Used to Ease Opioid Withdrawal Symptoms?

Yes, kratom has been used by some to ease opioid withdrawal symptoms. Due to its partial agonist effects on opioid receptors, kratom mimics the effects of opioids in a milder form, helping to reduce withdrawal symptoms such as cravings, anxiety, and pain. A study in the Journal of Addiction Medicine noted that kratom users reported using the substance as a substitute for opioids to manage withdrawal symptoms. However, the study also emphasized that kratom itself carries a risk of addiction and withdrawal, making its use for opioid withdrawal a controversial and unregulated treatment option.