Kratom Addiction & Withdrawal


Kratom is the name of a tree in Southeast Asia, and also the name of the plant-based product derived from its leaves.1,2 It’s used as an energy booster as well as to manage pain.1,2

In the U.S., kratom can often be found as whole, chopped or powdered leaves that may filled into capsules, as well as leaf extracts in commercially prepared liquids or tea-like brews.3 It is typically sold through the Internet and at herbal store or tobacco/smoke shops, where it is typically marketed as a “legal” or “natural” high.4

There have been a number of deaths linked to the use of kratom, according to the U.S. Food and Drug Administration’s (FDA) Adverse Event Reporting System.5 In many of the cases, however, kratom was one of a number of drugs the individual used or can be tied back to adulterated kratom—or kratom that’s not pure as it has been mixed with other chemicals or substances.5

Although the FDA tracks these adverse events and has taken, Kratom remains unregulated at the federal level and the FDA has not approved for any medical use. The deaths prompted the FDA and the U.S. Drug Enforcement Administration to express concern regarding its use.6,7

The Centers for Disease Control and Prevention (CDC) has also raised flags, noting that kratom prompted 1,807 calls to poison control centers between 2011 and 2017.8 The CDC also noted that between July 2016 and December 2017, kratom was involved in polydrug overdose deaths in 27 of 32 states that participate in the State Unintentional Drug Overdose Reporting System.8 In 2018, kratom tainted by salmonella bacteria infected 199 people from 41 states.9

Effects of Kratom

Traditionally, kratom was used by workers in Malaysia and Thailand in low doses as a stimulant in order to increase work efficiency and endurance in the hot and human climate.4 In addition to the physical and mental energy boost, it also increases alertness and talkativeness.2 In higher doses, kratom produces effects more like a depressant, producing sedation, pleasure and decreased pain.1

In addition to the desired, dose-dependent effects, there are a number of potential side effects:1,2

  • Sweating.
  • Nausea and vomiting.
  • Itching.
  • Sleepiness.
  • Dry Mouth.
  • Constipation.
  • Increased urination.
  • Appetite loss.
  • Seizures.
  • Hallucinations.

Kratom has also reportedly caused more alarming side effects, including weight loss, aggression, hostility and psychosis.11,13

Kratom Withdrawal and Dependence

Similar to opioids and other opioid-like drugs, evidence points to kratom causing dependence.1,12 Moderate to heavy regular users may experience withdrawal symptoms once they stop taking the drug.1,12 Kratom withdrawal symptoms can include:1,10

  • Irritability.
  • Hostility.
  • Aggressive behavior.
  • Jerky movements of the arms and/or legs.
  • Emotional changes.
  • Runny nose.
  • Insomnia.

Researchers have not yet formally studied any specific medical treatment for kratom addiction, however, the National Institute of Drug Abuse has reported that people seeking treatment have found that behavioral therapy is helpful.1

Interestingly, kratom is being investigated by researchers for its potential to mitigate drug cravings and w0ithdrawal effects resulting from opioid dependency.3

References

  1. National Institute on Drug Abuse. (2019). DrugFacts: Kratom.
  2. U.S. Drug Enforcement Agency. (2020). Drugs of Abuse: A DEA Resource Guide: 2020 Edition.
  3. Henningfield, J. E., Fant, R. V., & Wang, D. W. (2018). The abuse potential of kratom according the 8 factors of the controlled substances act: Implications for regulation and research. Psychopharmacology, 235(2), 573–589.
  4. Veltri, C., & Grundmann, O. (2019). Current perspectives on the impact of Kratom use. Substance Abuse and Rehabilitation, 10, 23–31.
  5. U.S. Food and Drug Administration. (2017). Kratom Data from the FDA Adverse Event Reporting System.
  6. U.S. Food and Drug Administration. (2019). FDA and Kratom.
  7. U.S. Drug Enforcement Agency. (2016). DEA Announces Intent To Schedule Kratom.
  8. Olsen, E. O., O’Donnell, J., Mattson, C. L., Schier, J. G., & Wilson, N. (2019). Notes from the Field: Unintentional Drug Overdose Deaths with Kratom Detected – 27 States, July 2016-December 2017. MMWR, 68(14), 326–327.
  9. Centers for Disease Control and Prevention. (2018). Multistate Outbreak of Salmonella Infections Linked to Kratom (Final Update).
  10. U.S. Drug Enforcement Agency Diversion Control Division. (2020). Kratom.
  11. Fluyau, D., & Revadigar, N. (2017). Biochemical Benefits, Diagnosis, and Clinical Risks Evaluation of Kratom. Frontiers in Psychiatry, 8, 62.
  12. Sanderson, M., & Rowe, A. (2019). Kratom. Canadian Medical Association Journal, 191(40), E1105.
  13. Tavakoli, H. R., Buchholz, A. C., Kabir, I. K., Deb, A., & Gayk, J. N. (2016). Kratom: A New Product in an Expanding Substance Abuse Market. Federal Practitioner, 33(11), 32–36.


About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More


Get Help for Drug Addiction during Coronavirus

Traveling for healthcare & essential services is permitted across the US. Addiction treatment is essential, and we are here for our patients in this difficult time.

Learn More