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Kratom Withdrawal & Its Side Effects

Last Updated on November 4, 2023 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Michael Loes MD

Kratom is a drug with similar but not identical properties compared to opioids.

Long used in Southeast Asia for medicinal and ritual purposes, kratom use has recently started to appear in the United States and Europe both as alternative medicine and as an increasingly abused recreational drug. Kratom has been illegal in Thailand since the 1940s.

What Is Kratom?

What is Kratom? Cultures in Southeast Asia have used kratom, an herb with psychoactive properties, for centuries. It is used both as a recreational drug and for medical purposes. Kratom is made from the leaves of a native Southeast Asian evergreen tree called Mitragyna speciosa (a tree in the coffee family). This tree is found in Thailand, Papua New Guinea, Malaysia, Myanmar, and Indonesia.

Other names for kratom products include biak biak, ketum, ithang, thom, and kauam. The traditional uses of kratom include adding it during cooking, chewing the leaves, smoking, similar to tobacco, making extracts, teas, or putting the drug into pill form.


There are multiple phytochemicals in kratom but only a handful have been isolated for their specific psychoactive properties which may manifest at low doses as a stimulant, and at high doses as a sedative with opium-like effects. One phytochemical in kratom that gives the substance its stimulant effects is mitragynine. In larger doses, mitragynine acts as a sedative, much like codeine or morphine.16 Kratom is unregulated federally in the US but some states, and some countries such as Argentina, Israel, and most of Europe have banned the drug. In Canada, kratom has been ruled unsafe for human consumption.17

Research on Kratom

Mitragynina speciosaThe effects of kratom use are diverse and depend highly on dosage. Research from the University of Florida has looked at how kratom binds to certain opioid receptors in the brain (the same receptors which are activated by other opioids, whether in recreational or medicinal use). According to this research, and from the FDA, there is some indication that kratom could be a useful agent for assisting with opiate withdrawal.5,6

Kratom has not been extensively studied in clinical trials on humans, but some clinical data exists on the toxicology and effects of the drug. Animal studies have also been published, revealing more about the similarities and differences in the drug’s effects in comparison to opioids. Kratom is sometimes referred to as an “atypical” opioid because of these differences.2

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Risks of Kratom Use

There are no FDA-approved uses for kratom.

For centuries, kratom has been used where it grows in Southeast Asian countries. There it has been used to relieve exhaustion and fatigue and even physical discomforts and is considered beneficial, for instance, for a person to keep working past the point of physical exhaustion.

Like opioids, kratom use can cause dependency and addiction. After regular use, withdrawal can cause similar symptoms as coming off opiates. Kratom distribution has drastically increased worldwide in the last few years.7

Kratom is currently imported illegally into the US for recreational or unlicensed use, even sold as a dietary supplement in some cases. When it is abused recreationally there can be adverse effects similar to those of other opioids, and there have been 44 cases of kratom-related deaths in recent times, according to the FDA.3,4

Kratom Withdrawal

Kratom is a drug that has a high risk of tolerance, dependence, and addiction. There is a very great chance of suffering kratom withdrawal symptoms when you stop taking the drug.7-10,14

Kratom withdrawal symptoms can include:
  • hallucinations
  • coma
  • respiratory depression
  • respiratory arrest
  • cardiac arrest
  • cravings
  • severely depressed mood
  • sadness
  • severe anxiety, nervousness
  • restlessness
  • tension
  • insomnia
  • muscle spasms
  • muscle pain
  • irritability
  • itching over the body
  • tremors
  • fever
  • anger
  • abdominal pain
  • nausea
  • blurred vision
  • loss of appetite
  • chills
  • diarrhea
  • similar neonatal withdrawals in infants born to mothers regularly using kratom 16

Medical Uses for Kratom

As previously mentioned, research out of the University of Florida indicated that kratom may have benefits for lessening the discomforts of opiate withdrawal, including pain reduction.

Dr. Chris McCurdy suggests that this study is one of the most important for revealing that Kratom could be a potential treatment for those recovering from opioid dependency. Currently, buprenorphine and methadone are the primary pharmaceuticals used to treat opioid withdrawal, but each of these has its own side effects and limitations.

A huge limitation of the medical use of kratom is induced tolerance, dependence, and addiction, which is similar to other opioid-type drugs.8

Kratom Use For Pain Management

Kratom has a long history as a traditional remedy for various ills, including pain relief. When used regularly, according to a study out of Malaysia, more than half of regular users developed severe dependence and an additional 45% developed moderate dependence.9

The trouble with using any opioid drugs for pain management is that they are addictive over time, and typically develop tolerance, becoming ineffective over time.

Kratom Use For Opioid Withdrawal

As discussed, because the mitragynine chemical in kratom mimics the effects of opioids and bonds to opiate receptors in the brain, some have suggested kratom could assist in coping with the effects of withdrawal from other opiate-based drugs and medications. Perhaps as a feature of the opioid epidemic in the US and Canada, studies suggest kratom use has exploded over the last 10 years, possibly from at least a segment of the population looking for a method of opiate withdrawal. In the case of using kratom for this purpose, it is a bad choice, that can result in many health risks. 

As with treating addiction to any substance, the truth is that rather than break the addiction and return to sobriety in life, the initial addictive substance will instead be replaced with another addictive substance. Dependence on kratom can occur when taken regularly and may also result in severe adverse side effects and withdrawals when the drug is stopped abruptly.7-9,14,16

Regular use of kratom has been said to increase tolerance, and therefore, the need to increase the dosage of the herb. Routine consumption of high doses of kratom will induce adverse side effects, which are similar to other manifestations of high doses of opioid drugs, resulting in worsening conditions.

Toxic Side Effects of Kratom Use

Administration of kratom ranges from smoking, eating, and drinking, but all capitalize on the fact that kratom is an orally active drug. When taken through the mouth, kratom can cause numbness of the tongue, dry mouth, vomiting, and nausea.

When taken in larger doses, kratom is associated with side effects including tachycardia, agitation, drowsiness, vomiting, confusion, and others.

Kratom use is also associated with severe sedation, depressed respiration, cardiac arrest, coma and death.3,10,13-15

Is Kratom Hard on the Liver?

Kratom is processed in the body as a toxin. Experiences for individuals will differ depending on how long the substance is used, the size of your body, and a range of other factors. In cases of using kratom as well as other recreational or medicinal drugs, the combination may result in liver damage, even in low-dose usage 10

While case studies of acute liver injury with kratom use are rare, the limited data shows that it is a possibility. The onset of nausea, fatigue, pruritus (itchy skin), and finally dark urine followed by jaundice, or yellowing of the whites of the eyes or skin, are signs of acute liver injury.

A very concerning issue is the lack of scientific study and clinical trials of the substance, resulting in the public vulnerability to believing kratom to be more benign than it actually is.

Traditional Use of Kratom

Traditionally, individuals indigenous to the same Southeast Asian regions where the kratom tree grows would chew or brew tea from the leaves. Kratom was consumed to fight fatigue and improve work productivity or to relieve pain. There is also evidence for the appearance of kratom in indigenous religious ceremonies.

Is Kratom a Controlled Substance?

Kratom is not regulated on the federal level like substances such as cannabis or other recreational drugs, but it is illegal in some states in the United States of America. The substance is not immune to nationwide regulation or ban in the future. Currently, the FDA has labeled kratom as a drug with no known medical benefits and considers kratom alkaloids to be psychoactive substances. Further, the FDA advises against the purchase of kratom in any form, including powder and as an ingredient in dietary supplements. While kratom is federally unregulated, Kratom is banned in the following states:

  • Alabama
  • Arkansas
  • Indiana
  • Rhode Island
  • Vermont
  • Wisconsin

There is also pending legislation in Connecticut, Hawaii, Kansas, Michigan, Missouri, New Hampshire, Ohio, Oklahoma, Oregon, Tennessee, and Texas—which, in the event that it passes, will limit, restrict, or ban the use, purchase, or sale of kratom in any form.

In Australia, kratom is considered a controlled substance. Canada has prohibited the promotion of ingested use of kratom ruling it unfit for human consumption.

The European countries of Romania, Poland, Sweden, Denmark, Lithuania, and Latvia have marked it as a controlled substance since 2011. The UK has disallowed the import, export, and sale of the substance since 2016 under the Psychoactive Substances Act.

In 2017, The Republic of Ireland listed kratom as an illegal substance under the names mitragynine and 7-hydroxy mitragynine.

In the traditional countries of production, there have been some recent changes to status as well. Indonesia will see it listed as an illegal substance in 2024. The timing was pushed back after the widespread banning in 2019 to give farmers more time to change to alternative crops.

Southern Thailand fully legalized kratom as well as cannabis as both are considered commercially viable crops and eliminated their classification as a narcotic.11,12

Help for Kratom Withdrawal at Alternative to Meds Center

At the end of the day, different substances affect individuals in different ways depending on a slew of different factors that can come into play. Body chemistry typically affects the results certain substances will have on the body and mind, and kratom is no different.

sobriety at sedona drug rehabAs with any substance use, recreational or medicinal, it is better to maintain the end goal of remaining sober, without the need or dependence on kratom or any other drug.

Leading a sober and healthy life is the end goal of the Alternative to Meds Center. We strive to give you the tools to take control of your life. We believe in creating a program that is individual to you and you alone. Education is the first step in achieving the naturally restored and balanced life you deserve on your journey toward true holistic healing.

On our services overview pages, you will find a wealth of information about non-drug-based therapies that thousands of our clients have benefited from. Diet and nutrition are fundamental principles of mental wellness. Exercise, counseling, cleansing, especially neurotoxin removal, and rebuilding neurochemistry with natural substances are other fundamental features of the work we do here at the center. These actions can benefit kratom withdrawal, and improve mental wellness at the same time. 

Like any numbing drug, using kratom to mask symptoms pales in comparison to authentically reviving one’s health, energy, well-being, and natural mental health using the principles and treatment guidelines that have provided so much success for our clients over the last nearly 2 decades. Call us today for help with kratom withdrawal, kratom side effects, kratom addiction, or pain management without the need to rely on drugs for relief.


1. DEA Fact Sheet Kratom [published online ND] [Cited 2023 June 8]

2. Cinosi, E., Martinotti, G., Simonato, P., Singh, D., Demetrovics, Z., Roman-Urrestarazu, A., Bersani, F. S., Vicknasingam, B., Piazzon, G., Li, J. H., Yu, W. J., Kapitány-Fövény, M., Farkas, J., Di Giannantonio, M., & Corazza, O. (2015). Following “the Roots” of Kratom (Mitragyna speciosa): The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries. BioMed research international2015, 968786. https://doi.org/10.1155/2015/968786

3. FDA and Kratom [published online 06/02/2023) [cited 2023 June 9]

4. FDA Announcement – Seizure of Adulterated Dietary Supplements Containing Kratom [published online 10/29/2021] [cited 2023 June 9]

5. UF College of Pharmacy Kratom tea study stirs up new support for relieving opiod dependence [published online October 20, 2020] [cited 2023 June 9]

6. FDA Commissioner Statement Scientific Evidence on the presence of opioid compounds in kratom, underscoring its potential for abuse [published online Feb 6, 2018] [cited 2023 June 9]

7. Bin Abdullah MFIL. Kratom Dependence and Treatment Options: A Comprehensive Review of the Literature. Curr Drug Targets. 2020;21(15):1566-1579. doi: 10.2174/1389450121666200719011653. PMID: 32682371. [cited 2023 June 9]

8. Matsumoto K, Horie S, Takayama H, Ishikawa H, Aimi N, Ponglux D, Murayama T, Watanabe K. Antinociception, tolerance and withdrawal symptoms induced by 7-hydroxymitragynine, an alkaloid from the Thai medicinal herb Mitragyna speciosa. Life Sci. 2005 Nov 19;78(1):2-7. doi: 10.1016/j.lfs.2004.10.086. Epub 2005 Sep 15. PMID: 16169018. [cited 2023 June 9]

9. Singh D, Müller CP, Vicknasingam BK. Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug Alcohol Depend. 2014 Jun 1;139:132-7. doi: 10.1016/j.drugalcdep.2014.03.017. Epub 2014 Mar 22. PMID: 24698080. [cited 2023 June 9]

10. Eggleston W, Stoppacher R, Suen K, Marraffa JM, Nelson LS. Kratom Use and Toxicities in the United States. Pharmacotherapy. 2019 Jul;39(7):775-777. doi: 10.1002/phar.2280. Epub 2019 Jun 13. PMID: 31099038. [cited 2023 June 9]

11. Charoenrafana S, Anukul C, Aramrattna C,  Attitudes toward Kratom use, decriminalization, and the development of a community-based Kratom control mechanism in Southern Thailand [Volume 95, Sept 2021] [cited 2023 June 9]

12. Kratom Legality by Country [published online ND] [cited 2023 June 9]

13. Eastlack, S. C., Cornett, E. M., & Kaye, A. D. (2020). Kratom-Pharmacology, Clinical Implications, and Outlook: A Comprehensive ReviewPain and therapy9(1), 55–69. https://doi.org/10.1007/s40122-020-00151-x [cited 2023 June 9]

14. Galbis-Reig, D A Case Report of Kratom Addiction and Withdrawal Wisconsin Medical Journal 2016 [cited 2023 June 11]

15. Neerman MF, Frost RE, Deking J. A drug fatality involving Kratom. J Forensic Sci. 2013 Jan;58 Suppl 1:S278-9. doi: 10.1111/1556-4029.12009. Epub 2012 Oct 19. PMID: 23082895. [cited 2023 June 11]

16. Davidson L, Rawat M, Stojanovski S, Chandrasekharan P. Natural drugs, not so natural effects: Neonatal abstinence syndrome secondary to ‘kratom’. J Neonatal Perinatal Med. 2019;12(1):109-112. doi: 10.3233/NPM-1863. PMID: 30149482; PMCID: PMC6484255. [cited June 11]


Originally Published by Lyle Murphy


This content has been reviewed and approved by a licensed physician.

Dr. Michael Loes, M.D.

 

Dr. Michael Loes is board-certified in Internal Medicine, Pain Management and Addiction Medicine. He holds a dual license in Homeopathic and Integrative Medicine. He obtained his medical doctorate at the University of Minnesota, Minneapolis, MN, 1978. Dr. Loes performed an externship at the National Institute of Health for Psychopharmacology. Additionally, he is a well-published author including Arthritis: The Doctor’s Cure, The Aspirin Alternative, The Healing Response, and Spirit Driven Health: The Psalmist’s Guide for Recovery. He has been awarded the Minnesota Medical Foundation’s “Excellence in Research” Award.

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