Kratom addiction is a substance use disorder involving compulsive use of Mitragyna speciosa alkaloids that bind to brain opioid receptors, producing opioid-like effects and leading to tolerance, withdrawal, and continued use despite negative consequences.
According to Green, M.’s 2024 study, ‘Kratom as a potential substance use disorder harm reduction agent, ’ kratom use in the United States affects 0.5-6.1% of the general population (lifetime use) while past-year use ranges from 0.7-4.1%. The substance use disorder population shows significantly higher rates, with 10% past-year and 21% lifetime use. Kratom users are predominantly employed white males from late teens to middle age with some college education. Poison control center data reveals 65% of all 2011-2017 reports occurred during 2016-2017 alone, followed by a 90% increase from 2017 to 2018. Among these incidents, 7.4% were classified as major or life-threatening. A 2017 survey found that 2.2% of users consumed kratom specifically to reduce alcohol use, while 18% listed it among multiple reasons for consumption.
The causes of kratom addiction include biological, psychological, and social factors. Biological causes involve genetic predisposition and brain chemistry changes resulting from regular use, leading to dependence and cravings. Psychological causes encompass mental health disorders and reliance on kratom to cope with stress and trauma. Social and environmental causes involve peer pressure, social influence, easy accessibility, misconceptions about safety, and external stressors such as financial instability and personal losses, which promote initiation and continued use.
Kratom addiction symptoms include physical signs such as tolerance and pupil constriction, along with psychological effects like mood swings and anxiety. Behavioral symptoms also manifest through social withdrawal and neglect of responsibilities.
Common treatment options for kratom addiction include medication-assisted detox, which uses medications like buprenorphine-naloxone to manage withdrawal symptoms. Residential treatment programs provide intensive care in a supportive environment, while Cognitive-Behavioral Therapy (CBT) helps address harmful thoughts and behaviors associated with addiction.
What is Kratom Addiction?
Kratom addiction is the physical and psychological dependence on kratom (Mitragyna speciosa), a tropical tree native to Southeast Asia whose leaves contain compounds with psychotropic effects. This condition manifests through tolerance development, withdrawal symptoms upon cessation, persistent use despite negative consequences, failed reduction attempts, intense cravings, neglect of responsibilities, and significant time investment in obtaining and using the substance.
Kratom produces both stimulant and opioid-like effects, with the severity of addiction varying based on frequency of use, dosage, individual physiology, and genetic factors. While some users initially consume kratom for pain management, anxiety relief, or opioid withdrawal mitigation, regular use often leads to dependence as the brain adapts to the presence of kratom alkaloids, particularly mitragynine and 7-hydroxymitragynine, which interact with opioid receptors in the brain.
The National Poison Data System reported over 1,800 kratom-related poison control calls in 2017, highlighting rising misuse and addiction risks. Kratom remains unapproved for medical use in the U.S. and is classified as a Drug of Concern due to its addictive potential and association with severe adverse effects.
What is Kratom?
Kratom is a tropical evergreen tree (Mitragyna speciosa) in the Rubiaceae family, native to Southeast Asia, including Thailand, Malaysia, Indonesia, and Papua New Guinea. Indigenous communities historically used their leaves for stimulant and analgesic effects, often chewing or brewing them into tea to combat fatigue and pain. The plant contains alkaloids like mitragynine and 7-hydroxy mitragynine, which interact with opioid receptors in the brain, producing sedative or stimulant effects depending on dosage. Kratom remains unregulated in the U.S. but is classified as a Drug of Concern by the FDA due to risks of addiction, withdrawal, and adverse health outcomes.
What Are The Causes of Kratom Addiction?
The causes of Kratom addiction include biological, psychological, and social factors. Biological causes involve genetic predisposition and altered brain chemistry; psychological factors include mental health disorders and trauma responses; while social influences encompass peer pressure, easy accessibility, and environmental stressors.
According to Smith, K. E.’s 2017 study, ‘Prevalence and motivations for kratom use in a sample of substance users enrolled in a residential treatment program’, kratom dependence develops through three key mechanisms. Regular, heavy kratom use directly increases tolerance and withdrawal severity. Self-medication drives dependence, with 68.9% using kratom to reduce opioid dependence, 64.1% as an opioid substitute, and 18.4% for pain management. Polydrug use history presents a significant risk factor, as kratom users consistently demonstrate more diverse substance use patterns than non-users.
Here are the common causes of Kratom addiction:
Biological Causes
Biological causes of Kratom addiction include:
- Genetic Predisposition: A family history of addiction increases vulnerability to kratom dependence, as certain inherited traits affect how individuals respond to the drug and their susceptibility to addiction.
- Brain Chemistry Changes: Regular kratom use alters brain opioid receptors and increases dopamine release, leading to physical dependence and cravings. The brain begins to rely on kratom to produce pleasurable feelings, creating a cycle of addiction.
Psychological Causes
Psychological causes of Kratom addiction include:
- Mental Health Disorders: Conditions such as anxiety, depression, bipolar disorder, ADHD, and personality disorders increase the risk of kratom addiction. Individuals use kratom to self-medicate symptoms, which fosters dependency.
- Stress and Trauma: Life stressors, trauma, and chronic pain often drive people to use kratom as a coping mechanism. This reliance escalates into habitual use and addiction without addressing underlying issues.
Social and Environmental Causes
Social and environmental causes of Kratom addiction include:
- Peer Pressure and Social Influence: Being in social circles where kratom use is common normalizes the behavior and encourages initiation and continued use. According to Khalid, K.’s 2021 study, ‘Exploring adolescents’ practice and perspective on the use and misuse of kratom in northwest Malaysia’, peer influence drives 41.3% of first-time kratom use among Malaysian adolescents. Of the 65 kratom users surveyed (aged 13-19), 11.5% specifically cited using kratom “to be accepted by peers.” Other reasons included improving physical stamina (16.4%) and pain relief (14.8%). The study identified older age and active smoking as significant predictors of kratom use.
- Accessibility and Perception: Easy availability of kratom and misconceptions about its safety as a “natural” or harmless supplement contribute to its misuse and addiction development.
- External Stressors: Factors such as financial instability, job loss, or personal losses trigger kratom use as a way to manage emotional distress, increasing addiction risk.
What Are The Symptoms of Kratom Addiction?
The symptoms of Kratom addiction include physical manifestations like tolerance requiring escalating doses, persistent itching, pupil constriction, tremors, excessive sweating, chronic fatigue, and various digestive issues. Psychological symptoms involve mood fluctuations, anxiety, cognitive difficulties, and intense cravings, while behavioral indicators encompass social isolation, neglect of responsibilities, secretive behaviors, and financial problems.
Here are the symptoms of kratom addiction in detail below:
Physical Symptoms
Physical symptoms of kratom addiction are:
- Tolerance and increased use: Tolerance to kratom develops as the body adapts to its effects, necessitating higher doses over time to achieve the desired results, sometimes reaching very high amounts such as 35-42 grams daily. According to Settle, A. G.’s 2022 study, ‘A Case of Severe Kratom Addiction Contributing to a Suicide Attempt’, kratom tolerance develops with consistent use, causing physical dependence. The American Kratom Association’s 8,000-user survey identifies doses above 5 grams as high, with toxicity occurring above 8 grams or at frequencies exceeding 22 doses weekly. The case study documents escalation from 1-2 tablespoons daily to 5-6 tablespoons (35-42 grams), surpassing the 15-gram threshold that produces opioid-like effects.
- Persistent itching: Persistent itching refers to an ongoing sensation that provokes the desire to scratch, indicating possible dermatological or systemic issues.
- Pupil Constriction (Miosis): Opioid-like activation of mu receptors reduces sympathetic nervous activity, leading to pinpoint pupils, especially at higher doses. According to Smith, K. E.’s 2024 study, ‘Responses to a “typical” morning dose of kratom in people who use kratom regularly: A direct-observation study’, pupil diameter decreased significantly after kratom dosing. Baseline measurements (4.8±1.1 mm right, 4.7±0.9 mm left) showed significant reduction 40-80 minutes post-dose, which persisted beyond 160 minutes. Higher kratom doses correlated with greater left-pupil constriction after 160 minutes (p=0.03). This miosis aligns with kratom’s known opioid-like effects and provides objective evidence of its physiological impact in regular users.
- Tremors: Neurological disruptions from kratom’s interaction with adrenergic and opioid receptors trigger involuntary shaking, often during withdrawal.
- Sweating: Excessive perspiration results from autonomic nervous system overactivity, particularly during withdrawal phases.
- Digestive issues: Digestive issues refer to disturbances in the normal functioning of the gastrointestinal system. These problems include nausea, vomiting, constipation, and abdominal pain, which affect comfort and overall health.
- Hydration and Urinary Changes: Dry mouth and increased urination indicate alterations in fluid balance and urinary system function.
- Sweating: Excessive sweating involves abnormal regulation of sweat production, often reflecting autonomic nervous system activity.
- Appetite and Weight: Changes in appetite and weight loss signify metabolic processes and nutritional status shifts.
- Respiratory and Temperature Responses: Runny nose and chills are responses associated with immune system activation and thermoregulation.
Psychological Symptoms
Psychological symptoms of kratom addiction are:
- Mood Swings: Fluctuations between euphoria (from dopamine release) and irritability or depression (during withdrawal) reflect neurotransmitter imbalance.
- Anxiety: Chronic use destabilizes serotonin and norepinephrine systems, heightening anxiety during both active use and withdrawal. According to Hossain, R.’s 2023 study, ‘A Critical Review of the Neuropharmacological Effects of Kratom: An Insight from the Functional Array of Identified Natural Compounds, ’ high doses of kratom (>15 g) cause anxiety, irritation, and increased aggression. Kratom exhibits a dual effect, treating anxiety at lower doses while producing anxiety symptoms at higher consumption levels.
- Cognitive Impairment: Difficulty concentrating or memory lapses arise as kratom disrupts prefrontal cortex function, impairing decision-making and focus.
- Cravings: Persistent urges to reuse kratom stem from reward pathway alterations, reinforcing compulsive behavior.
Behavioral Symptoms
Behavioral symptoms of kratom addiction are:
- Social withdrawal: Isolating oneself and neglecting social interactions due to kratom use.
- Neglect of Responsibilities: Work, academic, or familial obligations decline as kratom use takes precedence. According to Smith, K. E.’s 2022 study, ‘Assessment of Kratom Use Disorder and Withdrawal Among an Online Convenience Sample of US Adults’, 9.3% of kratom users reported that their kratom use repeatedly interfered with major role obligations at work, school, or home.
- Secretive Behavior: Hiding kratom consumption or lying about usage frequency signals psychological dependence.
- Financial Strain: Excessive spending on kratom products leads to monetary instability.
What Are The Effects of Kratom Addiction?
The effects of Kratom addiction include physical symptoms like gastrointestinal distress, neurological problems, and withdrawal discomfort, psychological impacts such as mood fluctuations and substance dependence, and social consequences including relationship strain and occupational difficulties.
Here are the key effects of kratom addiction:
Physical Effects of Kratom Addiction
Physical effects of Kratom include:
- Gastrointestinal Issues: Chronic kratom use leads to constipation, nausea, vomiting, and abdominal cramps due to its impact on the digestive system56.
- Withdrawal Symptoms: When stopping kratom, individuals suffer from opioid-like withdrawal, including muscle aches, jerky movements, runny nose, watery eyes, irritability, anxiety, insomnia, and mood swings.
- Potential Liver Toxicity: Rare cases of acute liver damage linked to long-term kratom use have been documented, with symptoms such as jaundice and dark urine. According to Botejue, M.’s 2021 study, ‘Kratom-Induced Liver Injury: A Case Series and Clinical Implications’, the Drug-Induced Liver Injury Network identified 8 out of 404 DILI cases (2%) were associated with kratom, with 7 of these cases (87.5%) having a confirmed causal relationship. Liver injury typically occurred after 22 days of kratom use. In the case reports, affected patients showed elevated liver enzymes, with one patient presenting AST levels of 345 U/L and ALT levels of 404 U/L, while another developed severe hyperbilirubinemia at 39.5 mg/dL.
- Cardiac Arrest: Kratom at higher doses causes opioid-like effects leading to respiratory depression, which progresses to cardiac arrest, as evidenced by the case of a young healthy 35-year-old man who suffered cardiac arrest after kratom ingestion without any other coingestants. According to Abdullah, H. M. A.’s 2019 study, ‘Cardiac arrest in a young healthy male patient secondary to kratom ingestion: is this ’legal high’ substance more dangerous than initially thought ?’, kratom ingestion leads to severe cardiovascular complications including cardiac arrest even in young, healthy individuals with no concomitant drug use. The patient developed systolic dysfunction with an ejection fraction of 20% and suffered small brain infarcts due to hypoxic injury, demonstrating kratom’s direct cardiotoxicity through its opioid-like properties.
Psychological Effects of Kratom Addiction
Psychological effects of Kratom addiction include:
- Mood Disturbances: Kratom addiction causes mood swings, irritability, anxiety, and depressive symptoms due to its interaction with brain neurotransmitters. According to Awad, M.’s 2024 study, ‘Kratom-Induced Psychiatric Decompensation and Paranoid Delusions’, the CDC and DEA reported that kratom causes psychosis or psychosis-like symptoms in some users. Studies conducted in Malaysia revealed specific percentages of psychiatric effects among regular kratom users, with 4% reporting psychotic symptoms and 0.5% reporting schizophrenia. These contrasting data points illustrate the current understanding of kratom’s potential psychiatric impacts while highlighting the need for additional clinical research.
- Cravings and Dependence: Cravings and dependence refer to the drug’s impact on opioid receptors, which results in tolerance and dependence. These effects make quitting difficult despite negative consequences.
- Cognitive and Behavioral Changes: Cognitive and behavioral changes involve confusion, agitation, and impaired judgment caused by the drug. These changes increase the risk of engaging in risky behaviors and polysubstance abuse. According to Zul Aznal, A. N.’s 2022 study, ‘Adolescent kratom exposure affects cognitive behaviours and brain metabolite profiles in Sprague-Dawley rats’, adolescent Kratom exposure impairs social behavior and spatial memory but not recognition memory. Treatment significantly affected social interaction (99.55% certainty), with morphine, mitragynine, and kratom decoction causing clear deficits. Mitragynine reduced object contacts during testing (99.99% certainty). While recognition memory remained intact, both mitragynine and kratom decoction damaged reference memory. The negative effects included distinct changes in brain metabolite profiles affecting arachidonic acid, pantothenate, CoA, and tryptophan pathways.
Social and Functional Effects of Kratom Addiction
Social and functional effects of Kratom addiction include:
- Impaired Social and Occupational Functioning: Impaired social and occupational functioning occurs when addiction causes strained relationships, loss of interest in activities, and decreased performance at work or school.
- Increased Risk-Taking: Increased risk-taking arises from altered risk perception, which leads to dangerous behaviors such as combining kratom with other substances.
What Are The Treatment Options for Kratom Addiction?
The treatment options for Kratom addiction include medically supervised detoxification, residential treatment programs, therapeutic interventions, structured rehabilitation programs, and ongoing support mechanisms. Patients benefit from medically managed withdrawal, cognitive behavioral approaches, partial hospitalization services, and intensive outpatient treatment structures that address both physical dependency and psychological aspects.
Here are the common treatment options for Kratom addiction:
Medication-Assisted Detox
Medication-assisted detox is a treatment approach that involves using medications to manage withdrawal symptoms and support recovery from substance dependence.
Use of medications such as buprenorphine-naloxone (Suboxone) has shown promise in alleviating withdrawal symptoms and supporting maintenance therapy. Other options include clonidine, dihydrocodeine, and lofexidine, which are used to manage opioid-like withdrawal symptoms during medication-assisted detox.
According to Arhin, M.’s 2023 study, ‘Successful Management of Kratom Use Disorder With Buprenorphine and Naloxone’, Kratom use disorder was treated with buprenorphine HCl-naloxone HCl starting at 2-0.5mg, two pills every four hours. The dose increased to 8-2mg during weeks 2-4, then gradually tapered over six months. Treatment included specific reductions: 2-0.5mg three tablets daily for two days, then two tablets daily for three days, followed by 1-1/2 tablets daily for three days, eventually reducing to 2-0.5mg 1/8 strips daily before discontinuation. The patient experienced only rhinorrhea and mild fatigue during treatment. Buprenorphine and clonidine are identified as effective medications for treating kratom withdrawal.
Residential Treatment Program
Residential treatment provides intensive, 24/7 care in a structured, supportive environment. A residential treatment program helps individuals with kratom addiction by removing them from everyday triggers and offering comprehensive medical and therapeutic support. Residents receive individualized treatment plans that include detoxification, counseling, behavioral therapies, and life skills training. The immersive setting promotes deep healing, helps manage withdrawal symptoms safely, and fosters lasting recovery through continuous peer and professional support. Residential programs suit those with severe addiction or co-occurring mental health conditions requiring close monitoring and focused care.
Tapering and Symptom Management
Gradual tapering of the kratom dose occurs alongside symptomatic treatment of withdrawal symptoms such as insomnia, myalgias, and gastrointestinal distress. Withdrawals are prolonged and resemble opioid withdrawal.
According to Swart, B.B.’s 2024 study, ‘Isolated kratom use disorder treated with extended-release buprenorphine taper, ’ tapering from kratom involved using two monthly injections of 100 mg extended-release buprenorphine after the patient achieved abstinence. A 36-year-old male with severe kratom use disorder received this treatment following unsuccessful attempts with naltrexone and a period of sublingual buprenorphine therapy.
Cognitive-Behavioral Therapy (CBT)
Cognitive-Behavioral Therapy (CBT) is a proven therapy that helps change harmful thoughts and behaviors driving addiction. Integrating Cognitive-Behavioral Therapy into treatment improves coping skills and prevents relapse. Treatment starts with medically supervised detox to manage withdrawal safely.
Behavioral therapies, counseling, and support groups address psychological and social aspects, while inpatient or outpatient programs provide structured care based on severity. Ongoing aftercare and addressing underlying issues like mental health or pain support lasting recovery.
Partial Hospitalization Program (PHP)
Partial hospitalization bridges the gap between inpatient and outpatient care, providing intensive treatment while allowing clients to return home each evening. These partial hospitalization programs help reduce kratom dependence by offering structured therapy and support in a less restrictive setting.
Intensive Outpatient Program (IOP)
Intensive Outpatient Programs (IOPs) help with kratom addiction by providing structured, flexible treatment that fits around daily responsibilities such as work and family. Through regular therapy sessions, group counseling, and educational support, an Intensive Outpatient Program addresses both the physical cravings and psychological triggers of kratom dependence. This approach equips individuals with coping skills to manage withdrawal symptoms, reduce cravings, and prevent relapse. The peer support and professional guidance offered in IOPs create a supportive environment that encourages sustained recovery while allowing participants to maintain their normal routines.
Is Kratom Habit-Forming?
Yes, kratom is habit-forming. It causes both physical and psychological dependency in users, often leading to addiction. Regular use of kratom results in tolerance, requiring larger amounts to achieve the same effects. This dependency leads to withdrawal symptoms when users stop taking kratom, including irritability, muscle aches, insomnia, and anxiety.
According to Singh, D.’s 2014 study, ‘Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users’, a single dose of Kratom drink contains approximately 79 mg of mitragynine, with users consuming an average daily intake of 276.5 mg. Individuals who drink three or more glasses of Kratom per day face higher odds of developing severe Kratom dependence, experiencing withdrawal symptoms, and struggling with an inability to control Kratom craving. These findings demonstrate a direct relationship between consumption volume and dependency severity.
How Long Does it Take to Get Addicted to Kratom?
It takes between a few weeks to several months to get addicted to Kratom, with the timeline varying from person to person. Some individuals develop addiction within just a few weeks of regular use, while others take longer. Kratom use leads to tolerance development, requiring users to consume increasingly larger amounts to achieve the same effects. This pattern gradually creates physical dependence, where the body becomes reliant on Kratom, resulting in withdrawal symptoms when attempting to stop use.
According to Garcia-Romeu, A.’s 2020 study, ‘Kratom (Mitragyna speciosa): User demographics, use patterns, and implications for the opioid epidemic’, daily use (59%) was the most common pattern among the 2,798 kratom users surveyed over an 11-month period in 2017, with 411 individuals reporting more than one year of continuous use specifically for opioid abstinence. Despite this regular consumption pattern, only 2% met the criteria for a moderate or severe kratom-related substance use disorder (SUD), and users reported very low distress about their kratom use (averaging just 3.2 on a 0-100 scale). These findings suggest that while physical dependence develops with regular use, clinically significant addiction appears relatively uncommon among kratom users.
Are The Symptoms Of Opioid Addiction Different From Kratom Use Disorder Symptoms?
The symptoms of opioid addiction differ somewhat from kratom use disorder symptoms, despite both substances affecting opioid receptors. The conditions share features like physical dependence, withdrawal symptoms, and behavioral changes, but individuals with opioid addiction experience more severe physical symptoms, including constricted pupils and pronounced respiratory depression.
According to Compton, W. M.’s 2019 study, ‘Epidemiology of the U.S. opioid crisis: the importance of the vector’, in 2017, approximately 11.4 million Americans aged 12 or older misused opioids, which includes misuse of prescription opioids and/or use of heroin
Kratom use disorder presents a unique profile with stimulant effects at lower doses and sedative effects at higher doses. Withdrawal from kratom is generally less intense than from traditional opioids but still includes uncomfortable symptoms like muscle aches, insomnia, and irritability. Both conditions require comprehensive treatment approaches, though specific medication protocols vary depending on the substance involved.
How Dangerous Is Mixing Kratom With Alcohol?
Mixing kratom with alcohol is very dangerous because both depress the central nervous system, increasing the risk of severe sedation, respiratory depression, and overdose. This combination of kratom and alcohol causes dizziness, impaired coordination, irregular heart rhythms, and confusion, raising the chance of accidents and organ damage. It also worsens mental health issues like anxiety and depression. The combined strain on the liver heightens the risk of liver damage.
Where to Find Kratom Addiction Treatment in Ohio?
Treatment for kratom addiction in Ohio starts with consulting addiction treatment centers, healthcare professionals, or support groups. Kratom addiction treatment includes accessing online resources and community-based programs that provide valuable support during recovery. Ethan Crossing offers specialized kratom addiction treatment with evidence-based therapies, detoxification services, and comprehensive aftercare support to help individuals overcome dependency and regain control of their lives.
