Kratom Addiction: Signs, Symptoms, Withdrawal, and Treatment

Kratom addiction develops when frequent use of the substance leads to a physical and psychological dependence, causing the user to experience cravings and withdrawal symptoms similar to those associated with opioids. Kratom is a plant-based substance derived from the leaves of the Mitragyna speciosa tree, which is native to Southeast Asia, specifically found in countries like Thailand, Indonesia, Malaysia, Myanmar, and Papua New Guinea according to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). These tropical regions cultivate the plant, where it is traditionally used for in local medicine for its stimulant effects when chewed or brewed in teas.

The dosage of kratom is determined by an individual's body weight, tolerance, and gender. Low doses (typically 1 to 5 grams) act as a stimulant, while higher doses (5 to 15 grams or more) have sedative and opioid-like effects. For example, men and individuals with higher body weight tolerate higher doses than women or smaller individuals, but there are no precise dosing guidelines based on sex or age. In 2021, 1.7 million Americans over the age of 12 used kratom according to “Key Substance Use and Mental Health Indicators in the United States” published by the Substance Abuse and Mental Health Services Administration (SAMHSA).

When consumed in low doses, kratom acts as a stimulant, boosting energy, alertness, and sociability, much like caffeine. It is said to improve mood and concentration although the efficacy and safety is unclear and there is no evidence that kratom is safe or effective for treating any condition according to the United States Food and Drug Administration (FDA). In higher doses, kratom takes on a sedative effect, providing pain relief, relaxation, and euphoria. At these levels, dangerous side effects like drowsiness, dizziness, and even respiratory depression occur, posing serious health risks, including the potential for overdose.

The signs of kratom addiction include increasing the dosage to achieve the desired effects, neglecting responsibilities, and an inability to control kratom use despite negative consequences. Users begin to isolate themselves and prioritize obtaining and consuming kratom over personal or professional commitments.

Common symptoms of kratom addiction include cravings for the substance, irritability, mood swings, fatigue, and physical symptoms such as nausea or constipation. Individuals experience difficulty concentrating and exhibit signs of depression or anxiety when not using kratom.

Withdrawal symptoms from kratom mimics those of opioid withdrawal and include muscle aches, insomnia, irritability, sweating, and cravings. In some cases, withdrawal also causes restlessness, mood swings, and flu-like symptoms. The severity of these symptoms depends on the duration and intensity of use.

Treating kratom addiction involves a combination of medical detox to manage withdrawal symptoms and behavioral therapies such as Cognitive Behavioral Therapy (CBT). Kratom use has increased rapidly, with 1807 kratom exposures and a 52-fold increase occurring over the years 2011 to 2017 as noted in a 2019 report from the American Association of Poison Control Centers (AAPCC).  In severe cases, inpatient rehab is necessary, while outpatient counseling and support groups help individuals maintain long-term recovery. 

When Does Kratom Consumption Cause Addiction?

Kratom consumption leads to addiction when taken in high doses over an extended period. A "high dose" is defined as 5 to 15 grams of kratom consumed at once. Repeated use at this level results in dependence due to the opioid-like effects that kratom produces, leading to cravings and withdrawal symptoms similar to opioid addiction. Kratom has been linked to 15 deaths between 2014 and 2016. However, no published studies specify the amount of kratom required to cause an overdose, making it difficult to determine a safe consumption level according to research titled “DEA Announces Intent to Schedule Kratom” by The Drug Enforcement Administration (DEA).

Addiction is more likely when kratom is taken in high doses because this is when the substance begins to act as a sedative rather than a stimulant. A high dose of kratom is typically defined as 5 to 15 grams. At these levels, users experience effects such as euphoria and pain relief, which mimic the actions of opioid drugs. Over time, the brain's reward system becomes dependent on kratom to produce these feelings, leading to physical and psychological dependence.

Kratom addiction also results in psychosis if chronically taken at high doses, which includes symptoms such as hallucinations, delusions, and confusion. Hallucinations and delusions are more common when kratom is taken in doses exceeding 15 grams, with long-term users reporting visual or auditory hallucinations, paranoia, and significant confusion.

Both teens and adults are susceptible to kratom addiction, but adults are more likely to develop dependence due to longer periods of usage and higher exposure. White, middle-class men are over three times more likely to use kratom during their lifetime compared to other groups according to Rogers, J. et. al. 2019 in “Kratom Use in the US: Both a Regional Phenomenon and a White Middle-Class Phenomenon? Evidence From NSDUH 2019 and an Online Convenience Sample,” published by Frontiers in Pharmacology. However, teens who experiment with high doses of kratom, especially in combination with other substances, also experience addiction and psychotic symptoms. 

What are the Signs, Symptoms and Side Effects of Kratom?

The signs, symptoms and side effects of Kratom include physical and psychological effects that increase in severity depending on the dose. Among 27,338 overdose deaths between July 2016 and December 2017, 152  individuals tested positive for kratom in their postmortem toxicology results. The protocols for postmortem toxicology testing were inconsistent across states. In 91 cases, medical examiners determined kratom to be a contributing cause of death, including seven cases where kratom was the only substance detected according to data from the State Unintentional Drug Overdose Reporting System (SUDORS).

• Small Pupils: Small pupils, or miosis, is a physical sign of Kratom addiction, occurring due to kratom’s interaction with opioid receptors in the brain, similar to opioids like morphine. The constriction of pupils is a common physical response, indicating the central nervous system's sedation. This effect is seen during high doses and withdrawal as the body readjusts to the absence of the drug.
• Tremors: Tremors are a physical symptom of kratom withdrawal, caused by overstimulation of the nervous system. Kratom, especially in high doses, affects the brain’s control over muscle function, leading to involuntary shaking or spasms. Tremors are particularly pronounced during withdrawal as the nervous system attempts to regain normal function. Seizures were reported in 6.1% of kratom exposures, indicating the severity of tremors according to a 2019 review of 935 kratom exposures reported to U.S. poison control centers over a seven-year period 
• Sweating: Sweating is both a physical side effect during kratom use and a physical symptom of withdrawal. Kratom affects the autonomic nervous system, leading to excessive perspiration as the body attempts to regulate temperature. Sweating commonly occurs during detoxification as the body attempts to rid itself of the substance.
• Nausea: Nausea is a physical symptom that results from kratom’s effects on the gastrointestinal system. Kratom slows digestion, leading to discomfort and nausea, especially at higher doses. This symptom worsens during withdrawal when the body adjusts to the absence of kratom. Nausea was reported in 11.2% of kratom exposure cases in a 2019 report to U.S. poison control centers.
• Vomiting: Vomiting is a physical symptom of kratom use and withdrawal. It is a severe extension of nausea, caused by the impact of kratom on the gastrointestinal system. High doses overwhelm the body, causing it to expel the substance. Vomiting is also common during withdrawal as the body attempts to cleanse itself of toxins. Vomiting was reported to U.S. poison control centers in 11.2% of kratom exposures.
• Muscle Aches: Muscle aches are a physical symptom common in kratom users, particularly during withdrawal. As the body becomes dependent on kratom, its absence leads to pain and discomfort in the muscles, often described as flu-like symptoms.
• Joint Pain: Joint pain is a physical symptom related to the physical stress kratom places on the body, especially with long-term use. This pain intensifies during withdrawal as the body reacts to the absence of kratom’s pain-relieving effects.
• Chills: Chills are a physical symptom of kratom withdrawal. The body’s temperature regulation is disrupted, leading to alternating periods of sweating and chills as the body detoxifies from kratom use.
• Diarrhea: Diarrhea is a physical symptom of kratom withdrawal, occurring as the gastrointestinal system adjusts after prolonged use. During use, kratom slows digestion, and during withdrawal, the digestive system may speed up rapidly, leading to diarrhea.
• Fatigue: Fatigue is both a physical symptom during withdrawal and a physical side effect of kratom use. Kratom’s sedative effects cause drowsiness and exhaustion during use, while withdrawal leads to extreme fatigue as the body struggles to regain energy. Drowsiness was reported in 13.6% of kratom exposure cases, according to the 2019 review by U.S. poison control centers.
• Weight Loss: Weight loss is a physical side effect of long-term kratom use, caused by its appetite-suppressing effects. Kratom disrupts normal eating habits and digestive processes, leading to malnutrition over time.
• Dry Mouth: Dry mouth is a physical side effect of kratom use, caused by a decrease in saliva production due to the drug’s impact on the nervous system. This symptom persists during both use and withdrawal.
• Constipation: Constipation is a physical symptom of kratom use, as the drug slows digestive processes. Infrequent bowel movements are common among users, especially those taking high doses for extended periods.
• Liver Damage: Liver damage is a physical side effect of prolonged kratom use, leading to liver toxicity. Symptoms like jaundice and dark urine occur as the liver struggles to process kratom’s chemical compounds, resulting in inflammation and, in severe cases, liver failure. A study by the American Association for the Study of Liver Diseases found liver injuries in kratom users after a latency period of two to six weeks.
• High Blood Pressure: High blood pressure is a physical side effect of kratom use, particularly in high doses. Kratom increases heart rate and elevates blood pressure, posing risks of heart complications over time, especially for individuals predisposed to hypertension. Tachycardia (increased heart rate) was reported in 16.9% of kratom exposure cases according to U.S. poison control centers.
• Dizziness: Dizziness is a physical side effect of kratom use, resulting from its sedative effects on the central nervous system. It impairs balance and coordination, causing disorientation and lightheadedness, particularly at high doses.
• Drowsiness: Drowsiness is a physical side effect of kratom use, especially at high doses. Kratom mimics opioid-like effects, inducing significant drowsiness and affecting the user’s ability to remain alert and functional. At higher doses, kratom acts as a sedative, and excessive drowsiness can lead to extreme sedation. In rare cases, coma and respiratory arrest were reported in 2.3% and 0.6% of exposures, respectively, according to the 2019 review.
• Trouble Breathing: Trouble breathing is a physical side effect of kratom use, particularly in high doses. Kratom suppresses the respiratory system, which can lead to respiratory depression, a life-threatening condition similar to opioid overdose. Respiratory depression was reported in 2.8% of kratom exposures as reported to U.S. poison control centers.
• Agitation: Agitation is a physical symptom of kratom addiction and withdrawal. Users may experience irritability or heightened restlessness, reported in 18.6% of cases in the 2019 review.
• Confusion: Confusion is a physical symptom that can occur during kratom use, particularly at high doses. This results from the drug's impact on cognitive function and was observed in 8.1% of cases reported to U.S. poison control centers.
• Hallucinations: Hallucinations are a physical symptom of kratom use, usually occurring in severe cases where the drug affects sensory perception. Hallucinations were reported in 4.8% of cases reported to U.S. poison control centers.
• Seizures: Seizures are a physical symptom of kratom use, particularly during withdrawal or at high doses. Seizures were reported in 6.1% of kratom exposure cases, highlighting the risk of severe neurological effects.
• Coma: Coma is a rare but serious physical side effect of high-dose kratom use. In extreme cases, the sedative effects of kratom mimic those of an opioid overdose, leading to coma, which occurred in 2.3% of reported exposures reported to U.S. poison control centers.
• Cardiac or Respiratory Arrest: Cardiac or respiratory arrest is a severe physical side effect of high-dose kratom use, resulting from its depressive effects on the cardiovascular and respiratory systems. This condition was reported in 0.6% of kratom exposure cases reported to U.S. poison control centers.
• Irritability: Irritability is a psychological symptom of kratom use and withdrawal. Kratom effects mood-regulating neurotransmitters such as serotonin and dopamine, leading to emotional instability when the substance is absent. Irritability was reported in 18.6% of kratom exposures according to the 2019 review of kratom cases.
• Mood Swings: Mood swings are a psychological symptom of kratom use and withdrawal. Kratom disrupts neurotransmitter activity, causing users to experience euphoria followed by depressive lows, especially during withdrawal as the brain attempts to restore balance.
• Anxiety: Anxiety is a psychological symptom of kratom withdrawal, triggered by the drug’s impact on stress and mood regulation in the brain. During withdrawal, users often experience heightened anxiety due to their dependence on kratom for emotional stability.
• Depression: Depression is a psychological symptom of kratom withdrawal. As the brain struggles to produce adequate levels of dopamine and serotonin without kratom, users may experience feelings of hopelessness, sadness, and low energy levels. This can significantly impact their mood and emotional well-being.
• Insomnia: Insomnia is a psychological side effect during both kratom use and withdrawal. Kratom disrupts sleep patterns by overstimulating the brain at lower doses or sedating it at higher doses, making restful sleep difficult. As withdrawal progresses, insomnia can worsen, adding to the discomfort of detoxification.
• Intense Cravings: Cravings are a psychological symptom and a hallmark of kratom addiction. The brain becomes reliant on kratom to maintain feelings of pleasure and well-being. During withdrawal, these cravings become more intense, making it difficult for users to quit and manage their addiction.
• Hallucinations: Hallucinations are a psychological side effect of high-dose kratom use, where the drug disrupts the brain’s perception of reality. Users may experience visual, auditory, or tactile hallucinations, especially with prolonged use. Hallucinations were reported in 4.8% of cases in the 2019 review of kratom exposures.
• Delusions: Delusions are a psychological symptom of chronic, high-dose kratom use. Users may experience a disconnection from reality, where they hold false beliefs that contradict evidence or logic. These delusions are a result of kratom’s impact on brain function and are more common with long-term use.
• Psychosis: Psychosis is a severe psychological symptom linked to kratom use, particularly in individuals with underlying psychiatric conditions. Kratom use was associated with exacerbation of psychotic symptoms, especially in those with existing psychiatric disorders according to Bachu, A. K. et al. (2023). 
• Confusion: Confusion is a psychological symptom associated with kratom use, particularly at higher doses. Users may experience cognitive disorientation, making it difficult to think clearly or make sound decisions. Confusion was observed in 8.1% of kratom exposure cases, according to the 2019 review.
• Agitation: Agitation is a psychological symptom of kratom withdrawal. Users often feel restless and irritable, with heightened emotional sensitivity. Agitation was reported in 18.6% of kratom exposure cases in the 2019 review, highlighting its prevalence during withdrawal.
• Sleep Disturbances: Sleep disturbances are a general side effect and common in kratom users due to the drug's effects on sleep cycles. Whether through stimulant or sedative effects, kratom disrupts normal sleep patterns, leading to poor quality rest and difficulty maintaining regular sleep schedules.
• Overdose: Overdose is a general side effect of Kratom misuse and occurs when a person takes an excessive amount of Kratom, leading to potentially life-threatening symptoms. Symptoms of kratom overdose include severe drowsiness, confusion, agitation, seizures, hallucinations, respiratory depression, and even coma. Kratom overdose is particularly dangerous because it mimics the effects of opioid overdoses, such as respiratory failure, which is the most significant risk. According to the FDA, kratom overdose has been linked to serious health issues, including seizures and respiratory depression, and is especially risky when mixed with other substances like alcohol or opioids.

What is the Kratom Withdrawal Timeline?

The kratom withdrawal timeline varies based on the individual’s size, weight and severity of their addiction to kratom according to the National Institute on Drug Abuse (NIDA). Individuals with a moderate to severe kratom dependency are likely to experience more intense and prolonged withdrawal symptoms. Research indicates that those who consume large amounts of kratom daily are at a higher risk of developing severe dependence, leading to stronger withdrawal symptoms and persistent cravings during the withdrawal process according to a study titled “Kratom Withdrawal: What to Know About Kratom Addiction & Treatment” published by Caron.org.

The kratom withdrawal timeline is as follows:

• First 6-12 Hours: Kratom withdrawal symptoms begin as early as 6 to 12 hours after the last dose. During this phase, users experience mild symptoms such as anxiety, irritability, and cravings. The intensity is typically low, but physical symptoms like sweating and restlessness also start to appear as the body begins adjusting to the absence of kratom.
• Days 1-3: The peak of withdrawal symptoms occurs between days 1 and 3. Symptoms become more intense and include nausea, vomiting, muscle aches, tremors, and fatigue. Psychological symptoms like anxiety, depression, and insomnia also intensify during this period as the body’s dependence on kratom is disrupted.
• Days 4-7: By days 4 to 7, the physical symptoms start to subside, but psychological effects such as anxiety, depression, and insomnia persist. Cravings for kratom remain strong during this phase, making it a critical time for managing relapse prevention.
• Days 8-14: In days 8 to 14, most of the physical symptoms have diminished, but some individuals still experience lingering fatigue, mood swings, and trouble sleeping. Psychological symptoms like depression and irritability persists, but they are typically less intense compared to the earlier days.
• Weeks 2 and Beyond: After two weeks, most withdrawal symptoms subside, but some long-term users still experience psychological effects like anxiety, depression, or mood swings for several weeks. Cravings persist, making ongoing support important for preventing relapse.

How to Treat Kratom Addiction?

To treat kratom addiction requires a comprehensive approach that targets both the physical dependence and psychological effects of the drug. Effective treatment methods include therapy, medications, and treatment centers, as well as additional strategies like lifestyle changes and support groups. These methods are essential for managing withdrawal, reducing cravings, and ensuring long-term recovery.

1. Therapy: Cognitive Behavioral Therapy (CBT) is a proven method for treating kratom addiction. It helps individuals identify and modify the thought patterns and behaviors driving their kratom use. Therapy addresses underlying issues like anxiety and depression, providing strategies for managing triggers and preventing relapse. CBT is highly effective in treating substance use disorders, offering long-lasting recovery benefits by reshaping the individual's approach to stress and coping according to Morin, J et. al. in “A Review of CBT Treatments for Substance Use Disorders” published by Oxford Academic. 

2. Medication: Medications such as clonidine and other non-opioid drugs are used to alleviate withdrawal symptoms like anxiety, muscle pain, and insomnia. These medications help ease the detox process by reducing the intensity of physical symptoms. While medications do not cure addiction, they play a large part in supporting recovery when combined with therapy and other treatments.

3. Treatment Center: Inpatient and outpatient treatment centers provide structured environments that offer medical supervision, counseling, and support during the recovery process. These centers ensure individuals have access to immediate care during withdrawal and rehabilitation. Patients in treatment centers have a higher chance of achieving sustained recovery due to the comprehensive, personalized care provided.

4. Lifestyle Changes: Incorporating healthy lifestyle changes such as regular exercise, balanced nutrition, and mindfulness practices is key to sustaining long-term recovery from kratom addiction. Physical activity boosts mood and reduces cravings, while mindfulness techniques help manage stress and anxiety without relying on substances.

5. Support Groups: Participation in support groups like Narcotics Anonymous (NA) provides a community of individuals facing similar challenges. These groups offer emotional support, accountability, and shared experiences, all of which are important for maintaining sobriety.

What are the Dangers of Mixing Kratom with Other Drugs?

The dangers of mixing kratom with other drugs poses significant health risks resulting in severe heart problems, including elevated heart rate and high blood pressure, and triggers vomiting and seizures. Mixing Kratom with other drugs increases levels of serotonin in the brain, which leads to serotonin syndrome (a dangerous condition causing confusion, agitation, and seizures). The interaction between kratom and other drugs overstimulates the central nervous system, potentially leading to life-threatening complications. More than 580 people in Florida died from kratom-related overdoses during the past decade. Most of these deaths were caused by a fatal mixture of kratom and at least one other substance according to Freund, H et. al. 2023 research published in the Tampa Bay Times.

Can You Misuse Kratom to Manage Another Addiction?

Yes, you can misuse kratom to manage other addictions due to its perceived ability to reduce cravings and withdrawal symptoms. However, this approach results in dependency and additional health complications.

1. Opioid Withdrawal: Individuals use kratom to alleviate opioid withdrawal symptoms because it mimics the effects of opioids by interacting with the same brain receptors. This substitution offers temporary relief from withdrawal symptoms like pain, anxiety, and cravings. However, sustained use leads to kratom dependence, resulting in a similar cycle of addiction and withdrawal symptoms to those of opioids, such as restlessness, muscle pain, and irritability.

2. Alcohol Addiction: People use kratom to curb alcohol cravings due to its sedative and mood-enhancing effects. While kratom reduces the immediate urge to consume alcohol, it fails to address the underlying psychological and behavioral aspects of alcohol addiction. This substitution introduces new issues, such as kratom dependency and worsening mental health, including anxiety and depression.

3. Prescription Drug Dependence: Kratom is used to manage dependence on prescription painkillers like oxycodone or hydrocodone. Kratom’s pain-relieving properties make it seem like an attractive alternative, but this merely shifts the addiction from one substance to another. Users find themselves developing a new dependency on kratom, perpetuating the cycle of addiction without solving the original issue.

When Can Kratom Cause Drug Dependence?

Kratom dependence begins within a few weeks of regular, high-dose use. Individuals consuming over 5 grams daily develop dependence within 4 to 6 weeks, though the time frame varies based on individual factors such as gender, age, and body weight. Men develop dependence slightly faster due to higher consumption rates, while women and adolescents take a bit longer due to smaller body mass or lower intake.

How Addictive is Kratom?

Kratom is highly addictive, especially in high doses (5-15 grams), where it mimics the effects of opioids, leading to physical and psychological dependence. At these levels, users experience withdrawal symptoms similar to those of opioids, such as cravings, irritability, and muscle aches. In low doses (1-5 grams), kratom acts more like a stimulant, which is less addictive but still has potential for misuse and dependence over time.

How is Kratom Regulated in the US?

Kratom is not federally regulated in the US by the FDA as of now, but it is banned or restricted in several states and localities. The FDA has issued warnings about kratom's safety, and the DEA lists it as a drug of concern but has not classified it as a controlled substance at the federal level. Some states, like Alabama and Arkansas, have banned kratom entirely, while others regulate its sale and use.

What is the Chemical Composition of Kratom?

Kratom's active compounds are mitragynine (C23H30N2O4) and 7-hydroxymitragynine (C23H30N2O5). These alkaloids interact with opioid receptors in the brain, producing effects similar to opioids like morphine. Mitragynine is the primary alkaloid, while 7-hydroxymitragynine is more potent and contributes significantly to kratom's opioid-like effects.

How is Kratom Drink Used?

Kratom drink is commonly consumed by mixing kratom powder with water or other beverages. One method, known as the "4×100", involves combining kratom leaves with cough syrup, cola, and ice to create a potent mixture popular in Southeast Asia. The drink is popular because it offers a quick and efficient way to consume kratom, with effects felt relatively quickly compared to other methods.This method of use is dangerous due to the interaction of ingredients. Other examples of kratom drink usage include:

1. Kratom tea: The powder or leaves are boiled and strained to create a tea that users drink for its stimulant or sedative effects.

2. Smoothies: Some people mix kratom powder into smoothies to mask the bitter taste.

3. Juice: Kratom is added to fruit juices, such as orange or pineapple juice, to make it more palatable.

Is Kratom Sold as Capsules?

Yes, kratom is sold in capsule form, making it easier for users to consume precise doses. In addition to capsules, kratom is also available in powder, tablets, extracts, and liquid shots. These various forms cater to different preferences, allowing users to choose based on convenience or desired potency.

Does Kratom Get You High?

Yes, kratom does get you high, especially in high doses (over 5 grams), where it produces opioid-like effects such as euphoria, relaxation, and pain relief. However, in low doses (1-5 grams), kratom acts as a stimulant similar to caffeine, increasing energy and alertness without causing a high. Responsible, low-dose usage typically does not lead to euphoric effects, but frequent or large doses are likely to induce a high due to the activation of opioid receptors in the brain.

Why is Kratom Used with CBD?

Kratom is used with CBD because both substances have pain-relieving and relaxing properties that appeal to individuals seeking relief from chronic pain, anxiety, or stress. While kratom provides stimulant or sedative effects depending on the dose, CBD is known for its anti-inflammatory and calming effects without producing a high. Users combine kratom and CBD in hopes of achieving enhanced pain relief or relaxation without the harsh side effects of stronger prescription medications. However, combining kratom with CBD is risky, as the interactions between these substances are not well studied.

How Does a Kratom High Feel?

A kratom high varies depending on the dose. At low doses (1-5 grams), kratom acts as a stimulant, making users feel more alert, energetic, and sociable, similar to caffeine. At high doses (over 5 grams), kratom produces sedative and euphoric effects similar to opioids, including deep relaxation, pain relief, and sometimes a sense of detachment from reality. Users in this range report feeling drowsy or calm, with some experiencing mild euphoria.

How is Kratom Abused?

Kratom is abused in several ways, primarily by individuals looking to experience its opioid-like effects. Here are three common methods of abuse:

1. High-Dose Consumption: People take large doses of kratom, exceeding 10-15 grams, to achieve strong euphoric and sedative effects, which increases the risk of addiction and dangerous side effects.

2. Mixing with Other Substances: Kratom is combined with alcohol, prescription medications, or other drugs to intensify its effects, increasing the risk of overdose or severe interactions.

3. Frequent Use: Individuals abuse kratom by taking it multiple times a day to avoid withdrawal symptoms and prolong its effects.

Those most likely to abuse kratom include individuals with a history of opioid addiction, people dealing with chronic pain, and individuals seeking to self-medicate for anxiety or depression.

What is the Kratom Tree?

The kratom tree, scientifically known as Mitragyna speciosa, is a tropical tree native to Southeast Asia, particularly in countries like Thailand, Indonesia, Malaysia, Myanmar, and Papua New Guinea. It belongs to the coffee family and holds cultural significance in these regions, where locals have traditionally used its leaves for their stimulant and medicinal properties. The kratom tree grows up to 80 feet tall and is recognizable by its large, glossy green leaves, which are oval and can grow up to 7 inches long. In local cultures, kratom has been used for centuries as a natural remedy for fatigue, pain, and as a recreational drug in some areas. Locally, it’s known by names such as "Ketum" in Malaysia and "Biak-Biak" in Indonesia.

What Do Kratom Leaves Contain?

Kratom leaves contain over 40 active compounds, with the most prominent being mitragynine (C23H30N2O4) and 7-hydroxymitragynine (C23H30N2O5). These alkaloids interact with the opioid receptors in the brain, leading to both stimulant and sedative effects depending on the dose. Mitragynine is the most abundant compound and primarily produces the stimulating effects at lower doses, while 7-hydroxymitragynine is much more potent and responsible for the opioid-like effects at higher doses. These compounds are unique to the kratom plant and are not commonly found in other plants, making kratom distinct in its effects.

What is a Kratom Extract Used For?

Kratom extract is concentrated and used for both medicinal and recreational purposes. In medicine, kratom extracts are sometimes used as an alternative to opioids for pain management, helping individuals with chronic pain or opioid withdrawal. Locally, extracts have been used traditionally to boost energy and stamina, especially for laborers working long hours in fields. Extracts are much more potent than kratom powder or leaves and are used recreationally for stronger effects, including pain relief and sedation. Due to its potency, kratom extract is also more likely to lead to dependency and side effects when abused.

What is Kratom Tea?

Kratom tea is a traditional beverage made from the leaves of the Mitragyna speciosa tree, native to Southeast Asia. The tea is prepared by boiling fresh or dried kratom leaves in water and then straining the liquid. This process extracts the active alkaloids, primarily mitragynine and 7-hydroxymitragynine, which give the tea its stimulating or sedative effects depending on the dose. Kratom is known by various names, including Maeng Da, ketum, biak-biak, thom, thang, and kakum. Traditionally, it was chewed by field workers to boost energy, endurance, and heat tolerance, while also relieving fatigue. The leaves were commonly used as a natural remedy to address ailments such as coughing, diarrhea, diabetes, and high blood pressure. Kratom was also utilized as a substitute for opium for pain relief or to ease opiate withdrawal symptoms according to Kubala, J. 2020 in “What Is Kratom Tea, and Is It Safe?” published by Healthline.

How is Kratom Used as a Stimulant?

Kratom is used as a stimulant primarily in powder or tea form at low doses (1-5 grams). At these levels, kratom activates stimulant-like effects, increasing energy, alertness, and sociability. Medicinally, it has been used to combat fatigue, improve productivity, and help individuals remain alert for long hours of work. Locals in Southeast Asia traditionally chew kratom leaves or brew them into tea to achieve these effects, making it a popular choice for laborers in Thailand and Malaysia to boost endurance and relieve minor aches and pains.

Is Kratom a Type of Drug Addiction?

Yes, kratom is a type of drug addiction. Kratom binds to opioid receptors in the brain, causing physical dependence similar to that seen with opioids like morphine. Regular users experience withdrawal symptoms such as cravings, anxiety, and muscle aches, indicating a psychological dependence. Over time, kratom users require increasing doses to achieve the same effects, a hallmark of addiction. These factors confirm that kratom abuse leads to drug addiction.