Kratom: Understanding Dependence, Withdrawal, and Addiction

Kratom is one of those substances that many people have heard of without really understanding what it is. It may be marketed as a natural supplement, a pain treatment, an energy product, or something that can help with opioid withdrawal. It may also be sold openly in places where people do not expect to encounter substances with dependence potential.

That can make kratom easy to underestimate.

Kratom comes from the leaves of the Mitragyna speciosa tree, a plant native to Southeast Asia. Its active compounds interact with opioid receptors in the brain and can produce different effects depending on the product and amount used. People may report more stimulant-like effects with smaller amounts, while larger amounts can produce sedation and opioid-like effects.

Mitragynine is the primary active compound found in traditional kratom leaf. Another compound, 7-hydroxymitragynine, commonly called 7-OH, has stronger opioid-like activity. Concentrated 7-OH products have also become increasingly available, creating additional concerns for consumers.

The fact that kratom is plant-based does not mean it is harmless. The FDA has warned about serious adverse effects associated with kratom, including substance use disorder, liver toxicity, and seizures.

Why People May Not Realize Kratom Can Become Addictive

The way kratom is marketed can shape how people think about it.

Someone may assume that a substance sold as a supplement is fundamentally different from other psychoactive substances. They may believe that because it is natural, legal in many places, or available at a convenience store or smoke shop, it must be relatively safe.

That assumption can make it harder to recognize when occasional use has become dependence.

Kratom may initially be used for a specific reason. Someone may be trying to manage pain, increase energy, cope with emotional distress, or get through withdrawal from another substance. Over time, however, the pattern can change.

A person may begin taking kratom more frequently, increase the amount they use, or find themselves thinking about when they can take their next dose. Eventually, they may be using it less because they want its original effects and more because they feel they need it to feel normal.

That is an important distinction.

Kratom and Dependence

Regular kratom use can lead to physical dependence. When the body adapts to repeated exposure to a substance, stopping or significantly reducing use can result in withdrawal symptoms.

Dependence is not the same thing as a substance use disorder, although they can occur together.

Kratom use disorder can involve difficulty controlling use, continued use despite problems, cravings, tolerance, unsuccessful attempts to stop, and withdrawal. Research suggests that problematic kratom use is more common than many people realize.

In a 2023 survey of 2,061 kratom users, approximately 25.5% met criteria for past-year kratom use disorder. The most commonly reported criteria included tolerance and withdrawal. Researchers caution that online survey samples cannot necessarily be generalized to everyone who uses kratom, but the findings demonstrate that dependence and problematic use can occur.

What Does Kratom Withdrawal Feel Like?

Withdrawal can be one of the clearest signs that the body has developed physical dependence.

People who regularly use kratom may experience symptoms when they stop or significantly reduce their use. Reported symptoms include anxiety, irritability, restlessness, fatigue, gastrointestinal discomfort, body aches, sleep difficulties, and cravings.

The severity of withdrawal can vary from person to person. It may also depend on the frequency and duration of use, the amount being taken, and the type of kratom product.

For some people, withdrawal creates a difficult cycle. They may want to stop using kratom, begin experiencing uncomfortable symptoms, and then take another dose simply to feel better. The substance can gradually become part of a daily routine that feels difficult to escape.

Research involving people with kratom use disorder has found that tolerance and withdrawal can be prominent features of problematic use.

Kratom Can Become a Substitute for Another Substance

One of the more complicated aspects of kratom is why people may begin using it in the first place.

Kratom has been used by some people in an attempt to manage opioid withdrawal symptoms. Others may turn to it while trying to reduce their use of another substance.

That does not necessarily mean the person is making a careless decision. They may genuinely be trying to find a way through a difficult period.

The concern is that kratom can become the new substance around which their day revolves.

Jason Kron, LCMHCA, LCASA, a clinician at One-Eighty Counseling, has observed this pattern in his work with people struggling with substance use.

When substance use begins to feel difficult to control, structured support can help a person understand the patterns behind their use and begin building healthier ways to cope. For individuals who need a higher level of support while remaining active in their everyday lives, One-Eighty Counseling offers an Intensive Outpatient Program (IOP) for substance use and co-occurring mental health concerns.