Kratom is available in convenience stores and online as a “natural” supplement, often advertised to boost energy, relieve pain, and help with opioid withdrawal. In reality, kratom acts on the same opioid receptors as heroin and oxycodone, and the addiction and withdrawal it can cause are not “natural” at all. If you or a loved one has developed an uncontrollable kratom habit, understanding how it actually works and how to treat it are some of the most important steps to take.
What Is Kratom?
Kratom is the common name for Mitragyna speciosa, a tropical tree from Southeast Asia that has been consumed traditionally to relieve pain, provide energy, and alleviate the effects of opioid withdrawal.[1] In the United States, kratom is sold as a dietary supplement in the form of powder, capsules, and liquid extracts under many different brand names, and is widely available in convenience stores, smoke shops, and online retailers.
The active compounds in kratom (primarily mitragynine and 7-hydroxymitragynine) bind to the same opioid receptors in the brain as opioids such as heroin, oxycodone, and fentanyl.[2] At low doses, kratom produces stimulant-type effects like increased energy and alertness. At higher doses, kratom produces sedation, euphoria, and pain relief similar to opioids.[3] This dose-dependent pharmacology is one of the features that makes kratom particularly deceptive, since it presents differently depending on how much is used, making its opioid nature less immediately obvious.The FDA has issued multiple warnings against the use of kratom for any purpose because it has no proven medical benefits, carries a high risk of abuse and dependence, and has been linked to severe adverse reactions, including liver damage and death.[4] The DEA has previously sought to classify kratom as a Schedule I controlled The FDA has issued multiple warnings against the use of kratom for any purpose because it has no proven medical benefits, carries a high risk of abuse and dependence, and has been linked to severe adverse reactions, including liver damage and death.[4] The DEA has previously sought to classify kratom as a Schedule I controlled substance.[5] As of 2026, kratom remains federally unscheduled but has been banned or restricted in several states and municipalities.
What States Is Kratom Banned In?
The legality of kratom varies significantly by location.[6] Places where kratom is banned or heavily restricted include:
- Alabama
- Arkansas
- Indiana
- Rhode Island
- Vermont
- Wisconsin
The legality of kratom is shifting continuously, so anyone using or purchasing kratom should be aware of current local regulations. The recent state-level restrictions demonstrate that as more people become aware that this substance has serious public health ramifications, more states are creating laws against it. Despite this, kratom continues to be allowed as an over-the-counter supplement in many areas.
Why Is Kratom Addictive?
Kratom has the potential to cause addiction through its ability to stimulate mu-opioid receptors in the brain. With regular use, the brain adapts to kratom in the same way it adapts to opioids, downregulating mu-opioid receptors, limiting production of naturally occurring opioids, and becoming reliant on kratom to maintain baseline functioning.[7] This is the neurological foundation of kratom addiction.
Tolerance to kratom develops quickly, causing users to need larger doses to achieve the same effect and to use more frequently to avoid withdrawal symptoms. Many people who began using kratom to treat pain, anxiety, or opioid withdrawal find themselves stuck in a cycle of escalating use — the very cycle they were trying to avoid.
Physical Warning Signs of Kratom Addiction
Kratom has different effects depending on the dose. Low doses increase energy and sociability while high doses produce opioid-like sedation. Physical warning signs of kratom addiction include:
Physical warning signs of kratom addiction include:
- Increasing tolerance, requiring greater amounts more frequently
- Constipation and digestive complications
- Significant weight loss and loss of appetite
- Nausea, particularly when attempting to reduce use
- Sweating and changes in skin appearance
- Insomnia or disrupted sleep
- Long-term heavy use may result in liver damage, such as jaundice or elevated liver enzymes
- Withdrawal symptoms developing within hours of a missed dose
Behavioral signs of kratom addiction include:
- Inability to function normally without kratom
- Spending significant time and money obtaining the substance
- Failed attempts to cut down or stop
- Continued use despite recognizing negative health effects
- Hiding use from family members or healthcare providers
- Using kratom to manage withdrawal from kratom itself
Kratom Withdrawal Symptoms
Withdrawal is a very reliable indicator of physical dependence. Kratom interacts with the same receptors in the brain as opioids. Because of this similarity, the withdrawal symptoms experienced during kratom withdrawal will also resemble those of opioid withdrawal, although the timing may differ due to different compounds and usage patterns.[8]
Kratom withdrawal symptoms include:
- Intense cravings for kratom
- Anxiety, agitation, and irritability
- Muscle aches and joint pain
- Nausea, vomiting, and diarrhea
- Sweating and hot flashes
- Insomnia and restlessness
- Depression and mood swings
- Runny nose and watery eyes
Acute kratom withdrawal typically begins within a day after the last dose and can last from several days to a week or longer.[9] Post-acute withdrawal symptoms such as depression and cravings can last much longer, especially in heavy users. Although kratom withdrawal is not typically life-threatening, it is extremely uncomfortable, and the severity of symptoms will often lead to relapse unless the person has professional care and support.
How to Treat Severe Kratom Withdrawal Symptoms
The most effective way to manage severe kratom withdrawal symptoms is in a medically supervised detox center to monitor symptoms, provide support throughout the process, and treat any complications that may arise.
Because kratom works on the same receptors as opioids, patients managing severe kratom withdrawal can benefit from certain medications, particularly buprenorphine, that have been shown to provide clinical support to those managing opioid withdrawal symptoms.[10]
Treatment for severe kratom withdrawal may include:
- Medically supervised detox and monitoring throughout the withdrawal period
- Buprenorphine or other medications (based on each person’s clinical needs)
- Support in managing anxiety, insomnia, nausea, and muscle pain during withdrawal
- Psychiatric support for the mood disturbances and depression commonly associated with kratom withdrawal
- Transition into comprehensive addiction treatment once the person is stable
Attempting to detox from kratom alone can be especially difficult for long-term or heavy users. The combination of physical withdrawal symptoms and cravings severely affects a person’s ability to manage kratom withdrawal effectively.
Kratom Addiction Treatment at All In Solutions
Kratom dependence is a legitimate substance use disorder which can be treated using evidence-based methods for treating opioid use disorder. At All In Solutions, treatment is individualized based on each person’s history, severity of use, and clinical needs.
