Kratom Withdrawal

There are significant research gaps when it comes to kratom withdrawal, but we can make some assumptions based on its similarities to opioids. Kratom withdrawal is usually milder than opioid withdrawal, although severe cases have been reported.

How Long Does Kratom Withdrawal Take?

Kratom withdrawal is an area in need of more research, and there isn’t enough available literature to fully detail a concrete withdrawal timeline. However, a combination of anecdotal evidence and the frequent assertion that kratom operates similarly to opioids on the body can be used to at least estimate what a withdrawal timeline may look like. Keep in mind that future research may invalidate this timeline and will likely be more accurate. 

If we assume kratom’s withdrawal timeline is similar to that of short-acting opioids, kratom withdrawal might look roughly like the following:

8–24 Hours Since Last Use

Somewhere within this window, a person physically dependent on kratom is likely to begin seeing some of the signs of withdrawal. These often mirror the signs of opioid withdrawal, but they are not as severe. Notably, only a minority of kratom users seem to report experiencing this kind of dependence. 

At the same time, these symptoms can still be serious enough that they impact a person’s health and make it difficult for them to stop using kratom.

4–10 Days Since Last Use

Over this period, a person will first experience an increase in their withdrawal symptoms and then a peak, at which point they should begin to see a reduction in their symptoms until they begin to feel more “normal.” 

Protracted Withdrawal

It’s unclear whether people dependent on kratom also experience what is called protracted withdrawal after the initial acute opioid withdrawal phases described above. Opioid use is associated with this type of withdrawal, which can last as long as six months. Protracted withdrawal is associated with a general feeling of malaise and cravings for opioids. 

Signs of Kratom Withdrawal

Kratom use is understudied, with no specific substance use disorder included in the DSM-5 related to kratom use. However, it does appear that a minority of people experience withdrawal when they stop taking kratom, usually experiencing symptoms that would be rated from mild to moderate. 

Fewer people seem to experience a substance use disorder related to kratom use. It is likely that later versions of the DSM will include specific criteria related to this type of use disorder as we learn more about the drug.

Withdrawal symptoms associated with kratom use include the following:

• Depressed mood
• Anxiety
• Restlessness
• Irritability
• Tension
• Back and muscle pain
• Joint pain
• Teary eyes
• Runny nose
• Insomnia
• Diarrhea
• Feverish sensation
• Loss of appetite
• Tremors
• Itching
• Difficulty concentrating
• Chills

As touched on earlier, these symptoms are similar to those associated with opioid withdrawal, although they should generally be less severe. 

Importantly, kratom has been known to cause neonatal withdrawal symptoms. If a person taking kratom regularly is pregnant, the baby can also become physically dependent on kratom. Symptoms associated with neonatal withdrawal include the following:

• Restlessness
• Irritability
• Vomiting
• Oral intolerance

Treatment Options for Kratom Withdrawal

Because its widespread use in the United States is a somewhat newer phenomenon, and there are significant research gaps regarding its use and properties, experts aren’t entirely sure on the best way to treat kratom addiction and withdrawal at this point.

Some research has suggested the drug Suboxone has promise as part of a replacement therapy for kratom-dependent users. Intravenous clonidine and a combination of oral dihydrocodeine and lofexidine have shown promise as part of inpatient detoxification treatment. 

One 2016 case report discusses a woman who was experiencing severe symptoms reportedly associated with kratom use who had her withdrawal symptoms successfully managed with clonidine therapy and scheduled hydroxyzine.

Despite these research gaps, it is important to talk to an addiction professional if you’re struggling to overcome kratom use or experiencing significant withdrawal symptoms. They can still help you form a treatment plan and may be able to refer you to treatment providers who are experienced with dealing with kratom dependence specifically. 

Important Questions About Kratom

These are some important questions we don’t yet have sufficient answers to regarding kratom use:

• Can kratom serve any legitimate medical purposes?
• What rate of kratom users experience significant dependence and withdrawal symptoms?
• How else does kratom affect a user’s health over time?
• What should be the diagnostic criteria of a substance use disorder associated with kratom use?
• What is the best way to treat kratom withdrawal and dependence?

For now, experts recommend being very wary about kratom use. While research has suggested it may have some legitimate medical use, it is also underregulated and underresearched. Additionally, many sellers of kratom may make unverified claims about its benefits while also downplaying or even lying about its known risks.

Since physical dependence is possible, kratom use can quickly lead to repeated use and eventually addiction. If you’re struggling with this, reach out for help today. A comprehensive treatment program can help you to leave substance misuse in your past.

References

Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. (2009). World Health Organization.

Kratom. National Institute on Drug Abuse.

Kratom Dependence and Treatment Options: A Comprehensive Review of the Literature. (2020). Current Drug Targets. 

A Case Report of Kratom Addiction and Withdrawal. (February 2016). WMJ.

Assessment of Kratom Use Disorder and Withdrawal Among an Online Convenience Sample of US Adults. (February 2022). Journal of Addiction Medicine.

Current Perspectives on the Impact of Kratom Use. (July 2019). Substance Abuse and Rehabilitation.

Understanding Kratom Use: A Guide for Healthcare Providers. (March 2022). Frontiers in Pharmacology.