Kratom addiction has become an alarming safety issue in the United States increasing in scale as the drug has gained more and more wide scale popularity. The dangers are twofold, with Kratom acting as a gateway drug that leads addicts back to their substances of choice (often opiates), as well as for it’s standalone addiction potential.
Kratom was originally labelled as a dietary supplement, then later as a soap or incense to sidestep FDA restrictions. As such it is currently not subject to regulation under the Federal Controlled Substances Act as a drug. There has recently been a movement in the US towards regulation and it is on the DEA Drugs of Concern watch list¹ as well as the National Institute on Drug Abuse identifying Kratom as an emerging drug of abuse¹. The US Department of Health and Human Services has even gone as far to recommend¹ that the DEA include Kratom as a Schedule 1 drug as it currently has no accepted medical use and poses a high potential for abuse. It is currently illegal in many countries around the world including Denmark, Australia, Malaysia, and Thailand (one of the countries from which it originates).
Other than strictly recreational use or for the reduction of anxiety or depression, Kratom is often used as an opioid withdrawal treatment. As far as a treatment for anxiety and depression, the lack of medical evidence means that any and all claims reporting this are anecdotal in nature and scientifically unsound. The Mayo Clinic has even gone so far as to say that Kratom is “unsafe and ineffective” regarding these beneficial claims¹.
Kratom Withdrawal Symptoms
As Kratom is still quite mysterious in terms of pharmacodynamics, there is no medication that is FDA approved for Kratom withdrawal or detox and there are currently no drugs in development or clinical trials for Kratom withdrawal. The experience of Kratom withdrawal has been described as very similar to Opioid withdrawal. The timeline for withdrawal is unknown, but some of the symptoms which can be expected include¹²³:
- Anxiety / Irritability
- Depression (with or without suicidal ideation)
- Dysphoria (a general sense of unease or unhappiness)
- Hypertension (very high blood pressure)
- Incessant Yawning or Stretching
- Rhinorrhea (extremely runny nose)
- Mood Swings
- Muscle, Bone, and Joint Pain
- Diarrhea and Nausea
Using Kratom for Opiate Withdrawal
Research studies on rodents found that Kratom withdrawal, just like with opioids, can be observed after only 5 days of continuous use, as tolerance starts to develop. Kratom also appears to exhibit 2-way cross-tolerance to Morphine, meaning that when experiencing withdrawal from Morphine, administration of 7-HMG, a type of Kratom, would reduce opiate withdrawal symptoms, and vice-versa.
Additionally, Kratom withdrawal could be precipitated in 7-HMG addicted rodents through IV administration of Naloxone¹. Although Mitragynine does produce similar effects to classic Opioids as well as exhibiting cross-tolerance, the specifics of its molecular docking to Opioid receptors is thought to be different that typical Opioids¹² (like Morphine or Oxycodone).
With Kratom being promoted as an Opioid withdrawal suppressor, many people begin using it as a way to get off true Opioids like Heroin or Oxycodone. While there are some studies showing cross-tolerance (mentioned above), continued use of Kratom can produce addiction with withdrawal symptoms very similar to that of true Opioids.
An online Kratom use survey done in October 2016 had 8,049 people complete the forms. Of these, 56.59% of respondents admitted to using Kratom consistently for more than 1 year. Additionally, 2,352 people admitted to using Kratom for help getting off of a drug dependency (either illicit or prescription). Finally, only 0.65% of respondents admitted to seeking medical help for their Kratom use, suggesting that many people do not consider regular Kratom use a problem. This may be due to the prevalence of the anecdotal benefits of Kratom use as well as the lack of disseminated scientific documentation of the long term effects of Kratom use, either positive or negative.
Regardless of the lack of awareness, Kratom addiction is a very real concern. Beginning either as a hobby, social activity, or withdrawal regimen, chronic Kratom use can quickly lead to physical dependence. The timeline for Human withdrawal symptoms is not clearly defined but, in rodent studies, tolerance has been observed as early as 5 days of use which is an indicator of dependence¹. Daily use is certain to lead to physical dependence at some point, and dependence is just one stop on the way to full blown addiction.
Side Effects of Kratom Use
Some of the minor potential side effects one may experience while using any amount of Kratom for extended periods of time include:
- Diaphoresis (excessive sweating)
- Polyuria (excessive urination)
- Decreased Appetite / Subsequent Weight Loss
- Confusion or Dizziness
- Depressed Breathing
- Anxiety / Agitation
With chronic use, tolerance will build requiring more Kratom to achieve the same effects. When increasing the dose you use, the risks rise accordingly. Some of the more serious effects which present in Kratom addiction include:
- Skin Discoloration (particularly of the face)
- Nausea / Vomiting
- Increased Aggression
Kratom Treatment and Recovery
Currently there are no Kratom-specific detox and treatment programs, however any reputable detox center will gladly accept those going through Kratom withdrawal. Addiction is a disease that requires treatment. The specifics of someones drug or alcohol use may vary, but the underlying issue is the same. For this reason, it is recommended to attend a treatment program for Kratom addiction.
Once through withdrawals, you will need to be proactive in your recovery. This means seeking out a treatment program and support group to further your sobriety. There are several types of short to long term treatment available which can be beneficial. These include:
In addition to paid treatment programs, 12 Step programs have been adapted for a variety of addictions including drugs, alcohol, or behavioral. 12 Step programs appear to have an extremely solid track record when it comes to people getting and staying sober. There is no apparent reason that this approach would not work for Kratom as well, since addiction is addiction.