Kratom (Mitragyna Speciosa) use, addiction & recovery
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Written by: Alexandra Talarico -
Clinically Reviewed by: Ashley Gardner -
Compliance Reviewed by: Marianne Birmingham
What is kratom?
Key Takeaway: Kratom (Mitragyna Speciosa) is a Southeast Asian plant containing psychoactive alkaloids that act on opioid receptors, producing both stimulant and sedative effects depending on dosage.
Kratom, also known as Mitragyna speciosa, is a tropical tree that originates in Southeast Asia and was first discovered by the Dutch botanist Pieter Willem Korthals. The harvested leaves of the kratom tree are used fresh or dried as both an intoxicant and as a medicine. Kratom leaves have opiate-like properties that have long been recognized in various regions of Southeast Asia but have only recently become known in the West. The psychoactive substances mitragynine and 7-hydroxymitragynine are the main alkaloids of the Kratom leaves. In Southeast Asia, fresh leaves are usually chewed (most often on an ongoing basis) by workers to achieve a stimulating effect and lessen fatigue. In other places, dried leaves are often brewed as tea or extracted with water, which is then evaporated into a resin suitable for consumption.
There are three different types of kratom: white, red, and green leaf veins. The different varieties contain a different composition of alkaloids. While varieties with green leaf veins, such as Horned Leaf Kratom, are more likely to have an activating effect, the varieties with red leaf veins, such as Maeng Da Kratom, are said to have a rather sedating effect. Since there are many different varieties of kratom trees in nature, the content of alkaloids also depends on various location factors and climatic influences, so these three types can only be regarded as general classifications.
Where is kratom grown?
Key Takeaway: Kratom grows naturally in tropical Southeast Asia, with Indonesia being the primary source for commercial kratom products.
Kratom grows naturally in several regions of Southeast Asia, specifically: Thailand, Malaysia, Indonesia (on the islands of Kalimantan and Sumatra), the Philippines (Luzon, Mindanao, Mindoro), Papua New Guinea and in the Indochina territory of Vietnam. It grows mostly in lowland forests and in swampy areas. Most of the kratom used for commercial sale is grown in Indonesia.
What does kratom do?
Key Takeaway: Kratom acts on opioid receptors in the brain, producing analgesic, euphoric, and stimulating effects at low doses, and sedative effects at higher doses.
Pharmacologically, kratom acts in a similar way to substances such as opioids and caffeine. The effects are, however, less pronounced. Kratom consumption reportedly produces analgesic, euphoric, and stimulating feelings among its users.
The active substances in kratom, 7-hydroxymitragynine and mitragynine, are thought to act as agonists at the mu- and delta-opioid receptors as well as alpha-2 adrenergic and 5-HT2A receptors in the brain to create a strong analgesic effect. These are the same receptors impacted by opioids and some other drugs.
The pure alkaloid mitragynine increases the excitability of the craniosacral and sympathetic parts of the autonomic nervous system, as well as increasing the excitability of the medulla oblongata and motor centers of the CNS. A strong dose of kratom (more than 10 grams of dry leaves per serving) can create a pronounced analgesic (pain-relieving) and sedating effect; however, if the required dosage is exceeded, then blurring of vision, nausea, and vomiting are also possible. A weaker dose (about 1-3 grams) has slightly stimulating properties that resemble caffeine without certain effects such as rapid heartbeat.
Reportedly, it relieves mild pain, helps focus, and increases physical endurance.
How is kratom used?
Key Takeaway: Kratom is most commonly consumed as pills, capsules, or tea, although some people chew fresh leaves or smoke them.
Most people take kratom as a pill, capsule, or extract. Some people chew kratom leaves or brew the dried or powdered leaves as a tea. Sometimes the leaves are smoked or eaten in food.
How long before kratom kicks in and how long does it last?
Key Takeaway: Kratom effects begin within 30 to 60 minutes, with stimulating effects lasting 2 to 5 hours and analgesic effects lasting 4 to 5 hours.
The effects of kratom take about 30 minutes to an hour to kick in. The duration of the analgesic action is about 4-5 hours, and the stimulating effect is 2-5 hours. Kratom’s peak of action happens within an hour or two of intake.
What are the side effects of kratom?
Key Takeaway: Side effects range from mild (nausea, dry mouth) at low doses to more severe effects (seizures, psychosis, liver toxicity) with prolonged high-dose use.
The most common side effects that can occur at low doses are itching, dry mouth, nausea and vomiting, and in some cases anxiety and agitation.
At higher doses, side effects may include increased heart rate, constipation, lightheadedness, low blood pressure, and sweating. Another high-dose side effect of kratom, known among its users as the “kratom wobbles,” is an eye condition commonly known as nystagmus. Kratom eye wobbles affect the muscles responsible for controlling the eyes, causing them to contract involuntarily and making the eyes move or wobble in different directions.
Kratom causes constipation by binding to opioid receptor sites in the gastrointestinal system; this creates a wide range of side effects. It impedes gastric emptying and slows down movement of food throughout the intestines, as well as increases the involuntary muscle tension of the anal sphincter, making it more difficult to excrete stool. It also reduces water and electrolyte release inside the intestinal passage, making stool much harder and bulkier, intensifying the bowel movement problems caused by kratom constipation. These side effects are also caused by opioids and are called, more generally, Opioid-induced constipation (OIC).
Prolonged use of kratom, especially at high doses, can cause weight loss, seizures, and psychosis, as well as lead to tolerance and dependence similar to that seen with other opioids. Kratom addiction is manifested by symptoms such as pain, nausea, gastrointestinal disorders, insomnia, hypertension, and psychological symptoms such as anxiety and irritability. According to a 2017 study, compared to other opioids, kratom has a fairly low potential for respiratory depression, likely due to its molecular structure, which has recently been referred to as a biased agonist (Henningfield, 2017).
Rare cases of liver toxicity have been reported after the consumption of plant extracts and were associated with characteristic symptoms such as jaundice and fatigue. Serious toxicity is relatively rare and generally appears at high doses or when kratom is used with other substances.
Where is kratom illegal?
Key Takeaway: Kratom legality varies significantly. It is banned in six U.S. states and several European countries, while remaining legal in most other jurisdictions.
As of April 2025, kratom is illegal in six U.S. states, including Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin, as well as Washington, D.C., and is regulated in 18 states. Where regulated, kratom sales include age limits (18+ or 21+), and some states also require product labeling.
Within the EU, kratom is a legally controlled substance in Denmark, Latvia, Lithuania, Poland, Romania, Sweden, Switzerland, Ireland, and the UK.
How addictive is kratom and how long does it take to get addicted to it?
Key Takeaway: Regular kratom use can lead to physical dependence within 1 to 4 weeks, with addiction risk influenced by individual biology and history of substance use.
The use of kratom is likely to lead to habituation, and those who use it consistently may experience withdrawal symptoms when they stop. There are varying reports on the length of daily use required for physical symptoms to manifest. Reports range from one week of daily use to a full month for first signs of physical addiction. Individual biological differences and history of addiction both play a significant role. Some individuals develop mental and physical addiction more quickly than others.
What is kratom withdrawal?
Key Takeaway: Kratom withdrawal produces opioid-like symptoms including muscle cramps, insomnia, anxiety, and gastrointestinal distress.
Kratom withdrawal is a set of physical and mental drug discontinuation symptoms that begin to develop and increase in strength with prolonged daily use of kratom. Typical physical withdrawal symptoms include muscle cramps, pain, difficulty sleeping, insomnia, watery eyes and nose, heat attacks, fever, chills, decreased appetite and diarrhea. Typical mental withdrawal symptoms are restlessness, tension, anger, anxiety, agitation and nervousness. The severity of kratom withdrawal symptoms depends heavily on the dosage at the time of discontinuation and the length of time kratom was used on a regular basis.
How long does kratom withdrawal last?
Key Takeaway: Acute kratom withdrawal typically lasts 5 to 7 days, with psychological symptoms potentially persisting for several weeks.
Kratom withdrawal usually starts within 12 hours after discontinuation of its use and hits its peak within 24-36 hours. The length of kratom withdrawal depends on the length of usage and the daily dose taken. Acute kratom withdrawal can last anywhere from 5 to 7 days, with a possible follow-up period of psychological adjustment that can last up to several weeks.
| Factor | Kratom | Traditional Opioids | Stimulants (Caffeine) |
|---|---|---|---|
| Effects | Stimulant at low doses (1-3g): increased energy, focus, alertness. Sedative/analgesic at high doses (10g+): pain relief, euphoria, relaxation | Sedation, analgesia, euphoria, respiratory depression, drowsiness | Increased alertness, enhanced focus, elevated energy, reduced fatigue |
| Legality | Legal in most U.S. states. Banned in Alabama, Arkansas, Indiana, Rhode Island, Vermont, Wisconsin. Banned in several EU countries including UK, Sweden, Poland | Controlled substances (Schedule II-IV). Legal only with valid prescription | Legal and unregulated worldwide |
| Withdrawal Symptoms | Muscle cramps, insomnia, anxiety, nausea, diarrhea, irritability, fever, chills. Onset 12-24 hours. Duration 5-7 days acute | Muscle aches, nausea, vomiting, diarrhea, anxiety, insomnia, sweating. Onset 8-24 hours. Duration 5-10 days acute, months for PAWS | Headache, fatigue, irritability, difficulty concentrating, depressed mood. Onset 12-24 hours. Duration 2-9 days |
| Treatment Options | Medically-assisted detox, MAT (buprenorphine), behavioral therapy, counseling, holistic therapies | MAT (methadone, buprenorphine, naltrexone), medically-supervised detox, behavioral therapy, inpatient/outpatient rehab | Supportive care, gradual tapering, no FDA-approved medications required |
7-OH (7-Hydroxymitragynine): What You Need to Know
7-OH, short for 7-hydroxymitragynine, is a naturally occurring alkaloid found in trace amounts in the kratom plant. However, concentrated or enhanced 7-OH products are different from traditional kratom leaf. These products can contain substantially higher amounts of 7-OH and may have stronger opioid-like effects, increasing the risk of dependence, withdrawal, and other serious health effects.
Is 7-OH the Same as Kratom?
No. 7-OH occurs naturally in kratom leaves, but it is only a minor constituent of the plant’s alkaloids (less than 2% of the total alkaloid content in natural kratom leaves).The products increasingly sold as 7-OH, 7-hydroxy, 7-OHMZ, or 7-HMG are often concentrated or enhanced products designed to deliver much higher amounts of 7-OH than would naturally occur in kratom leaves. These products may be sold as tablets, gummies, drink mixes, shots, or powders, and may be marketed under the broader label of “kratom.”
Natural kratom leaf and concentrated 7-OH products are not pharmacologically equivalent. 7-OH has substantially greater activity at the body’s mu-opioid receptors than the primary alkaloid in kratom, mitragynine.
- What Are the Risks of 7-OH?
Concentrated 7-OH products can produce opioid-like effects and carry a risk of tolerance, physical dependence, addiction, and withdrawal. Reported adverse effects associated with 7-OH and kratom-derived products include nausea and vomiting, constipation, sedation, seizures, liver injury, cardiovascular effects, respiratory depression, and, in serious cases, death. The risk may increase as the amount or concentration of 7-OH increases.
Because concentrated 7-OH products can produce physical dependence, stopping regular use may cause withdrawal symptoms. Symptoms can include anxiety, depressed mood, muscle aches, sleep disturbances, gastrointestinal symptoms, and other opioid-like withdrawal effects. Withdrawal severity can vary depending on the product, amount used, frequency of use, duration of use, and individual factors.If you or someone you know is experiencing withdrawal, escalating use, cravings, or difficulty stopping 7-OH, professional 7-OH detox and addiction treatment can provide medical evaluation, withdrawal management, and ongoing support.
- Is 7-OH Legal?
Federal regulation of 7-OH changed in 2026. On July 1, 2026, the U.S. Drug Enforcement Administration (DEA) announced its intent to temporarily place 7-OH above a specified threshold into Schedule I of the Controlled Substances Act. The temporary scheduling action specifically targets concentrated or enhanced 7-OH and does not apply to botanical kratom products containing naturally occurring 7-OH below the specified threshold. The DEA’s July 2026 notice specifies a threshold of more than 0.050% 7-OH by weight or volume, or more than 1 milligram of 7-OH per article, with the temporary scheduling order applying to covered products above that threshold.Federal scheduling does not mean that every product labeled “kratom” or every naturally occurring trace amount of 7-OH is automatically a Schedule I controlled substance. The federal action distinguishes natural botanical kratom from concentrated or enhanced 7-OH products. State laws may impose additional restrictions or prohibitions.
How is kratom withdrawal treated and how can Recovery Centers of America help?
Key Takeaway: Kratom addiction responds to the same evidence-based treatments used for opioid dependence, including medically assisted detox and MAT with buprenorphine.
According to the National Institute on Drug Abuse, kratom causes effects similar to opioids and may cause physical dependence, which means users may feel significant withdrawal symptoms when they stop taking kratom (NIDA, 2022). Due to the similarity between kratom and classic opioids, kratom addiction can be handled with the same protocols.
Recovery Centers of America treats opioid dependence with a range of treatments including medications and behavioral therapies.
We start opiate addiction treatment with a medically monitored detox, during which we monitor the patient around the clock, continually evaluating physiological and psychological symptoms and using medications to control any of the symptoms that begin to manifest themselves. Medications that may be used during this phase of treatment include palliative or “comfort” medications such as Clonidine, Robaxin, Trazodone, Phenobarbital, Bentyl, Librium, and others. Medical aspects of detoxification may last up to 10 days before patients become medically stable. However, psychological symptoms and intermittent cravings can continue for some time and require additional treatment to subside.
After medical detoxification, the next phase of treatment may include small group therapy sessions, individual sessions, educational seminars, and workshops. To assist with calming the body and the mind, classes for mindful meditation, yoga, progressive relaxation, and other therapeutic techniques may be provided during treatment. To ensure a long-term recovery from kratom use, patients are offered wellness seminars and life skills workshops which focus on developing a balanced lifestyle that includes healthy habits, physical exercise, sober recreational activities, and building supportive relationships.
Recovery Centers of America also offers Medically-Assisted Treatment options such as buprenorphine to treat opioid addiction and withdrawal. Buprenorphine was shown to be an effective treatment for kratom addiction and withdrawal by a 2018 study published in the Journal of Addiction Medicine (Khazaeli et al., 2018).
Related Substance Guides
Understanding kratom’s effects and treatment options becomes clearer when compared with related substances:
- Prescription opioids – Traditional opioids share similar receptor activity with kratom
- Heroin – Illicit opioid with similar withdrawal patterns
- Fentanyl – Synthetic opioid often involved in polysubstance use
- Benzodiazepines – Sometimes used alongside kratom
Frequently Asked Questions
Is kratom an opioid?
Kratom is not classified as an opioid, but its active compounds (mitragynine and 7- hydroxymitragynine) act on opioid receptors in the brain. This produces opioid-like effects, including pain relief, euphoria, and potential for dependence and withdrawal.
Can you overdose on kratom?
Yes, although fatal kratom overdose is rare when used alone. The risk increases significantly when kratom is combined with other substances. Symptoms of kratom toxicity include seizures, liver damage, and respiratory issues.
Is kratom safe to use for opioid withdrawal?
Self-treating opioid withdrawal with kratom is not recommended. While some people use kratom to manage opioid withdrawal symptoms, this can lead to kratom dependence.
Medical supervision with FDA-approved medications like buprenorphine is safer and more effective.
How do I know if I’m addicted to kratom?
Signs of kratom addiction include needing increasing amounts for the same effect (tolerance), experiencing withdrawal symptoms when stopping, continued use despite negative consequences, and unsuccessful attempts to quit.
Does insurance cover kratom addiction treatment?
Most health insurance plans cover substance use disorder treatment, including kratom addiction. Recovery Centers of America is in-network with many major insurers.
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Sources
The abuse potential of kratom according the 8 factors of the controlled substances act:implications for regulation and research – Henningfield et al. (2017)
Kratom – National Institute on Drug Abuse
Treatment of Kratom Withdrawal and Addiction With Buprenorphine – Khazaeli, Azin MD; Jerry, Jason M. MD; Vazirian, Mohsen MD (2018)
On This Page:
- What is kratom?
- Where is kratom grown?
- What does kratom do?
- How is kratom used?
- How long before kratom kicks in and how long does it last?
- What are the side effects of kratom?
- Where is kratom illegal?
- How addictive is kratom and how long does it take to get addicted to it?
- What is kratom withdrawal?
- How long does kratom withdrawal last?
- How is kratom withdrawal treated and how can Recovery Centers of America help?
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