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How Addictive Is Kratom?

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Jan 22, 2024 • 10 cited sources

Kratom, known as Mitragyna speciosa, is a drug with both stimulant-like and opioid-like effects. It comes from a tropical tree in the coffee family, typically grown in Southeast Asia. 

Researchers say kratom has addictive properties, and some people who use the drug have classic symptoms of addiction, such as an inability to quit using the drug.[1]

Kratom production isn’t regulated by state or federal agencies, so it’s difficult to ensure drugs are pure before you use them. Any kratom dose could contain something dangerous and deadly, such as fentanyl.

What is Kratom?

The Mitragyna speciosa tree, native to Southeast Asia, is the source of kratom. Harvested berries can be transformed into pills, powders or teas for oral consumption. 

Kratom has many active ingredients, and the most well-studied ones are mitragynine and 7-hydroxymitragynine.

It’s difficult to predict how taking kratom might change your body. Some people feel energized, while others feel sleepy or euphoric. It is a unique substance in that it produces both stimulant-like and opioid-like effects. People may misuse it to get high while others may use it to self-medicate opioid withdrawal symptoms.

Kratom’s Legal Status

Experts believe kratom is dangerous. In 2018, the U.S. Department of Health and Human Services recommended a federal ban on kratom and kratom-like products.[2] That ban wasn’t implemented, meaning kratom is still legal at the federal level, but some states have passed laws making distribution or use illegal. 

The DEA has also listed kratom as a Drug and Chemical of Concern, which means they recognize its harms but have not yet scheduled it.[9]

In states where kratom is legal, you could find it in gas stations, head shops and drug stores. Some people get past state bans via online purchases, buying kratom labeled for aromatherapy or soap making. This lack of regulation means you never really know what you are getting when you purchase it. 

Why Do People Use Kratom?

For hundreds of years, people have used kratom as a cough, cold or diarrhea therapy. Today, people cite different reasons for their drug use. 

In a study of more than 8,000 people who use kratom, about 80% said they felt decreased pain, a mood boost and more energy when they used the drug. But about half used kratom to stop or reduce their opioid use.[3]

In online chat forums, people claim that using kratom eases opioid withdrawal symptoms like diarrhea and muscle aches, helping them detox more easily.

However, kratom isn’t approved by the Food and Drug Administration (FDA) for the treatment of opioid withdrawal. Fortunately, drugs like Suboxone are approved, safe and effective ways to treat the symptoms of opioid use disorder (OUD), including withdrawal symptoms and cravings.

Kratom Side Effects 

People taking kratom can experience a wide variety of side effects, especially if they’re using contaminated doses. 

Researchers say common kratom side effects include the following:[1],[4]

  • Anorexia 
  • Constipation
  • Drowsiness
  • Dizziness
  • Dry mouth
  • Fast heart rate
  • Increasing urination
  • Itching 
  • Nausea
  • Sweating
  • Vomiting
  • Confusion
  • Tremors
  • Liver problems

Some people using kratom have experienced severe side effects, such as seizures. [1]

What is the Addiction Potential of Kratom?

Kratom contains two compounds (mitragynine and 7-hydroxymitragynine) that work on brain receptors associated with substance use disorders.[1] At the chemical level, kratom works somewhat like other addictive drugs, such as heroin. 

Drugs like kratom attach to opioid receptors and trigger effects like euphoria, pain-relief and increased energy. These pleasurable effects can lead to repeated kratom use, which can cause dependence, withdrawal symptoms and addiction.

Researchers say natural forms of kratom are associated with lower addiction symptoms. But modern drug laboratories extract potent chemicals, making doses stronger and much more powerful.[5] That potency could increase the risk of dependence and addiction.

Why is Kratom Addictive?

Quick Answer

Two known addictive compounds in kratom are mitragynine and 7-hydroxymitragynine. Some medical experts are concerned about kratom’s misuse and addiction potential because these compounds activate opioid receptors in the brain—although kratom is generally considered far less addictive than opioids like heroin, fentanyl and oxycodone. However, the latest research shows that mitragynine doesn’t have misuse potential and reduces the rewarding effects of morphine while 7-hydroxymitragynine has addiction potential and has been shown to increase morphine self-administration in mice.[8]

Comparing Kratom’s Addiction Potential to Other Substances

Although kratom does appear to have some addiction potential, it is far less addictive than opioids like prescription painkillers and heroin. [10]

Research shows that mitragynine, one of the two best-studied compounds in kratom, has low abuse potential compared to opioids, stimulants and other drugs of misuse. [10]

That said, 7-hydroxymitragynine, which is in kratom, has higher misuse potential than mitragynine. It may also increase the use of other opioids.[8] 

Signs of Kratom Addiction

Kratom use disorder is characterized by compulsive use despite negative consequences. Kratom addiction is a complex and multi-faceted brain disease and medical condition.

Signs of a kratom addiction can include the following:[7]

  • Failing to reduce or quit kratom use
  • Using higher or more frequent doses than intended
  • Experience strong cravings
  • Using kratom in hazardous situations
  • Using kratom results in inability to fulfill obligations at home, school or work
  • Using kratom despite psychological or physical health issues caused or worsened by use
  • Using kratom despite interpersonal or social problems caused or worsened by use
  • Neglecting previously enjoyed hobbies in favor of kratom use
  • Spending an excessive amount of time obtaining and using kratom
  • Needing higher doses to feel the desired effects (tolerance)
  • Experiencing kratom withdrawal symptoms when you abruptly stop using (dependence)

Some people with kratom addiction are adept at hiding their symptoms, making spotting the problem more difficult. But as the addiction grows stronger, the symptoms become tougher to hide.

Kratom Addiction Treatment

There are no approved therapy options for people with kratom addiction.[1] While doctors understand how to treat substance use disorders related to opioids like heroin, kratom remains a gray area. 

Experts recommend Medication for Addiction Treatment for people with kratom misuse issues.[6] Medications like Suboxone combined with therapy can help people stop misusing drugs and maintain a sober life. 

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

Sources
  1. Kratom. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/kratom. March 2022. Accessed March 2023. 
  2. HHS Recommended That the DEA Make Kratom a Schedule I Drug, Like LSD or Heroin. Stat. https://www.statnews.com/2018/11/09/hhs-recommended-dea-ban-kratom-documents-show/. November 2018. Accessed March 2023. 
  3. Patterns of kratom use and health impact in the US—results from an online survey. Drug and Alcohol Dependence. https://www.sciencedirect.com/science/article/pii/S0376871617301825. July 2017. Accessed March 2023. 
  4. Kratom. U.S. Department of Justice. https://www.dea.gov/sites/default/files/2020-06/Kratom-2020_0.pdf. April 2020. Accessed March 2023. 
  5. Kratom Addiction Potential and Legal Status. Neuropathology of Drug Addictions and Substance Misuse. https://www.sciencedirect.com/science/article/pii/B9780128006344000895. 2016. Accessed March 2023. 
  6. Best Practices in Managing Patients with Kratom Addiction. Providers Clinical Support System. https://pcssnow.org/wp-content/uploads/2020/09/KRATOM-webinar-PCSS-2020-final-version-9.28.20-1.pdf. October 2020. Accessed March 2023.
  7. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
  8. Abuse liability and therapeutic potential of the Mitragyna speciosa (kratom) alkaloids mitragynine and 7-hydroxymitragynine. Addiction Biology. https://doi.org/10.1111/adb.12639. 2019. Accessed January 2024.
  9. Kratom Regulation: Federal Status and State Approaches. Congressional Research Service. https://crsreports.congress.gov/product/pdf/LSB/LSB11082#. November 2023. Accessed January 2024.
  10. Kratom Abuse Potential 2021: An Updated Eight Factor Analysis. Front Pharmacol. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8860177/#. 2022. Accessed January 2024.

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