Kratom Withdrawal: The Opioid-Like Effects of Mitragyna Speciosa

by Elliot Reimers, M.S.(C), CISSN, CNC | Reviewed by Advisory Board

kratom withdrawal symptoms

Kratom Withdrawal Symptoms, Side Effects, and Potential Drawbacks

Kratom (Mitragyna speciosa) is a “new-age” herbal remedy that’s growing rapidly in use among the general population. However, at the time of writing this article, there is a paucity of well-controlled published studies examining the effects of kratom in humans. Although, there is considerable evidence that kratom and isolated constituents of Mitragyna speciosa have therapeutic properties in other animals [1].

Using kratom appears to induce analgesia (i.e. it's a painkiller), making it appealing for treating muscle aches and chronic pain. Interestingly, kratom is a stimulant in low doses, but a sedative in higher doses. Many kratom users also report euphoria when taking high doses.

As such, kratom is somewhat like a natural opiate alternative. Sounds awesome, right? Not so fast; kratom, much like phenibut, is another nootropic that carries a high risk of substance abuse and consequent withdrawal symptoms. 

Kratom Use: A Brief Overview

The term “kratom” refers to the leaves of Mitragyna speciosa, a tree indigenous to Thailand (and other countries in Southeast Asia). Kratom has been used for centuries in these regions for its purported opioid-like properties and mild stimulatory effects [2].

Traditionally, kratom users would simply consume fresh leaves of Mitragyna speciosa (or use them to make kratom tea). Unfortunately, it’s an arduous task trying to obtain fresh kratom leaves if you’re not living in regions where the tree natively grows.

However, dried kratom leaf and kratom extract retain potency and are now readily available on a myriad of websites, and even at some health food stores. Dried kratom leaf can be brewed into a tea, refined into an extract for tinctures or capsules, or even smoked or vaporized (although smoking kratom yields unremarkable effects).

For the vast majority of kratom users (especially newbies), supplementing with full-spectrum kratom extract in capsule form is ideal. Doing so makes it easier to track dosage and potency.

Making fresh kratom tea from dried leaves is another practical method of using the herb, but it is far from tasty. Nevertheless, quite a few "kratom bars" are popping up across the United States, South America, and Europe.

How Does Kratom Work?

While kratom users have heard much about mitragynine, 7-hydroxymitragynine, speciogynine, and paynantheine, the role of the other 40+ alkaloids in Mitrogyna speciosa has been relegated to the background. The benefits of kratom are ostensibly a result of the synergy among these alkaloids [3].

Kratom alkaloids like mitragynine, 7-hydroxymitragynine, and mitraphylline are structurally similar to hallucinogenic tryptamines found in "magic mushrooms" and lysergic acid diethylamide (LSD, or "acid"). At low doses, these alkaloids are thought to act on the adrenergic system (the same sets of receptors that respond to adrenaline & noradrenaline), imparting a stimulatory effect comparable to a strong dose of caffeine [4].

At more modest doses these alkaloids begin to activate opioid receptors [5]. These are the same group of receptors that prescription opiates, such as morphine and codeine, act on to produce analgesia, euphoria, and sedation. In fact, medicinal chemistry research suggests that 7-hydroxymitragynine is upwards of 17 times more potent than morphine at activating opioid receptors [6].

Naturally, kratom is thought to be a practical herbal remedy for treating opiate addiction. Ironically, that presumption has engendered a crisis of kratom abuse.

Like traditional opioid drugs, kratom is addictive [7]. The withdrawal symptoms associated with kratom use can be quite harsh (resembling those of opioid withdrawal). In severe cases, kratom users may need to consider substance abuse treatment facilities.

Kratom Benefits and Risks

The benefits of kratom use largely depend on an individual's history of using stimulants and opioid-like substances, and dosage. To reiterate, the major bioactive compounds found in kratom leaves stimulate the central nervous system at lower doses, while sedating the mind and body at higher doses. Modest doses of kratom also produce considerable opioid-like effects.

While kratom may help treat chronic pain and opioid withdrawal symptoms, and provide a momentary mental "lift," its addictive properties come with a consequence: kratom withdrawal. Using kratom daily is generally inadvisable for that reason.

Much like any stimulant or opiate, the more you take kratom, the higher the dose you need to provoke the desired effects. Consequently, chronic use will make the symptoms of kratom withdrawal even more severe. Ultimately, that all feeds into a self-sustaining vicious cycle of using kratom more frequently (and in larger doses) to counteract the withdrawal.

Kratom and Mental Health

There is currently very limited clinical research available describing the effects, let alone benefits, of kratom use in humans with anxiety and other mental health conditions [8]. Meanwhile, anecdotal reports suggest paradoxical results in people who use kratom for mental health. 

At lower doses of kratom (e.g. 1-5 grams per day), some users note that the stimulatory effects actually increase their anxiety and cause a sense of irritability. In higher amounts, kratom may produce euphoric, calming, and analgesic effects in people with anxiety. Curiously, modest doses of kratom lead to dysphoria in some instances. 

Be wary that your response to kratom may be highly variable from what someone else experiences. 

Kratom Dosage and Toxicity

Effective kratom dosage is highly individual. The best thing to do is start off with a low dose and increase it by small increments each time you use kratom until you find a "sweet spot." However, we can't advise taking kratom until there's more concrete evidence that it's safe.

As a general guideline, here are the dose ranges for kratom:

  • Low (1 – 5 grams) --> mild stimulatory effects
  • Moderate (6 – 15 grams) --> stimulation that likely progresses to analgesia and sedation
  • High (16 – 25 grams) --> potent analgesia, sedation, and euphoria
  • Very high (26 – 50 grams) --> peak analgesia, sedation, and euphoria

Kratom toxicity is quite rare, but there have been reports of individuals experiencing seizures and psychosis when chronically using more than 15 grams of kratom per day [9]. In extreme cases, kratom abuse can be lethal [10].

Realistically, doses above 15 grams are superfluous for the majority of people. Exercise extreme caution before taking more than 25 grams of kratom, especially if you haven’t used it before.

Kratom Withdrawal Symptoms and Substance Abuse

A pressing question that remains controversial is, "How addictive is kratom?" Several anecdotal reports propose that it might be less addictive than traditional opioids, but there is also a wide range of reports intimating the opposite.

In Southeast Asia, people are aware that kratom abuse is more than just a phenomenon. Regardless, that hasn't stopped cultures from consuming kratom for its euphoric and mind-altering effects.

But as time evolves, reports of kratom withdrawal continue to unsettle regulatory bodies and scientists alike [11]. The symptoms of kratom withdrawal are comparable to those of prescription opioid withdrawal. Such symptoms may include:

  • irritability
  • diarrhea
  • dysphoria
  • mood swings
  • vomiting
  • sleep disorders
  • hypertension (high blood pressure)
  • excessive yawning
  • muscle aches
  • joint pain. 

As kratom use has broadened to Europe and the United States, more people are becoming physically or psychologically dependent on this proverbial "herbal opioid." Alas, the opioid-like effects associated with kratom can be quite addictive; and once you become dependent on kratom, withdrawal is inevitable.




Elliot Reimers, M.S.(C), CISSN, CNC
Elliot Reimers, M.S.(C), CISSN, CNC

Author

Elliot holds a B.S. in Biological Sciences from the University of Minnesota, as well as being a Certified Sports Nutritionist (CISSN) and Certified Nutrition Coach (CNC). He is currently pursuing a Master's of Science in Molecular Pharmacology and Toxicology at Michigan State University. Elliot began freelance writing circa 2012 and has since written 100s of articles and several eBooks pertaining to nutritional science, dietary supplements, exercise physiology, and health/wellness. Being a “science whiz,” he has a passion for helping people understand how nutrients (and other chemicals) and exercise work on a cellular and molecular level so they can make smarter choices about what they put in, and do with, their bodies. When Elliot is not busy writing or studying, you can find him pumping iron, hiking the mountains of beautiful Colorado, or perusing nutraceutical research.



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