Kratom as an opioid addiction treatment: Benefits and limitations

Kratom as an opioid addiction treatment: Benefits and limitations

Kratom is a plant that is widely used in the southeast part of Asia. It has been known for centuries as a remedy to relieve pain and stimulate cognitive processes. Today it is becoming more and more popular throughout the world as an opioid agonist.

What is kratom

Kratom (or Mitragyna speciosa) is an evergreen tree. It belongs to the same family as the coffee tree and some other psychoactive plants. Kratom leaves have been used for a while by laborers and farmers who seek anesthetic and stimulating effect. People can chew, smoke, grind into powder, or prepare Kratom as an infusion. This can boost a worker’s energy because it is a natural stimulator when used in low doses.

Higher doses of kratom can bring the feeling of euphoria and relieve pain. This is because, pharmacologically, kratom acts on specific receptors in a manner similar to substances such as narcotics and yohimbine.The effect is, however, weaker and subtler. These medicine properties permit kratom to be a part of drug rehabilitation programs (find out more).

Although structurally related to yohimbine and other tryptamines, its pharmacology is quite different as it acts primarily as a μ-opiate receptor agonist. It contains many alkaloids, including mitragynine (formerly thought to be the principal active ingredient), mitraphylline and 7-hydroxymitragynine (which is the main active chemical in this plant). In other words, it is structurally different from opioid drugs, but it is able to stimulate the same receptors in a person’s brain as opioids.

How does it help to fight opioid withdrawal symptoms?

Its ability to mitigate withdrawal discomfort in individuals with narcotic addiction stems from two factors. These are the agonism of the μ-receptor by mitragynine and 7-hydroxymitragynine. As it is impossible to get the prescription in drug rehab facilities,  former drug users tend to order it online. Manufacturers sell it in the US and Europe as pressed capsules containing powdered leaf.

Although it is relatively potent by dose, the strong euphoric effect is not its characteristic. The euphoric phase quickly gives way to a sedative phase that does not provide enjoyment, unlike drugs like codeine. On the other hand, sedation relaxes the muscles which relieves a person during the period of abstinence.

Some sources suggest that kratom’s analgesic effect is similar to less potent narcotics such as codeine. However, the ‘hardness’ or ‘softness’ of a drug does not depend on the strength of its effects but is reflected in the cravings that arise after consumption. If it causes sedation, it is quite neutral regarding pleasure. Compared to the state induced by opiates, kratom does not elicit colorful dreams or create the impression of traveling. This is in contrast to how drugs typically behave.

It has a stimulating activity similar to that of Yohimbe and an immunostimulatory activity identical to that of Uncaria. The effects of kratom vary according to its origin. Bali kratom tends to be the most sedative, while Thai kratom is more stimulating. The euphoric effect of kratom typically fades in less than an hour, making it relatively short-lived. This allows for a subsequent sedation period lasting five to six hours. Some people may experience nausea or vomiting after consuming a kratom infusion. This can happen due to its extremely bitter taste, which cannot be masked, or due to taking a dose exceeding 10 grams.

Advantages of kratom

The advantage of kratom is that it is legal in most countries of the world, and it is said to be one of the safest means capable of eliminating withdrawal symptoms. There are currently many reports of the successful use of kratom for detoxification. Using kratom for these purposes may not yield the expected benefits and can even be harmful in uncontrolled and prolonged use. Kratom, although potentially safe and effective, is unlikely to be beneficial with uncontrolled and prolonged use. To date, no clinic officially uses kratom in the treatment of its patients, despite its potential in treating drug addiction.

It is likely to provide a large number of medicinal uses, for example, a mild analgesic comparable to codeine or propoxyphene. It could also serve as an alternative to methadone, being cheaper and much safer. Farmers grow this plant in Asia and then export it to other countries. Individuals suffering from chronic pain and fibromyalgia use it.

The metabolic effects of kratom leaves consist in boosting one’s immune system and increase energy. The 2009 research studying various alkaloids proves kratom to be effective against multiple causative agents. Those who have Chronic Fatigue Syndrome find kratom to be a natural solution to the lack of energy.

Less known characteristics of kratom include increasing of libido and decreasing of appetite.

The most controversial advantage of kratom is, indeed, its psychotic effect. It may represent a solution for patients who want to reduce anxiety, depression symptoms, mood swings, insomnia, sooth their nerves. The main reason is that this plant is capable of releasing the hormones controlling our mood: serotonin and endorphins. The same effect applies to people suffering from attention disorders. Kratom increases motivation and focus.

Adverse effects of kratom

There is no denying that kratom has its side effects and its safety is for the moment controversial. Continuous use of this plant can lead to the phenomenon known as ‘kratom hangover.’ This state is characterized by hallucinations, paranoia, nausea, and vomiting. Users of kratom can experience adverse effects such as liver dysfunction, seizures, hypothyroidism, hypertension, constipation, and lung and heart damage.

There is no way one could ask for kratom in a rehab center. In 2017, Food and Drug Administration of the United States of America made a press announcement that kratom is unsafe and caused 36 deaths. The same document reports a ten-fold increase in calls related to poisoning by products which contain kratom to poison control centers during the period from 2010 to 2015. Most kratom users connect this to treating their symptoms without consulting professional healthcare providers. Indeed, many conditions, from Chronic Pain Disorder to depression, require confirmation and monitoring by a specialist. However, kratom advocates use the substance according to their proper treatment plans. Kratom also contributes to the opioid crisis in the United States of America.

Case reports published online link the intentional use of products containing kratom to severe withdrawal symptoms. This leads some people to seek rehab for kratom addiction. If enough evidence exists to prove it, authorities should classify kratom as a drug itself. Researchers have limited scientific data on the effects of kratom.

Dependent users of kratom report experiencing various withdrawal symptoms. These include muscle pain, headache, arrhythmia, irritability, sweating, nausea, vomiting, diarrhea, anxiety, difficulty falling asleep, tremors, among others.

Addiction to kratom

The use of kratom is likely to lead to habituation, and those who use it can regularly experience withdrawal syndromes when they stop to do it. Some daily consumers of kratom report the appearance of minor inconveniences, comparable to those induced by deprivation of coffee: nervousness, agitation, or, on the contrary, lack of energy. Defenders of kratom use often claim that this tree is of the same family as coffee which means that it is no more harmful than the aforecited beverage.

However, it does not appear that researchers have truly established this fact. Researchers have not conducted long-term human studies, so we must extrapolate any evaluation of kratom’s long-term consequences from animal studies and a small number of reports by anthropologists.

Getting help

As in any case of oral opioid poisoning, after recent ingestion (less than an hour) gastrointestinal decontamination with activated charcoal is recommended. Studies in animals have shown conflicting results on the efficacy of opioid antagonists such as naloxone in reversing the effects of Mitragyna speciosa. Considering the safety profile and potential benefits of naloxone in the emergency setting, healthcare providers should consider administering this antidote to patients with respiratory depression following the use of Mitragyna speciosa, in addition to providing usual support.

Persons suffering from withdrawal symptoms can follow a drug detox program in special drug rehab facilities. During withdrawal treatment, the medical staff is able to cope with effects that represent a medical risk for a patient (for example, high blood pressure).

Since dependence on kratom is not studied enough, there is no specific detox program for this kind of addiction. Medications that are used to treat withdrawal symptoms are the same applied to treat addiction from an opiate. They include dihydrocodeine (a semi-synthetic opioid analgesic much weaker in comparison with other opioids) and lofexidine (a non-opioid). After successful withdrawal from kratom, drug counseling professionals help patients to recover to the fullest.

All in all, more scientific evidence is needed to rate kratom’s benefits and limitations. Though governments tend to ban this plant, there are numerous personal stories which might prove that kratom is efficient such conditions as pain and withdrawal symptoms. Further research will permit to prevent kratom-related poisoning and deaths, and elaborate treatment plans for people addicted to it.


  1. Drugs of Abuse. A DEA Resource Guide. 2017 Edition
  2. World Drug Report 2013. United Nations Office on Drugs and Crime
  3. “The Benefits of Kratom, and Risks of Kratom Extracts, From the People Who Use the Botanical Medicine.” Forbes
  4. Finding the Best Alcohol and Drug Treatment Programs: A Complete Guide. Addiction Resource

About the Author

Thanush Poulsen is a Danish blogger who closely investigates the problem of addiction. His works aim to increase people’s awareness of addiction as a rapidly rising threat for the public health.

Also read our blog on Piperine

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