Is Kratom Addictive? Understanding the Issue

Kratom, a tree native to Southeast Asia, has gained popularity in the United States and other parts of the world for its perceived medicinal properties. Often used for pain relief, opioid withdrawal, and as a natural remedy for various ailments, kratom’s rise has sparked a contentious debate about its addictive potential.

As more people begin to use kratom in its powder form or other kratom-derived products, concerns are mounting over whether this herbal substance is truly safe or if it may lead to kratom dependence, kratom addiction, and even substance use disorder.

This article explores the question: Is kratom addictive? We will examine current research, emerging evidence, and expert opinion, while providing insights into its pharmacology, regulation, and health implications.

What Is Kratom?

Kratom (Mitragyna speciosa) is a tree native to Southeast Asia, particularly in countries like Thailand, Indonesia, and Malaysia.[1] Traditionally, the kratom leaves were chewed or brewed into tea by local populations for their stimulant effect in low doses and pain relief in higher doses.

Kratom contains active alkaloids—primarily mitragynine and 7-hydroxymitragynine—which interact with the same receptors in the brain as opioids, particularly the mu-opioid receptors.

Despite its psychoactive properties, kratom is not an opioid in the traditional sense. However, its main kratom compounds bind to opioid receptors, leading to effects similar to opioids like morphine or hydrocodone. This pharmacological activity is what has raised concerns among medical professionals, researchers, and public health agencies.

How Kratom Affects the Brain

The psychoactive drugs in kratom act on various neurotransmitter systems. At low doses, kratom produces a stimulant effect, increasing alertness and energy. At higher doses, the effects shift to sedation, muscle pain relief, and euphoria—closely resembling traditional opioids. This dual action makes kratom unique but also contributes to its known addictive properties.

Over time, regular use can lead to physical dependence, as the body adjusts to the presence of kratom. When kratom is suddenly stopped after prolonged use, users may experience moderate withdrawal symptoms, similar to those seen in opioid withdrawal, including:[2]

• Irritability
• Insomnia
• Nausea
• Muscle aches
• Cravings
• Sweating
• Anxiety and depression

What the Science Says: Is Kratom Addictive?

According to the National Institute on Drug Abuse (NIDA), there is increasing concern about kratom’s addictive potential, though the exact prevalence of kratom addiction remains unclear due to limited robust clinical trials.[1]

A 2021 kratom report from the U.S. Food and Drug Administration (FDA) noted that the herb has led to negative consequences in a growing number of cases, including dependency and addiction.[3]

In the United States, kratom is not federally scheduled as a controlled substance, but the Drug Enforcement Administration (DEA) has listed it as a “drug of concern.”[4] Some states have independently banned its sale or use.

Data from the Substance Abuse and Mental Health Services Administration (SAMHSA) show an increase in kratom exposures reported to poison control centers—from 13 in 2011 to over 1,800 in 2019.[5] This sharp rise suggests that kratom is increasingly being used in ways that could lead to drug abuse or substance use disorder.

Kratom Use Disorder: Diagnostic Criteria

Kratom is not explicitly mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which outlines the specific diagnostic criteria for substance use disorder. However, if someone experiences compulsive substance use, develops tolerance, experiences withdrawal symptoms, and continues using despite negative consequences, they may meet the criteria for kratom use disorder.

The American Psychiatric Association recognizes that non-traditional substances, including herbal ones like kratom, can lead to mental health conditions and substance abuse patterns consistent with addiction. Clinicians are increasingly treating individuals who use kratom heavily and develop dependency symptoms.

Who Uses Kratom and Why?

Many kratom users are seeking alternatives to prescription medications. People who use kratom might consume the drug to manage:

• Chronic pain
• Opioid withdrawal
• Mental health issues such as anxiety and depression
• Energy enhancement and increased focus

Unfortunately, the same study found that around 30% of users experienced some level of kratom withdrawal when they stopped using it, indicating kratom physical dependence.[6]

Kratom and the Opioid Epidemic

One reason kratom has gained attention is its potential role in combating the opioid epidemic. Some advocates argue that kratom may offer a safer alternative to prescription opioids, especially for individuals struggling with opioid addiction or opioid use disorder. Indeed, kratom’s ability to interact with opioid receptors makes it potentially useful for opiate withdrawal.

However, this substitution may not be without risks. Using kratom in place of opioids may simply replace one dependency with another, particularly if used in higher doses or over long periods. Addiction treatment professionals caution that kratom is not a cure for opioid addiction and should not replace established therapies such as medication-assisted treatment (MAT).

Risks, Drug Interactions, and Regulation

Kratom’s legal status remains controversial. As of 2023, the Food and Drug Administration (FDA) has not approved kratom for any medical use and has warned consumers of potential health risks. The agency also cautions against contamination in unregulated kratom products, including exposure to heavy metals, Salmonella, or other drug interactions when combined with other drugs or other substances such as alcohol, stimulants, or antidepressants.

Adverse reactions may include:

• High blood pressure
• Seizures
• Liver toxicity
• Hallucinations
• Mental disorders

These risks, combined with the absence of federal kratom regulation, make it difficult for medical professionals to recommend kratom safely.

Addiction Treatment and Support

If someone is struggling with kratom addiction, the approach to treatment is similar to other forms of substance use disorder. Options include:

• Addiction specialist consultation
• Behavioral therapy (CBT, DBT)
• Support groups
• Medication management (in some cases)
• Integrated treatment for co-occurring mental health conditions

Early intervention is key, especially when kratom regularly affects a person’s job, health, or relationships.

Find Help for Kratom Addiction

The answer is yes—kratom is addictive, though not for everyone. Like many psychoactive drugs, kratom carries the risk of physical dependence, tolerance, and withdrawal symptoms, particularly when used frequently or in higher doses. While it may offer short-term relief for chronic pain or opioid withdrawal, its use is not without serious potential consequences.

Until there are more robust clinical trials and clearer kratom regulation, medical experts advise caution. Those considering using kratom—whether for pain relief, mood enhancement, or opioid use reduction—should consult with a healthcare provider and be aware of its known addictive properties.

If you or a loved one suffers from kratom addiction, it’s time to seek professional help. At Flourishing Foundations Recovery, we can provide you with the support and tools you need to overcome addiction. Contact us today for more information on how we can help.

Frequently Asked Questions (FAQ)

1. Can kratom be detected in drug tests?

Standard drug tests like those used for employment or probation (e.g., 5-panel or 10-panel tests) typically do not detect kratom. However, specialized tests can identify kratom’s alkaloids, such as mitragynine and 7-hydroxymitragynine, if specifically requested. Detection windows vary but may range from 1 to 9 days depending on frequency of use and dosage.

2. Is it safe to combine kratom with alcohol or prescription medications?

No. Combining kratom with alcohol, antidepressants, benzodiazepines, or opioids increases the risk of dangerous drug interactions. These combinations can lead to respiratory depression, liver damage, seizures, or even fatal overdose. Always consult a healthcare provider before using kratom alongside any other drugs or medications.

3. Can kratom be used safely for long-term pain management?

Long-term use of kratom for chronic pain remains highly controversial. While some users report sustained relief, others develop kratom dependence or tolerance, requiring progressively higher doses. Without medical supervision, long-term use may lead to addiction and complicate the management of underlying pain conditions.

4. Is kratom safe to use during pregnancy or breastfeeding?

There is no evidence that kratom is safe for pregnant or breastfeeding individuals. In fact, case reports have documented neonatal withdrawal syndrome in infants exposed to kratom in utero. Due to the lack of safety data and potential for harm, kratom use is strongly discouraged during pregnancy and lactation.

5. Are there any approved medical uses for kratom in the U.S.?

As of now, the Food and Drug Administration (FDA) has not approved kratom for any medical use. It is not classified as a dietary supplement, nor is it recognized as a treatment for any health condition. Claims about its benefits remain unsupported by clinical practice guidelines and should be approached with caution.

6. Is there a difference between kratom strains (like red, green, or white)?

Kratom is often marketed in different “strains” (red vein, green vein, white vein), each claimed to have distinct effects—e.g., sedating, stimulating, or balanced. However, these classifications are largely anecdotal and not supported by scientific evidence. Potency and effect can vary significantly due to inconsistent sourcing and a lack of regulation.

References:

1. The National Institute on Drug Abuse (NIDA): Kratom
2. Science Direct: Kratom withdrawal: Discussions and conclusions of a scientific expert forum
3. The Food and Drug Administration (FDA): FDA and Kratom
4. The Drug Enforcement Administration (DEA): Kratom
5. Taylor and Francis Online: Kratom exposures reported to United States poison control centers: 2011–2017
6. Science Direct: Kratom addiction per DSM-5 SUD criteria, and kratom physical dependence: Insights from dosing amount versus frequency