Banned by the FDA for import as a “dietary supplement” from Southeast Asia and other regions of the world where it is indigenous and regularly used, kratom is a plant-based substance with mind-altering effects. Kratom comes from the leaves of the Mitragyna speciosa tree, which is related to the coffee plant. Active ingredients in kratom, 7-hydroxymitragynine and mitragynine, work to produce stimulant effects at low doses and sedative effects at higher doses, the National Institute on Drug Abuse (NIDA) reports.
Kratom, also called thom, ketum, biak-biak, herbal speedball, ithang, and kahuam, is ingested by chewing the leaves, brewing them into a tea or beverage, or swallowing them in the form of gel capsules. Kratom is relatively easy to obtain over the Internet and may be increasing in popularity in Western cultures.
Small amounts of kratom can cause higher energy levels, talkativeness, alertness, and increased sociability. In higher amounts, kratom may activate opioid receptors in the brain, dulling pain sensations and causing a euphoric and mellowing “high.”
The Drug Enforcement Administration (DEA) warns that regular use of kratom can be habit-forming and lead to addiction. Side effects of drug dependence include withdrawal symptoms that may be uncomfortable and optimally managed through a professional detox program.
Withdrawal Symptoms and Timeline
According to NPR, within the United States, kratom abuse is popular among individuals attempting to self-medicate pain sensations or those using it as a substitute for more powerful opioid drugs, like prescription narcotics or heroin, to combat opioid withdrawal.
Opioid addiction is a major public health concern in America, as the National Survey on Drug Use and Health (NSDUH) reports that nearly 2.5 million adults in the United States battled addiction to either prescription painkillers or to the illegal opioid drug heroin in 2014. Kratom may seem to temporarily manage opioid cravings and withdrawal side effects that can be intense by activating the same receptors in the brain. Kratom is not thought to activate them to the same extent, however, meaning the “high” is typically considered to be less extreme than that of other opioids. It does mean that the drug can cause dependence just like other opioids can, leading to its own set of withdrawal side effects that likely parallel opioid withdrawal symptoms.
Withdrawal symptoms may start as soon as a drug has processed itself out of the body. Since kratom has a half-life of around 3-4 hours, as published by the journal Biomed Research International, it is likely out of the system in about 6-8 hours, meaning that withdrawal can start.
As with most opioid drugs, kratom withdrawal likely begins with agitation, anxiety, sweating, a runny nose, watery eyes, insomnia, and muscle aches. After a day or two, symptoms progress to include;
- jerky movements
- heart palpitations and irregularities
- high blood pressure
- stomach cramps
- bone and joint pain
- muscle spasms
- weight loss and anorexia
- decreased sex drive
- aggression and hostility
- dilated pupils
- drug cravings
This is known as acute withdrawal, which involves the height of withdrawal symptoms, and can last for up to a week. After that point, insomnia, dysphoria (difficulties feeling pleasure), cravings, and mood disturbances can continue for several weeks or even months.
The Individual Nature of Kratom Withdrawal
The detox timeline and duration of withdrawal are not the same for everyone. In fact, it is a highly personal experience that can differ greatly from person to person. Some people may be able to stop using kratom more easily than others, for instance. There are several factors that can play a role in how significant, and how long, kratom withdrawal may be, including:
- Amount of kratom used at one time: The amount of kratom ingested in each dose can influence addiction. Regular high doses can result in a more intense withdrawal process.
- Length of time abusing kratom: The longer a person has been using the drug, the more difficult it may be to stop using it.
- Polydrug abuse: Kratom is often mixed with other substances (e.g., laced with opioids, consumed in a “4×100” solution mixed with cough syrup, or mixed with other drugs and/or alcohol). Combining drugs can complicate withdrawal and the detox process.
- Co-occurring mental health or medical conditions: Kratom may be often abused as a method to self-medicate pain sensations or combat opioid dependence. The presence of additional medical and/or mental health problems can make withdrawal symptoms more significant and require specialized care and attention during detox and treatment.
- Personal and/or family history of addiction: As a heritable disease, individuals with close family members who suffer from addiction may be more likely to also suffer from addiction and drug dependence. Similarly, a personal prior history of addiction can influence the detox timeline and withdrawal side effects as well.
- History of trauma or high levels of stress: Environmental factors, like previous incidents of trauma or chronic stress, can exacerbate withdrawal symptoms and potentially increase the duration of the process. A lack of a strong support system and negative influences in a person’s surroundings can also impact cravings and the ability to abstain from returning to drug use.
Kratom withdrawal can be minimized and side effects safely controlled through a medical detox program that takes into account all biological, genetic, and environmental factors during treatment. Medical detox can help to decrease the overall withdrawal timeline and make the entire process smoother and more manageable.
Detox from Kratom
Kratom acts on opioid receptors in the brain. With continued use, it can affect changes to brain chemistry and structure. This is what can make withdrawal so significant, as it can take time for the brain to rebuild itself to how it was previously. Both physical and psychological side effects during this time can be hard to manage without help.
Medical detox programs are relatively short in duration, about 5-7 days on average. They help individuals to restore a physical semblance of balance before continuing on with a complete drug addiction treatment program.
Medical detox programs use both pharmacological tools and supportive measures in order to accomplish this. Currently, there are no specific medications to aid in kratom detox, or for the treatment of kratom addiction; however, medications can still be helpful in managing specific symptoms of withdrawal. For example, insomnia may be treated with a sleep aid, depression and anxiety with mood stabilizers, and abdominal discomfort with gastrointestinal medications.
Aggression, hostility, and suicidal ideations are also potential side effects of kratom withdrawal. Medical detox provides a secure environment staffed by trained mental health professionals who work around the clock to ensure that all individuals remain safe and are not a danger to themselves or others. Vital signs and medical conditions or concerns are closely monitored during medical detox. Relapse, or a return to kratom use, can be prevented by the supportive care offered during medical detox.
Powerful withdrawal side effects and cravings can make it difficult to stop using kratom without help. Medical detox, followed by a comprehensive addiction treatment program, can help a person to become drug-free and stay that way.