Signs, Symptoms, and Treatments

Kratom (mitragyna speciosa) is a tropical evergreen tree native to Southeast Asia including Thailand, Indonesia, Malaysia and Papua New Guinea. The leaves contain chemical compounds called mitragynine and 7-hydroxymitragynine, which interact with the same receptors in the brain as opioids, though kratom is not chemically classified as an opioid.[1]

In the United States, kratom is most often sold as a powder, capsule, tablet, liquid extract, or tea, frequently marketed as a dietary supplement, herbal remedy, or natural alternative for energy, pain, anxiety, or opioid withdrawal. Kratom is also known by several regional names, including ketum, thom, kakuam, and biak, particularly in Southeast Asia, where the plant originates.[2] Despite its natural plant origin, kratom is not recognized by the U.S. Food and Drug Administration as a pharmaceutical for any medical purpose, and the FDA has released several warnings about kratom’s safety concerns, including liver toxicity, seizures, and dependence.

The Drug Enforcement Administration (DEA) has listed kratom as a Drug and Chemical of Concern, meaning it is not federally scheduled but will be monitored for its abuse potential.[3] Since kratom products are not regulated the way medications are, the actual amount of active ingredients can vary widely from one product to another, which adds another layer of risk for anyone using it regularly.

Part of what makes kratom unique and confusing is that its effects depend heavily on the dose. At lower doses, kratom produces stimulating effects such as increased energy, alertness, and sociability; higher doses create effects more like opioids, including sedation, feelings of euphoria, and pain relief.[4] 

The opioid-like effects occur because mitragynine and 7-hydroxymitragynine bind to mu-opioid receptors in the brain, the same receptors affected by opioids like morphine and oxycodone.[5] That is the main reason kratom can cause dependence, withdrawal, and addictive patterns of use that look like those seen with opioids.

Many people first reach for kratom out of genuine pain or a desire to manage other addictions. Dependence is not a moral failing; it is a physiological response to a substance that acts powerfully on the brain.

Signs of kratom addiction can be particularly difficult to recognize since kratom is often considered completely harmless. Many people begin using kratom openly and slowly fall into a cycle of dependency before realizing it. Friends and family members may see signs of kratom use before the user recognizes a problem.[6]

Signs of kratom addiction include:

• Using kratom in larger amounts or more frequently than intended
• A need to consume higher doses or more often
• Spending a significant amount of money on kratom
• Stockpiling kratom or feeling anxious when supply runs low
• Gastrointestinal problems such as constipation, nausea, reduced appetite, or unexplained weight loss
• Dry mouth, excessive urinating, sweating, or itching
• Mood swings, restlessness, irritability
• Feeling drowsy, slower reactions, or appearing sedated
• Struggling to cut down or stop using kratom despite wanting to
• Withdrawing from family, friends, work, or social activities for the sake of using kratom
• Continuing to use kratom despite negative consequences on overall health, work, and relationships

If you notice several of these signs in yourself or a loved one, consider contacting a treatment professional for guidance. Asking questions early is a caring, non-judgmental first step in identifying what’s happening and finding necessary treatment.

Kratom tolerance can develop rapidly. Tolerance occurs when an individual’s body adapts to a substance, so dosages that once produced desired effects no longer have the same response, so the individual must consume more to get the same results.[7] Over time, tolerance often slides into physical dependence.

The brain begins to rely on kratom and needs it for normal functioning, including sleep regulation, mood control, and pain modulation. At that point, missing a dose can lead to clear withdrawal symptoms, even if the person never thought of themselves as addicted.

Multiple factors contribute to kratom dependence, including daily consumption, high doses, combining kratom with other substances like alcohol or opioids, a personal or family history of substance use disorders, and untreated mental health conditions such as anxiety, depression, or trauma. Since kratom products vary widely in potency, two people taking the same brand or label may have very different experiences and risks.[8]

When someone develops a dependence on kratom and then stops using it, or drastically reduces the amount they take, they will likely experience withdrawal symptoms similar to those seen in opioid withdrawal, though generally less severe.[9]

Some common symptoms associated with withdrawing from kratom may include:

• Muscle aches and joint pain
• Disrupted sleep or insomnia
• Anxiety, irritability, and mood swings
• Jittery or restless feelings
• Runny nose, watery eyes, and sweating
• Nausea, vomiting, and diarrhea
• Craving for kratom
• Chills and hot flashes

Although withdrawal from kratom itself does not generally pose a serious threat of death, it can be very unpleasant, and this can cause an individual to return to using. Those who use kratom with other substances or have pre-existing medical or mental health conditions may experience more complex withdrawals, making professional support highly beneficial.

Kratom is not a scheduled substance in the U.S., but its legality differs substantially across states, local cities, and towns. According to current publicly available data, kratom has been banned by law at the state level in Alabama, Arkansas, Indiana, Rhode Island, Vermont and Wisconsin, with some additional local bans in counties or municipalities in other states.[10] Several states have instead chosen to regulate kratom through what are known as Kratom Consumer Protection Acts, which set age limits and labeling or product standards rather than outright bans.

Please note that laws governing kratom are continually changing and local ordinances may differ from state-wide regulations. Since kratom laws can change, and because local rules sometimes differ from state ones, anyone with questions about the legal status of kratom in their specific area should check current local and state guidance. 

At Agape Detox Center, we provide comprehensive care for individuals struggling with kratom addiction and dependence. Our medical team evaluates each client’s history, symptoms, and overall health to develop an individualized treatment plan designed to promote comfort and safety throughout the recovery process. In addition to medical monitoring, clients have access to evidence-based therapies that address the behavioral, emotional, and psychological aspects of addiction. 

Because kratom use is often linked to underlying mental health concerns or other substance use issues, our team also provides integrated support for co-occurring conditions, helping clients build a strong foundation for long-term recovery.