Kratom for opioid withdrawal: Does it work?
Kratom is promoted as an aid in overcoming withdrawal from opioid medications, but research suggests that it leads to more health problems than it solves.
If you take pain medications such as oxycodone (OxyContin, Roxicodone) for a long time, your body becomes used to these drugs and dependence may develop. If you become dependent, you may experience unpleasant physical signs and symptoms — such as sweating, trembling and cravings — when you stop taking these medications. This process is called withdrawal, and it may last for several days to weeks.
Because withdrawal can be unpleasant, many people look for ways to ease their symptoms. Getting extra rest or doing things that are distracting, such as watching TV, helps some people during withdrawal. Other people take medications or substances to try to reduce their symptoms.
Kratom, an herbal extract from the leaves of an evergreen tree (Mitragyna speciosa) that grows in Southeast Asia, is one substance that is promoted as a treatment for withdrawal. Kratom is sold as a dietary supplement and is not currently regulated in the United States, but federal agencies are taking action to combat false claims about kratom.
In Asia, people have used kratom in small amounts to reduce fatigue or treat opium addiction. In other parts of the world, people take kratom to ease withdrawal, feel more energetic, relieve pain, or reduce anxiety or depression. People take kratom to ease withdrawal because kratom evokes feelings of euphoria and may be obtained more easily than drugs prescribed for withdrawal.
Natural, but not safe
Because kratom may ease withdrawal symptoms, researchers have studied it as a potential treatment. The evidence suggests that rather than treating addiction and withdrawal, the use of kratom may lead to them.
In one study, people who took kratom for more than six months experienced withdrawal symptoms similar to those that occur after opioid use. Over time, people who use kratom may develop cravings for it and need the same medications that are used to treat opioid addiction, such as buprenorphine (Buprenex) and naloxone (Narcan, Evzio). When kratom is used during pregnancy, the infant may experience symptoms of withdrawal after birth.
As with pain medications and recreational drugs, it is possible to overdose on kratom. The treatment for kratom overdose is similar to that for opioid overdose, and people experience many of the same treatment problems. Kratom has caused at least 36 deaths. Although people may enjoy the good feelings that kratom can produce, kratom has not proved to be an effective treatment for opioid withdrawal.
April 25, 2019
- Chang-Chien GC, et al. Is kratom the new 'legal high' on the block?: The case of an emerging opioid receptor agonist with substance abuse potential. Pain Physician. 2017;20:E195.
- Voelker R. Crackdown on false claims to ease opioid withdrawal symptoms. JAMA. 2018;319:857.
- Kruegel AC, et al. The medicinal chemistry and neuropharmacology of kratom: A preliminary discussion of a promising medicinal plant and analysis of its potential for abuse. Neuropharmacology. In press. Accessed May 2, 2018.
- Grundmann O. Patterns of kratom use and health impact in the US — Results from an online survey. Drug and Alcohol Dependence. 2017;176:63.
- Smith KE, et al. Prevalence and motivations for kratom use in a sample of substance users enrolled in a residential treatment program. Drug and Alcohol Dependence. 2017;180:340.
- Swogger MT, et al. Experiences of kratom users: A qualitative analysis. Journal of Psychoactive Drugs. 2015;47:360.
- Diep J, et al. Kratom, an emerging drug of abuse: A case report of overdose and management of withdrawal. Anesthesia & Analgesia Case Reports. In press. Accessed May 2, 2018.
- Singh D, et al. Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and cravings in regular users. Drug and Alcohol Dependence. 2014;139:132.
- Swogger MT, et al. Kratom use and mental health: A systematic review. Drug and Alcohol Dependence. 2018;183:134.
- Pizarro-Osilla C. Introducing ... kratom. Journal of Emergency Nursing. 2017;43:373.
- Feng L, et al. New psychoactive substances of natural origin: A brief review. Journal of Food and Drug Analysis. 2017;25:461.
- Statement from FDA Commissioner Scott Gottlieb, M.D. on FDA advisory about deadly risks associated with kratom. U.S. Food and Drug Administration. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm584970.htm. Accessed April 17, 2018.
- Statement from FDA Commissioner Scott Gottlieb, M.D., on the agency's scientific evidence on the presence of opioid compounds in kratom, underscoring its potential for abuse. U.S. Food and Drug Administration. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm595622.htm. Accessed April 17, 2018.