Kratom Addiction: Signs and Side Effects of Kratom Abuse

Kratom (Mitragyna speciosa) comes from the leaves of a tropical evergreen plant native to Southeast Asia. Kratom rose to prominence as an herbal solution that is advertised as an energy booster, mood lifter, anxiety reducer, pain reliever, and remedy for opioid withdrawal symptoms.

Kratom is not classified as a federally controlled substance in the United States, so it is legal to buy, possess, or use kratom at the national level. However, the FDA has not approved kratom for any medical use due to its significant risks and considers it an unapproved dietary ingredient. Therefore, it is illegal to market kratom as a supplement or food additive.

In response to growing concerns about kratom abuse, addiction, and potential side effects, some states and localities have implemented regulations to control or restrict its availability. These regulations may include bans, reclassification of its active components as Schedule I substances, age restrictions, labeling requirements, and limits on specific concentrations.

There are several methods of using kratom. Users can chew the leaves, swallow dry leaves, drink a beverage brewed from the leaves, or consume an extract. It is valued as a natural stimulant and pain reliever, but many users fail to understand the significant risks and dangers of kratom.

Studies show that roughly 2 million people in the U.S. use kratom annually, and of those users, over a quarter (25.5%) meet the criteria for a substance use disorder (SUD), based on DSM-5 standards. Another study conducted in 2024 found that 55% of regular kratom users become dependent, with relapse rates following an attempt to quit reported as high as 78–83% at three months.

Recognizing the risks of Mitragyna speciosa abuse and taking action early is critical for improving outcomes and supporting recovery in users. However, the lack of federal regulations, along with kratom’s general reputation as a natural remedy, can make it hard for people to understand the high-risk and addictive nature of kratom.

In this article, we’ll discuss the causes, symptoms, and side effects of kratom abuse, and what to do if you or someone you love is struggling. For those seeking help, RehabNet offers a free, 24/7, confidential helpline that connects you with trusted treatment centers.

There is a common misconception that kratom is “safe” or “natural” because it comes from a plant and because it remains unregulated at the federal level. However, this is untrue. Like many natural remedies, kratom’s advertised benefits are balanced by significant drawbacks and dangers.

Kratom is a complex substance that has dual stimulant and sedative properties at different doses. Lower doses tend to create a stimulant effect, making users more alert and energetic. Higher doses can produce a sedative effect, with users reporting that it reduces pain and makes them feel calm and less anxious.

This dual nature is related to how Kratom interacts and works with opioid and other receptors in the brain. Kratom contains several active alkaloids, most notably mitragynine and 7-hydroxymitragynine, that bind to the μ-opioid (mu-opioid) receptors in the brain.

Unlike traditional opioids like morphine or heroin, mitragynine and 7-hydroxymitragynine act as partial agonists, meaning they activate the receptor to a lesser extent.

Mitragynine and 7-hydroxymitragynine also have additional mechanisms that act on other chemical systems of the brain, including serotonin, dopamine, norepinephrine, and kappa opioid receptors, which may contribute to kratom’s stimulant and mood-altering effects.

Euphoria from kratom and its pain relief effects can drive psychological and physical dependence. Many long-term users develop tolerance from prolonged use, contributing to the kratom dependence mechanism and leading to misuse and addiction.

Although neither is ideal, there are key clinical differences between kratom addiction and abuse. It is possible to engage in kratom misuse without progressing to addiction.

Kratom abuse refers to the misuse of kratom, such as taking it in higher doses, more frequently, or in riskier ways than intended. Signs of kratom abuse include, but are not limited to:

• Manic behavior such as being overly talkative, erratic, or aggressive
• Failure to uphold personal responsibilities due to use
• Preference for kratom use over previously enjoyed activities
• Investing significant time in obtaining, using, or recovering from kratom
• Using kratom in physically hazardous situations
• Using despite knowing it can cause problems
• Taking higher doses than intended or for longer periods than planned
• Using it recreationally, or combining it with other substances

Individuals abusing Kratom may not necessarily be addicted. If they can control their use and stop when they choose, even if stopping causes side effects or discomfort, this is a sign that misuse has not progressed to addiction.

Kratom addiction is a more advanced and severe stage of use characterized by compulsive use despite harm. It may include severe cravings and an inability to stop using despite attempts to quit.

Unfortunately, it’s relatively easy to progress from misuse to addiction. Studies show that roughly a quarter of kratom users fit the qualifications for a substance use disorder (SUD), many of whom began by using kratom recreationally.

Regular recreational use can lead to increased tolerance and dependence, which can cause users to escalate their dosage and frequency to avoid withdrawal symptoms. If use persists, users can develop psychological and behavioral symptoms that can cause cravings and compulsive drug-seeking behavior to become prominent.

For users experiencing addiction, attempts to quit may trigger withdrawal symptoms similar to opioid withdrawal, making recovery difficult without support. Relapse is common, and the cycle of abuse and addiction can repeat for years if it is not addressed through treatment.

Yes, Kratom can cause dependence, particularly in long-term users. One study showed that among experienced users with over 1 year of use, 66.7% met diagnostic criteria for SUD. Although many of these cases showed mild severity, any level of addiction is dangerous and disruptive.

Kratom’s dependence mechanisms work on two levels: physical and psychological.

• Physical dependence: This form of dependence refers to the body’s physical adaptation to the presence of a drug. As the body becomes used to and then reliant on the presence of the drug, stopping use can cause physical symptoms and discomfort. Although these symptoms can be severe or even dangerous in some cases, many clinicians believe that physical dependence is relatively more straightforward to treat as the symptoms pass quickly.
• Psychological dependence: This form of dependence refers to the mental or emotional need for a substance, which users may rely on to cope with stress, anxiety, or other issues. It primarily involves emotional and behavioral symptoms, and those struggling with it may use it compulsively, unable to stop despite serious consequences due to perceived emotional and psychological benefits. Psychological dependence is more likely to cause addiction, and relapses in times of stress are common.

Kratom withdrawal symptoms closely mimic opioid dependence when stopping use due to a strong similarity in the way they impact the brain and cause addiction. This makes the dangers of self-dosing for opioid withdrawal even more severe. Individuals who begin using for this purpose may end up trading one addiction for another.

Long-term users may need increasing doses to function as their physical dependence on kratom and their tolerance levels advance.

There is a broad spectrum of variation in kratom user behavior. However, there are some common signs and symptoms you can look for if you are wondering how to tell if someone is addicted to kratom.

Behavioral changes due to kratom addiction:

• Secrecy
• Isolation
• Loss of interest in other activities
• Drug-seeking behavior
• Inability to cut back
• Using Kratom multiple times a day
• Increasing doses

Physical signs of kratom addiction:

• Nausea
• Sweating
• Weight loss
• Tremors

Emotional symptoms of kratom abuse:

• Irritability
• Anxiety
• Depression

If you are using kratom and you notice these symptoms, you should speak to your doctor as soon as possible. If someone you know or love is using kratom and you begin seeing concerning behavior, taking the time to have a loving, honest, and nonjudgmental conversation with them can be one of the best things you can do to help.

As with many addictive substances, the sooner medical intervention occurs, the better. If you’re unsure where to look for help, third-party tools like RehabNet’s free, confidential helpline can provide critical assistance for those who want to learn more.

Kratom withdrawal symptoms most commonly occur when stopping or reducing prolonged use. Kratom detox effects vary significantly with dosage and length of use, with high-dose, long-term users facing the most severe withdrawal symptoms.

Common symptoms include:

• Insomnia
• Anxiety
• Agitation
• Depression
• Muscle aches
• Runny nose
• Nausea
• Fatigue
• Fever
• Sweating/Chills
• High blood pressure
• Restlessness
• Visual distortions
• Difficulty concentrating

The kratom dependence withdrawal timeline can vary, but most users follow a similar pattern. Early symptoms of withdrawal begin within 6-12 hours of the last dose and can include both physical and psychological symptoms.

The side effects of quitting kratom reach their peak within 1-3 days. During the peak, withdrawal symptoms can be severe and even dangerous. Medically supervised detox is generally advisable to maintain user safety and comfort.

After 4-10 days, physical withdrawal symptoms should begin to subside. However, psychological symptoms can take longer to resolve. Some long-term or high-dose users experience post-acute withdrawal syndrome (PAWS). Individuals with PAWS experience psychological symptoms like cravings, depression, and mood swings for weeks or even months after stopping kratom.

Notably, the symptoms of kratom withdrawal are similar to those of opioid and caffeine withdrawal. However, the severity of the symptoms varies significantly, with caffeine withdrawal being the least severe, followed by kratom withdrawal, and with opioid withdrawal being the most severe.

Although it is often marketed as a natural remedy, the side effects of kratom abuse can be hazardous. It can cause both physical and psychological side effects in users, with long-term or high-dose users facing particularly severe side effects like hallucinations.

Some side effects are short-term and resolve once an individual stops using kratom. Others can cause permanent damage that leaves users with lifelong health issues.

Short-term kratom side effects include:

• Nausea
• Dry mouth
• Constipation
• Dizziness
• Paranoia
• Anxiety
• Mood swings
• Muscle pain
• Drowsiness
• Trouble breathing
• Hallucinations
• Delusions

Long-term kratom use can lead to even more serious, sometimes lifelong, problems, like liver damage, memory issues, weight loss, and skin discoloration.

Kratom toxicity and overdose are a possibility. However, the exact amount required to cause an overdose is not well established.

Signs of a Kratom overdose can include:

• Nausea and vomiting
• Rapid or irregular heartbeat
• High blood pressure
• Agitation, anxiety, or irritability
• Drowsiness or excessive sleepiness
• Confusion or psychosis
• Seizures
• Coma
• Respiratory depression

Overdosing on kratom alone is rare. Mixing kratom with other substances like opioids, stimulants, benzodiazepines, or alcohol can increase overdose risks.

Just as not all alcohol drinkers develop alcoholism, not all kratom users will become addicted. But determining who is at risk for kratom addiction is complicated, and the development of addictive behavior is frequently the result of numerous factors working together.

Common kratom risk factors include:

• History of substance abuse or mental health issues
• Using Kratom to self-medicate for pain, anxiety, or opioid withdrawal
• Lack of medical oversight or using unregulated products
• Social influences or online promotion of Kratom
• Easy accessibility through online retailers

While knowledge of these risk factors can be helpful, it is possible to develop a kratom addiction without any risk factors. Kratom is an unregulated substance that is not approved for medical use. There is no medically safe dosage or use pattern of kratom according to current FDA guidelines.

The diagnostic criteria for KUD are similar to those of other substance use disorders, such as stimulants and opioids. Medical practitioners use a set of criteria established in the DSM-5 to make a kratom addiction diagnosis. Patients who experience at least two of the following symptoms in 12 months can be considered addicted.

DSM-5 kratom criteria include:

• Kratom is frequently taken in larger amounts or over a longer period than was intended.
• The user experiences a persistent desire or makes unsuccessful efforts to cut down or control use.
• The user spends significant time on activities necessary to obtain the substance, use the substance, or recover from its effects.
• Cravings, or a strong desire or urge to use the substance, occur.
• Recurrent use that results in the inability to fulfill obligations at work, school, or home.
• Continued usage despite persistent or recurrent social or interpersonal problems caused or worsened by kratom use.
• Important social, occupational, or recreational activities are given up or reduced because of kratom use.
• Using it in physically hazardous situations.
• Continued use despite knowledge of physical or psychological problems caused or worsened by kratom.
• Tolerance
• Withdrawal

Diagnosing kratom addiction requires not only medical and psychological assessment by a medical professional, but also a commitment to honest discussions about frequency and dosage on the part of the patient.

Many patients hide their usage due to feelings of shame surrounding their condition. But this can be extremely dangerous as it not only prevents them from getting help, but also leaves them open to potential negative prescription drug interactions and other issues.

If you or someone you love is beginning to suffer from the side effects of Kratom abuse or addiction, seek help immediately. Addressing the problem early improves outcomes, creating a greater likelihood of long-term, stable recovery.

Kratom abuse can have a persistent, negative impact on individuals and families struggling with misuse of this supposedly natural remedy. However, help for kratom addiction is available. Speak to a doctor or reach out to a friend who may be struggling.

If you’re not sure where to get help for kratom abuse, RehabNet is a free, confidential source of information. Contact our helpline or use our online contact form to find the right treatment center for you and take the first step toward recovery.