Medically reviewed by Kevin Wandler, MD, Chief Medical Advisor
Kratom is sold in gas stations, smoke shops and online stores, often marketed as a natural way to boost energy, ease pain or manage opioid withdrawal. Because it comes from a plant, many people assume it is safe. But kratom affects the brain in ways that resemble opioids, and it carries real risks, including dependence.
This article explains what kratom is, how it relates to opioids, why some people use it to self-treat opioid withdrawal and which safer, evidence-based options exist.
What Kratom Is
Kratom comes from the leaves of a tree native to Southeast Asia. It is sold as powders, capsules, teas, drinks and concentrated extracts. The main active compounds are mitragynine and a related, more potent compound often called 7-OH.
Products labeled as kratom can differ dramatically from one another. Some contain plain leaf powder, while others are extracts or enhanced products with much higher concentrations of active compounds. Labels do not always reflect what is actually inside, which makes it hard to know how strong a product is before taking it.
At lower amounts, kratom may act as a stimulant. At higher amounts, it can produce sedation and pain relief similar to opioids. Effects vary widely depending on the product, its strength and the person using it.
How Kratom Relates to Opioids
Compounds in kratom bind to opioid receptors in the brain, the same receptors targeted by drugs like oxycodone, heroin and fentanyl. That is why kratom can relieve pain, create a sense of well-being and ease some opioid withdrawal symptoms. It is also why regular use can lead to tolerance, physical dependence and withdrawal.
The National Institute on Drug Abuse notes that kratom withdrawal symptoms can include muscle aches, irritability, insomnia, a runny nose, jerky movements and emotional changes, symptoms that closely resemble opioid withdrawal.
Regulatory Status
Kratom is not approved by the FDA for any medical use. The FDA has advised consumers not to use kratom products and has raised concerns about serious side effects and contamination. More recently, the agency has also moved to address concentrated products that contain high levels of 7-OH. The Drug Enforcement Administration lists kratom as a drug and chemical of concern. State and local rules about kratom vary and continue to change.
Risks of Kratom Use
- Dependence and addiction: Regular use can lead to physical dependence and compulsive use.
- Side effects: Nausea, constipation, dry mouth, frequent urination, loss of appetite, sweating and itching have been reported.
- Serious health effects: Reports include liver injury, seizures, high blood pressure, breathing problems and, in some cases, psychosis.
- Inconsistent products: Because kratom is not regulated like medicine, strength and purity vary, and some products have been found to be contaminated.
- Dangerous combinations: Using kratom with opioids, alcohol, benzodiazepines or other sedatives can raise the risk of dangerous effects, including slowed breathing.
If someone who has used kratom, especially with other substances, is unresponsive or breathing slowly, call 911. If you are in emotional crisis, call or text 988.
Using Kratom to Self-Treat Opioid Withdrawal
Some people turn to kratom to ease withdrawal from prescription opioids, heroin or fentanyl, or to cut back on opioids without formal treatment. The motivation is understandable. Opioid withdrawal can be miserable, and people may want to avoid it or avoid the stigma they fear from treatment.
But kratom is not a proven or approved treatment for opioid use disorder. Its strength is unpredictable, it can create its own dependence and it comes without the medical monitoring, counseling and support that make treatment effective. Some people find they have traded one dependence for another.
By contrast, FDA-approved medications for opioid use disorder, including buprenorphine, methadone and naltrexone, have been studied extensively and are considered a standard of care. Medication-assisted treatment combines these medications with therapy to reduce cravings, ease withdrawal and support recovery.
Stopping Kratom Safely
If you use kratom regularly, stopping suddenly can cause uncomfortable withdrawal. If you also use opioids or other substances, withdrawal may be more complicated. A medical team can assess everything you are using and recommend a safe plan, which may include opioid detox and medication support when clinically appropriate.
For a deeper look at the plant itself, read our article on kratom use and its risks.
Signs Kratom Use Has Become a Problem
- Using more kratom, or using it more often, to get the same effect
- Feeling sick, anxious or restless when you skip a dose
- Spending more money or time getting kratom than you intended
- Using kratom alongside opioids or other substances
- Trying to cut back without success
- Hiding your use from family or friends
If several of these apply, it is worth talking with a medical professional about what you are using and how to stop safely.
Treatment at Promises DFW
Promises Dallas-Fort Worth treats opioid use disorder and other substance use disorders through medical detox, residential treatment, partial hospitalization and a virtual IOP. Our opioid addiction treatment can include medication-assisted treatment when clinically appropriate, along with CBT, DBT, individual and group therapy and aftercare planning. For people whose kratom or opioid use is tied to anxiety, depression or chronic pain, treatment looks at those conditions too.
Frequently Asked Questions
Is kratom an opioid?
Kratom is not classified as an opioid, but its compounds act on opioid receptors and can cause opioid-like effects, dependence and withdrawal.
Can kratom help me quit opioids?
Kratom is not an approved or proven treatment for opioid use disorder. FDA-approved medications combined with therapy are the evidence-based option.
Can you overdose on kratom?
Serious reactions have been reported, particularly when kratom is combined with other substances. Call 911 if someone is unresponsive or struggling to breathe.
Find a Safer Path Forward
If kratom has become part of your opioid use, or has replaced it, you deserve care that is proven and safe. Our admissions line is open 24/7, your questions stay confidential and we verify insurance at no cost. When a bed is available, same-day admission is often possible.
Explore insurance options, contact our team online or call (469) 546-9303.