Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN
Written By: Phillippe Greenough
Article Updated: 01/25/2021
Number of References: 17 Sources
Kratom enjoys a popular reputation as a “safe and natural” drug or an effective method for detoxing from opioids, but this is not the case in reality. Yes it is natural, but it is natural in the same sense that heroin and cocaine are natural; they are all compounds extracted and refined from plants. Kratom should be approached with the same caution as one would approach these drugs, as kratom is absolutely habit-forming, quite addictive, and potentially dangerous. Kratom withdrawal is somewhat similar to opioid withdrawal and exhibits a similar timeline of around a week. Some of the symptoms are similar as well including, sweats, shakes, insomnia, diarrhea, anxiety, and depression as well as some unique additional symptoms. Below we will look at the exact symptoms of kratom withdrawal, the timeline progression, and the specific effects that withdrawal produces.
In This Article:
Contrary to popular belief, kratom is addictive and it produces very unpleasant withdrawal symptoms when a chronic user suddenly stops taking kratom. These symptoms can be severe if someone was using large amounts, and entering a kratom detox center is recommended if someone is expecting to undergo withdrawal from kratom and they have other health issues. The acute phase of kratom withdrawal will begin soon after a kratom addict has stopped using the drug and will typically last around one week. The symptoms of kratom withdrawal are very similar in appearance to opioid withdrawal although not as severe, as kratom works in a similar manner to classical opioids. That being said, there are additional symptoms that are unique to kratom and do not appear during withdrawal from the more common opioids. While rarely fatal in and of itself, acute withdrawal from kratom can complicate any underlying or pre-existing medical issues which may be very dangerous.
The half-life of mitragynine, the main psychoactive ingredient in kratom, is about 20 hours. This means that it takes 20 hours to go from the maximum blood levels of mitragynine to 50% of the maximum blood levels. This is in contrast to morphine which has a half-life of about 3 hours. The half-life is not the sole determining factor regarding the withdrawal timeline as there are a variety of other factors that play a role in the time to withdrawal onset and duration. This illustration may be useful in getting an idea for why kratom withdrawal may be slower to begin and last longer than classical opioid withdrawal. For the most part, an individual’s kratom use habits play the largest direct role in the kratom withdrawal timeline.
Acute kratom withdrawal is the most uncomfortable and risky phase of withdrawal. While fairly short-lived, this phase is characterized by physical and psychological symptoms that will escalate quickly in the days immediately after kratom use has ceased. The intensity of acute withdrawal is affected by a series of factors and the severity can vary between individuals. After roughly one week, these symptoms should be greatly reduced, and this marks the transition into the post-acute phase of withdrawal.
While there can be differences between people regarding the intensity and duration of kratom withdrawal symptoms, the typical withdrawal time;one may look something like this:
Within a day or two from the last use of kratom, withdrawal symptoms will begin to appear. The first symptoms to emerge are typically an increase in anxiety and nonstop sweating. About a day after these symptoms begin, they may be joined by an increasingly runny nose and shakiness. By the second night since withdrawal symptoms have begun sleep will often be difficult even though someone feels completely drained of mental and physical energy. Restlessness and irritability will lead someone to constantly toss and turn throughout the night and this will be joined by muscle and joint pain. Stomach issues such as nausea and diarrhea may be expected around the third day and appetite should be suppressed by this point as well. By the third or fourth day, cardiovascular issues may appear which frequently include increased heart rate and elevated blood pressure, although these are often the result of increased anxiety and a lack of rest and not directly symptoms of kratom withdrawal. These symptoms should steadily increase in intensity for the rest of the first week.
Some symptoms of kratom withdrawal that may be expected during the first week can include:
The exact cause for seizures and hallucinations during withdrawal is unknown, but this does happen. Seizures during withdrawal, while not necessarily common, are a very real concern. Suffering a seizure while driving or walking down a staircase for example could lead to some serious problems. As far as hallucinations are concerned, it is known that drugs that interact strongly with the κ opioid receptor are known to produce hallucinations during use and withdrawal, although the mechanisms are currently unclear.
The beginning of the second week may be difficult. This is usually when the withdrawal symptoms are at their peak, and several days of reduced sleep and food will only worsen the subjective experience. Aside from the physical symptoms, the psychological symptoms have only just begun to ramp up. Mood swings may be expected to persist as well, and this may worsen the subjective experience further. Between days 7 and 10 is usually when the peak intensity of physical symptoms is reached and they will begin resolving from this point forward. The physical symptoms usually subside more quickly than it took them to appear and intensify. The depression, anxiety, cravings, and mood swings will still most likely be present by the end of the second week.
Some of the symptoms of kratom withdrawal that may persist throughout the second week include:
The third week since withdrawal began is often much easier from a physical standpoint, however, the psychological symptoms will still be present and quite intense. Insomnia may not be an issue any longer, but getting to sleep will often take a long time, and staying asleep may remain difficult. Anxiety may have increased slightly since the last week and usually manifests in the form of social anxiety, making social gatherings very uncomfortable. Someone’s mood may be lightened somewhat by an increasing ability to get a healthy amount of sleep as well as the return of their appetite. The beginning of the fourth week should exhibit a marked improvement in someone’s state of mind. While still experiencing relatively mild anxiety, depression, and cravings, the most intense stage of withdrawal will be over. This is not to say that the next few months may not be difficult. These symptoms can persist for months and can often require medications and further treatment if someone is to stand the best chances of successful recovery. While the worst may be over, there are still steps someone must take if they are going to remain free from kratom addiction.
Some of the kratom withdrawal symptoms that may persist into the third and fourth week or withdrawal can include:
Post-acute withdrawal from kratom is much less intense than the acute phase, however, the tradeoff is that it lasts much longer. This phase is characterized by strictly psychological symptoms, some of which may take months or even years to fully resolve. While the timeline varies quite a lot between individuals, the symptoms set remains fairly standard.
Some of the symptoms most commonly reported during post-acute withdrawal from Kratom include:
While the physical symptoms may be resolved, the psychological symptoms may linger for several weeks or months. Medications are often needed to manage and reduce these symptoms as they can be intense and exhausting due to their persistence. These symptoms are due to opioid system downregulation and the subsequent neurological remodeling that is produced through chronic kratom use. The brain is capable of upregulation fairly quickly, but undoing the remodeling is a slow process and will take time. There are several factors that can affect the duration of post-acute withdrawal, but this phase can commonly last for several months. The symptoms will begin to fade with time, but this is nevertheless a mentally uncomfortable time.
The intensity of kratom withdrawal can vary quite a bit between individuals. Some of these factors are totally beyond someone’s power to control or change, while others involve voluntary choices or behaviors. Additionally, the duration of withdrawal seems to vary quite a lot between people. Some people will return to normalcy very quickly, while other people will have more severe symptoms that linger for a long time after quitting kratom use.
Some of the factors which greatly influence the intensity and duration of kratom withdrawal include:
The amounts of kratom and the length of time that someone used plays the largest role in both the intensity and duration of their withdrawal symptoms. The more kratom someone uses, the larger the degree of downregulation performed by the brain in response to the drug. During withdrawal, this results in more severe symptoms. Additionally, the longer someone uses kratom the more complete this downregulation becomes, thus the longer it takes to reverse. These factors are the largest contributors and they are also completely within someone’s power to affect. That being said, addiction is a mental illness so it is often the case that the more kratom someone uses, and the longer they use it, the more they want to use kratom. This is a vicious cycle that will act to amplify and deepen itself over time; this is a self-reinforcing cycle and one of the reasons addiction is so difficult to overcome.
Genetics plays a role in the potential for someone to be imprisoned by addiction. While the exact mechanisms are unclear, it is certain that addiction runs in families and therefore involves a genetic component. While anyone may become addicted to kratom if they use it enough, someone’s genetic predisposition may shorten the time needed to become a full-fledged kratom addict. Additionally, a heavy family history of addiction may indicate that someone will experience more intense withdrawal symptoms sooner than someone with no family history of addiction.
While tangentially related to a family history of addiction, a personal history of mental illness is certainly a large contributor to someone’s likelihood or susceptibility for addiction. While contributing in a more indirect manner, mental illnesses such as depression and anxiety occur much more commonly in those with addictions than in the general population. This indicates that mental health problems can accelerate and encourage someone to find relief in drug use, including kratom.
In describing and illustrating the symptoms of kratom withdrawal it would be helpful to know exactly how kratom works, but this is still somewhat unclear at present. While several of the most potent psychoactive compounds have been identified and are fairly well understood, there are over 40 active compounds present in kratom. Currently, the best understanding is that mitragynine and 7-hydroxymitragynine are the main contributors to the euphoric effects of kratom. These drugs work by activating opioid receptors, among other interactions, thereby reducing pain and anxiety, reducing stress, and promoting a relaxed and calm state of mind. These compounds may also produce stimulant-like effects that are dose-dependent.
The way that the active compounds in kratom produce these effects is similar but distinct from other opioids. Kratom activates the κ (Kappa), μ (Mu), and δ (Delta) opioid receptors, with the strongest affinity for the κ-opioid receptor. The opioid system performs a variety of vital roles in the brain and body which includes moderation of pain signals, maintenance of steady metabolism, regulation of cardiovascular rhythm, proper immune system function, and plays a role in emotionally induced feelings of euphoria.
Through chronic use of kratom, the brain will begin to adapt to the continuous stimulation of opioid receptors by decreasing the sensitivity of these receptors. This process is referred to as downregulation and is the brain’s attempt to protect itself from neurotoxic damage caused by chronic overstimulation. The immediate effect of downregulation is the development of tolerance, as decreased sensitivity at these opioid receptors requires more stimulus to produce the same effect. If someone continues to use kratom then dependence will develop, and withdrawal symptoms will begin to appear when they go a time without using kratom.
Kratom withdrawal is an unpleasant experience and, in extreme cases, can present unique and unpredictable risks. The fact that so little is actually known about the main psychoactive compounds, the dozens of totally mysterious or unidentified chemicals present in kratom, as well as the variety in growing and refining methods, means that withdrawal can produce different symptoms in different people since kratom itself varies in quality so much. Additionally, the variation in symptoms intensity is great and there is currently no reliable predictor of the exact symptoms or severity, other than the amounts of kratom someone used. Because of this as well as the discomfort of kratom withdrawal, it is recommended for someone to enter a kratom detox center if they are trying to quit using kratom.
Kratom Detox CentersThere are several other drugs that can produce uncomfortable or even dangerous withdrawal symptoms. We have more in-depth withdrawal guides for drugs such as:
If you are seeking drug and alcohol related addiction rehab for yourself or a loved one, the sponsored hotline is a confidential and convenient solution.
Calls to any sponsored hotline (non-facility) will be answered by:
If you wish to contact a specific medical detox center then find a specific detox center using our detox locator tool.
Alternatives to finding addiction treatment or learning about substance abuse: