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Understanding Kratom Addiction: Causes, Effects, and Treatment

Written by The Recovery Village

& Medically Reviewed by Dr. Kevin Wandler, MD

Medically Reviewed

Up to Date

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Updated 05/03/2024

Key Takeaways

  • Kratom, related to the coffee family, is used traditionally in Southeast Asia for energy and stamina.
  • Modern uses of Kratom include self-treatment for pain, depression, and opioid withdrawal, with active alkaloids mitragynine and 7-hydroxymitragynine affecting the brain's opioid receptors.
  • Concerns about Kratom's safety profile include potential side effects like nausea, aggression, liver damage, and death.
  • Kratom's interaction with the body is complex, affecting opioid, adrenergic, and serotonin receptors, and may lead to significant drug interactions.
  • The surge in Kratom's popularity in the West is due to its legal status and perceived benefits as a natural alternative to opioids.
  • Kratom's legal landscape is complex, with varying regulations across different jurisdictions, and potential for addiction and health risks.
  • Signs of Kratom addiction include physical symptoms like nausea and muscle aches, psychological symptoms like mood swings, and behavioral signs like compulsive use.
  • Long-term Kratom use is linked to health risks such as multiorgan toxicity, cardiotoxicity, and symptoms of opioid addiction.
  • Treatment for Kratom addiction involves medically supervised detox, therapy, support groups, and potentially medication.
  • Support groups and Cognitive Behavioral Therapy (CBT) are essential components of a comprehensive treatment strategy for Kratom addiction.

Understanding Kratom: Origins, Uses, and Active Components

Kratom, scientifically known as Mitragyna speciosa, is a tropical tree belonging to the coffee family, indigenous to Southeast Asia. Traditionally, in regions like Thailand, Malaysia, and Indonesia, kratom leaves have been chewed or brewed into tea to combat fatigue, enhance productivity, and as a part of religious ceremonies. In these cultures, kratom is valued for its ability to increase energy and stamina during long hours of work.

Modern uses of kratom have expanded to include self-treatment for pain, depression, and opioid addiction withdrawal. The herb's rising popularity in the West can be attributed to these perceived benefits, although scientific research is still ongoing to substantiate these claims. The two primary active alkaloids in kratom, mitragynine and 7-hydroxymitragynine, are known to interact with opioid receptors in the brain, which may explain some of its effects on pain relief and mood alteration.

Despite its traditional and anecdotal applications, kratom's safety profile is under scrutiny. Concerns have been raised regarding potential side effects, which can include nausea, aggression, and in severe cases, liver damage and death. The lack of regulation in the U.S. and the presence of heavy metals in some kratom products have further fueled the debate on its safety. As such, individuals interested in kratom should approach its use with caution and be aware of the possible health risks involved.

For more detailed information on kratom's effects and safety, consider visiting the National Center for Complementary and Integrative Health or reviewing scientific literature on the topic.

Active Alkaloids in Kratom and Their Interactions with the Body

Kratom, known scientifically as Mitragyna speciosa, is a plant native to Southeast Asia that has garnered attention for its unique pharmacological properties. The leaves of the kratom plant contain more than 40 identified alkaloids, which vary in concentration due to genetic differences, growth conditions, and processing methods. The most prominent and studied of these alkaloids are mitragynine and 7-hydroxymitragynine. These compounds interact with various receptors in the human body, including opioid, adrenergic, and serotonin receptors, leading to a complex range of effects such as pain relief, euphoria, and stimulation.

Research has shown that kratom's alkaloids can inhibit enzymes like CYP3A4 and CYP2D6, which may lead to significant drug interactions. This is particularly relevant for patients using other medications that are substrates for these enzymes. The variability in kratom's chemical composition complicates clinical outcomes and highlights the need for more controlled studies to understand its safety and efficacy, especially for pain treatment. Despite the growing number of alkaloids identified in kratom, most scientific investigations focus on mitragynine and 7-hydroxymitragynine due to their prevalence and potent effects.

The consumption of kratom traditionally involves preparing the leaves into a tea or decoction, or by grinding them into a powder. As kratom use has increased in Western cultures, concerns about its potential for addiction and adverse health effects have risen, prompting further research into its pharmacology and clinical implications.

Understanding Mitragynine and 7-Hydroxymitragynine in Kratom

Mitragynine and 7-hydroxymitragynine are the primary active alkaloids in Kratom, a plant with a history of use in traditional medicine and a growing profile for recreational use and potential addiction. These compounds interact with opioid receptors in the brain, with mitragynine binding to the human μ-opioid and κ-opioid receptors with nanomolar affinity, functioning as a partial agonist at the μ-opioid receptor.

While mitragynine has been associated with analgesic, antidepressant, and anxiolytic effects, 7-hydroxymitragynine is a metabolite of mitragynine with a significantly higher affinity for the μ-opioid receptor, approximately 22.5 times greater according to research. This higher affinity is associated with opioid-mediated abuse and a higher potential for addiction, which has raised concerns among the medical community.

Further studies have indicated that both mitragynine and 7-hydroxymitragynine can influence brain reward thresholds and response latencies, similar to opioids like morphine, as noted in research. This suggests that these alkaloids may have a role in the rewarding effects that contribute to Kratom's addictive potential. However, definitive human studies on abuse potential are still lacking, and more research is needed to fully understand the implications of these findings for Kratom users.

Interactions Between Kratom and the Opioid System

Kratom, derived from the Mitragyna speciosa tree, has gained attention for its complex interactions with the opioid system. The primary active alkaloids in kratom, mitragynine and 7-hydroxymitragynine, exhibit an affinity for opioid receptors in the brain, which explains the substance's pain-relieving properties. Recent studies have focused on kratom's pharmacology, pharmacokinetics, and its potential for drug-drug interactions, particularly concerning the inhibition of enzymes like CYP3A4 and CYP2D6.

These interactions can lead to significant clinical implications, as kratom's alkaloids may alter the metabolism of various medications. Furthermore, the binding of kratom alkaloids to opioid receptors, including mu (MOR), kappa (KOR), and delta (DOR), can produce effects akin to traditional opioids, raising concerns about its potential for addiction and abuse. Despite its therapeutic claims, kratom's opioid-like effects can lead to overdoses, withdrawal symptoms, and other health issues, as noted in reports of adverse events.

While kratom has been utilized traditionally for pain management and opioid withdrawal symptoms, its legal status remains controversial due to these health risks. The complex nature of kratom's interaction with the opioid system continues to be a focal point for research, as understanding these mechanisms is crucial for assessing its safety, therapeutic potential, and regulatory considerations.

Understanding the Popularity Surge of Kratom

The popularity of Kratom, a plant native to Southeast Asia, has surged in recent years, with many factors contributing to its widespread use. As a substance that can produce opioid- and stimulant-like effects, Kratom has attracted attention for both its traditional medicinal uses and its potential as a recreational drug. Research indicates that Kratom's legal status is a significant factor in its rising popularity. In the United States, Kratom is legal in many states, which has allowed businesses to sell it in various forms without fear of legal repercussions. This accessibility is largely due to the absence of federal prohibition, fostering an environment where Kratom can be readily available to consumers.

Another factor contributing to the increase in Kratom use is its perceived benefits. Users often report using Kratom as a means to reduce or stop opioid use, citing it as a less harmful substitute with fewer unpleasant side effects. This perception of Kratom as a 'legal high' and a natural alternative to opioids has led to its adoption by individuals seeking to manage pain or wean off of opioids. Furthermore, the lack of regulation at the federal level, coupled with the contentious debate over its legal status, has created a grey area that facilitates its use and distribution.

Despite its popularity, concerns regarding the safety and potential for abuse of Kratom have prompted some states and countries to regulate or ban the substance. The variability of its effects, which can range from mild stimulation to sedation, and reports of adverse health outcomes underscore the need for further research to fully understand the risks and benefits of Kratom use. As the debate continues, it is clear that the legal ambiguity and the search for opioid alternatives are key drivers behind the rise of Kratom's use.

Navigating the Legal Landscape of Kratom Use

The legal status of Kratom, a psychoactive substance derived from the leaves of the Mitragyna speciosa plant, is complex and varies widely across jurisdictions. Despite its potential for addiction, Kratom remains legal in many areas, contributing to its popularity as a 'legal high.' In the United States, Kratom is not regulated at the federal level, allowing for its legal possession in 45 states. However, specific states and counties have imposed their own restrictions or bans due to concerns over its opioid-like effects and associated health risks, including seizures and liver toxicity.

As Kratom products are not FDA-regulated, there is a lack of uniformity, leading to variability in the potency and safety of available products. This inconsistency raises public health concerns and complicates the substance's legal status. For instance, some states have introduced bills such as the Kratom Consumer Protection Act (KCPA), which aims to regulate the sale of Kratom by prohibiting adulterated products and mandating clear labeling with directions for safe use. Despite these efforts, the legal ambiguity surrounding Kratom continues to fuel debates among lawmakers, scientists, and the public regarding its therapeutic potential versus risks of misuse and addiction.

Recent legislative actions, such as the introduction of a bill in Congress and ongoing state-level debates, indicate that Kratom's legal status is under scrutiny and may undergo significant changes. Stakeholders from various sectors are actively engaged in shaping Kratom's legal future, reflecting the challenge of balancing potential therapeutic benefits against the risks of unregulated use.

Identifying Kratom Addiction: Signs and Symptoms

Kratom addiction manifests through various physical, psychological, and behavioral changes that can signal a growing dependency on the substance. At lower doses, Kratom may produce stimulating effects, such as increased energy and alertness, while higher doses tend to have sedative effects, including pain relief and drowsiness. Recognizing the signs of addiction is crucial in seeking timely treatment.

  • Physical Symptoms: These may include nausea, increased urination, muscle aches, and sleeping difficulties. Some users experience more severe side effects like sensitivity to sunburn, sweating, and gastrointestinal issues.
  • Psychological Symptoms: Kratom can cause mood swings, hallucinations, delusions, and confusion. There have been reports of psychotic symptoms associated with its use.
  • Behavioral Signs: Indicators of addiction encompass compulsive use, loss of control over intake, social isolation, neglecting responsibilities, and continued use despite negative consequences.

Withdrawal symptoms typically emerge within 12 to 48 hours after cessation and can last from a few days to over a week, indicating physical dependence. These symptoms often include muscle aches and difficulty sleeping. Understanding these signs is essential for recognizing Kratom addiction and the need for intervention.

Health Risks of Long-Term Kratom Use

Long-term use of Kratom, a plant-based substance with opioid-like effects, has raised significant health concerns. Despite its growing popularity for pain relief and potential therapeutic benefits, Kratom use is not without risks. A review of literature and case studies indicates that prolonged consumption can lead to a variety of adverse health outcomes. Research has linked Kratom to multiorgan toxicity and cardiotoxicity, with specific cardiovascular effects being a major area of concern.

Commonly reported symptoms of Kratom toxicity include muscle spasms, sleep disturbances, increased anger, stress, and tension, which may suggest a pathway to opioid addiction. Users have also experienced acute negative effects such as agitation, tachycardia, drowsiness, and confusion. In the United States, poison centers have received a significant number of calls related to Kratom ingestion, indicating the substance’s potential for harm.

Although Kratom is sometimes used to aid in opioid withdrawal, it is itself addictive. The presence of alkaloids like mitragynine and 7-hydroxymitragynine in Kratom can stimulate opioid receptors, leading to addiction and raising the risk of opioid-like adverse events. The variability in Kratom product composition further complicates its safety profile, as different products may contain varying doses of these compounds. As a result, users may unknowingly consume higher levels of potent alkaloids, increasing the risk of adverse effects and addiction.

Given the limited research on Kratom's long-term impact, healthcare professionals and users should exercise caution. Proper management of Kratom abuse involves stabilization to prevent organ injury, alleviation of withdrawal symptoms, and long-term maintenance strategies for sobriety.

Comprehensive Treatment Strategies for Kratom Addiction

Kratom addiction, resembling opioid dependency, necessitates a multifaceted approach to treatment. Detoxification is often the initial phase, ideally conducted under medical supervision to manage withdrawal symptoms that may appear within 12 to 48 hours after cessation. Symptoms can persist from a few days to over a week, emphasizing the importance of professional oversight during this critical period. Research indicates that a combination of medication, therapy, and support groups forms the cornerstone of effective treatment strategies.

  • Detoxification: A medically supervised detox ensures safe withdrawal management and paves the way for further recovery efforts.
  • Therapy: Evidence-based therapies, such as Cognitive Behavioral Therapy (CBT), are employed to alter thought patterns and behaviors associated with Kratom use.
  • Support Groups: Peer support through groups provides a platform for shared experiences and mutual encouragement, which is vital for long-term recovery.
  • Medication: While specific medications for Kratom addiction are still under study, supportive medications may be used to alleviate withdrawal symptoms.
  • Complementary Activities: Incorporating healthy activities like yoga and community involvement can aid in the holistic recovery process.

Recovery plans may also include dual diagnosis treatment programs that address co-occurring mental health issues alongside addiction. The journey to overcome Kratom addiction is challenging but achievable with a committed approach and comprehensive treatment plan.

The Importance of Medically Supervised Detoxification in Kratom Addiction Recovery

Medically supervised detoxification is a critical first step in the recovery from Kratom addiction. Withdrawal symptoms can begin within 12 to 48 hours after the last dose of Kratom, with the duration varying from a few days to a week. Symptoms may include anxiety, nausea, muscle aches, and insomnia, necessitating professional medical support to ensure safety and comfort during the detox process.

Medical detox typically involves inpatient care where individuals receive 24-hour support. This setting offers medical treatment to manage withdrawal symptoms, reducing the risk of relapse. Outpatient detox programs are also available, providing less intensive care where patients regularly check in with medical professionals.

Detoxification centers use various strategies to treat Kratom addiction, including administering medications to alleviate withdrawal symptoms and providing supportive therapy. Although there is no specific treatment uniquely designed for Kratom addiction, many centers apply protocols effective in treating opioid-like drug dependencies.

Comprehensive Kratom addiction treatment goes beyond detox, integrating therapy and medication-assisted treatment (MAT) for long-term recovery. Dual diagnosis treatment programs are particularly beneficial as they address both addiction and co-occurring mental health issues, offering a more holistic approach to recovery.

It is essential for individuals seeking to overcome Kratom addiction to commit fully to the detoxification process and subsequent treatment plans, as these are foundational steps towards sustainable recovery.

Implementing CBT to Combat Kratom Addiction

Cognitive Behavioral Therapy (CBT) is a well-established psychological treatment that has proven effective for a range of substance use disorders, including Kratom addiction. CBT operates on the principle that negative thought patterns and behaviors can be identified, interrupted, and altered to foster healthier coping mechanisms. This therapy is particularly beneficial for those struggling with Kratom addiction as it addresses the specific cognitive distortions and maladaptive behaviors associated with substance abuse.

According to a meta-analytic review, CBT has shown moderate efficacy in treating drug abuse and dependence. The therapy includes functional analysis of drug use, identification of triggers, and development of coping strategies. These strategies are crucial for managing cravings and avoiding relapse, which is particularly relevant for Kratom users due to its opioid-like effects and potential for addiction.

CBT also places emphasis on psychoeducation, helping individuals understand the impact of Kratom on their lives and the importance of making positive changes. Techniques such as role-playing and problem-solving are employed to prepare individuals for challenging situations. By fostering self-efficacy and resilience, CBT empowers individuals to take control of their Kratom use and work towards recovery.

Overall, CBT is a versatile and personalized treatment approach that can be tailored to the unique needs of individuals recovering from Kratom addiction. It equips them with the tools to change their thought patterns, ultimately leading to improved decision-making and a healthier lifestyle free from substance dependence.

The Role of Support Groups in Kratom Addiction Recovery

Support groups play a crucial role in the recovery process from Kratom addiction, offering a community-based environment where individuals can share experiences and receive peer support. The collective wisdom and shared experiences found within support groups can provide emotional solace and practical advice, helping members to navigate the challenges of addiction recovery. Research indicates that peer support can significantly improve outcomes in substance abuse treatment, fostering a sense of belonging and accountability.

Support groups typically offer a non-judgmental space where individuals can discuss the impact of Kratom on their mental and physical health, relationships, and financial stability. The shared goal of sobriety and the understanding that comes from others who have faced similar struggles can be empowering. This communal approach can mitigate feelings of isolation and provide motivation through the recovery journey. Moreover, support groups can be a source of valuable coping strategies, helping individuals to manage cravings and avoid relapse.

While professional treatment options such as medication-assisted treatment (MAT) and cognitive behavioral therapy (CBT) are crucial, support groups complement these approaches by addressing the social and emotional facets of recovery. It's important for those recovering from Kratom addiction to have access to support groups, whether they are specialized groups for Kratom users or broader substance abuse recovery groups.

If you are struggling with a drug or alcohol addiction, it might be time for professional treatment. The experts at The Recovery Village Palm Beach at Baptist Health are able to identify and treat substance use disorders as well as other co-occurring mental health conditions. Contact us today to learn more about treatment programs that can work well for you.