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Kratom Addiction: Signs, Symptoms & Side Effects

Written by Theresa Valenzky

& Medically Reviewed by Dr. Jessica Pyhtila, PharmD

Medically Reviewed

Up to Date

This article was reviewed by a medical professional to guarantee the delivery of accurate and up-to- date information. View our research policy.

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Last Updated - 06/19/2023

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If you or a loved one is struggling with addiction, help is available. Speak with a Recovery Advocate by calling 888-648-0738 now.

Updated 06/19/2023

Key Takeaways

  • Kratom is legally available in most parts of the U.S. as of May 2023
  • The FDA has issued consumer warnings against kratom use, and the DEA has declared it a chemical of concern
  • Kratom has purported medical uses, but evidence for these is unclear at this time
  • Kratom has stimulant and opioid-like properties and may be addictive
  • Kratom misuse may lead to kratom addiction
  • Kratom addiction is treatable

Although the effects of Kratom are poorly understood, there are some established key facts about the drug and its potential for addiction.

Although not a controlled substance, kratom is used nationwide and is considered a drug of concern by the Drug Enforcement Administration, and certain states like Florida have moved to restrict kratom sales. If you or a loved one take kratom, you should be aware of the risks involved with the drug.

What Is Kratom?

Kratom is the common name for Mitragyna speciosa, a type of evergreen tree related to coffee. Kratom — the drug — is made by grinding the leaves of the tree, which contain psychoactive chemicals.

Kratom has recently become popular as a novel substance of abuse in the U.S. It is viewed by many as a legal way to get high and as an alternative to opioids, as it is not illegal at the federal level. However, the Drug Enforcement Administration considers kratom a drug of concern, and some states, including Florida restrict kratom sales.

Kratom can be smoked, but the amount of leaf required is too large to be easily smoked. Some people dehydrate the tea to produce a resin that can be smoked.

Kratom is usually used orally. Locals in Southeast Asia sometimes chew the leaves off the trees or put them in their food. In the U.S., kratom is available in several formats, all based on M. speciosa leaves, either whole or ground up:

  • Powder: The powder is made by grinding the dried leaves and is usually sold in packets labeled “not for human consumption.”
  • Capsules or tablets: The powder is packaged into capsules or pressed into tablets.
  • Tea: Tea is made by brewing dried or powdered leaves.
  • Gum: Sometimes, the tree gum (resin) is chewed.

Kratom tastes bitter, so it is usually consumed with a sweetener. A popular drink in Southeast Asia — known as 4X100 — is a mixture of kratom tea, Coca-Cola, ice and codeine cough syrup.

Kratom Withdrawal Symptoms

Some former kratom users described kratom withdrawal as worse than when they withdrew from opioids. Kratom withdrawal typically produces symptoms very similar to those of opioid withdrawal, including:

  • “Goose flesh” (piloerection)
  • Hot and cold chills, shivering
  • Muscle aches
  • Insomnia
  • Irritability, agitation, aggression
  • Depression, anxiety
  • Runny nose
  • Jerky movements
  • Intense cravings

Signs and Symptoms of Kratom Addiction

When someone struggles with a substance like kratom, signs and symptoms of addiction often occur. Friends and loved ones may begin to notice changes in the person. Although not everyone addicted to kratom will display all signs and symptoms, showing some of the symptoms can indicate a problem.

  • Problems controlling kratom use
    • Taking more kratom than intended or for longer than intended
    • Inability to cut back or stop kratom
  • Social issues
    • Problems with work, school or relationships due to kratom
    • No longer participating in activities because of kratom
    • Problems keeping up with responsibilities because of kratom
  • Risky kratom use
    • Using kratom even when doing so might be risky
    • Taking kratom even though doing so is causing problems
  • Physical need for kratom
    • Needing more kratom to achieve the same effects as before
    • Withdrawal symptoms when the person tries to stop kratom

Kratom Side Effects

Kratom affects individuals differently, and there is variation in the chemical content between kratom products, depending on the type of kratom tree that it came from.

Generally, the side effects of kratom mimic those of opioids and, to a lesser extent, those of a mild stimulant. Available data suggest that most kratom users also use other substances of abuse concurrently with kratom, which may cause some of the side effects to be additive.

The stimulant kratom effects are uncomfortable for some people and can produce:

  • Anxiety
  • Irritability
  • Aggressive behavior

One side effect of kratom is the tainting of the uncontrolled substance. Already, the FDA has had to respond to batches of the drug that were poisoned with Salmonella, and some were found laced with heavy metals.

Short-Term Effects

How does kratom make you feel? Users report that kratom’s high effects give a feeling of being stimulated and relaxed simultaneously. The short-term side effects of kratom use include:

Nausea

  • A very common immediate side effect of kratom is nausea. Repeated use can cause anorexia and unhealthy weight loss.

Constipation

  • The digestive tract is lined with opioid receptors, and activating these by kratom’s opioid-like effects causes constipation.

Headache

  • Being a brain-altering drug, kratom has known adverse effects on the brain, including seizures, coma and kratom headaches.

Diarrhea

  • Kratom diarrhea is a rebound effect when the drug wears off. The digestive system tries to compensate for the drug’s constipating effects, resulting in diarrhea once the constipating effects wear off.

Blood Pressure

  • Kratom can cause blood pressure to rise to dangerous levels. Kratom’s effect on blood pressure is one of the leading reasons that kratom users call poison control centers in the U.S.

Long-Term Effects

Because kratom has received very little study in human subjects and the drug is a relatively small player in the illicit drug market, we don’t know all the long-term effects of kratom use. However, long-term or high-dose use of kratom has thus far been associated with:

Hyperpigmentation

  • Dark discoloration of the skin on the cheeks (malar hyperpigmentation) is a known effect of long-term kratom use.

Tremor

  • Uncontrollable and persistent shaking of the extremities and even seizures may occur with kratom.

Weight Loss

  • Kratom weight loss appears to be due to its nauseating and anorexic (appetite-reducing) effects, which can become chronic.

Tolerance to Drug

  • Kratom tolerance develops with even short-term use; users must use increasingly larger amounts of the drug to get the same effect. This is one of the characteristics of addiction.

Sexual Side Effects

  • Kratom is known to cause abnormal elevations of the pituitary hormone prolactin, which results in sexual side effects in men and women. In women, changes in menstrual cycles (ranging from ceasing to increased frequency), breast milk production, infertility and loss of libido can occur. In men, impotence, infertility, loss of libido and the development of breast tissue can occur with kratom use.

Liver Problems

  • Is kratom bad for your liver? Kratom is known to be hepatotoxic (poisonous to the liver) and has been documented in animal and human cases to cause liver injury and illness.

Heart Problems

  • Kratom has been documented as being cardiotoxic, which is one of the reasons that the FDA has warned consumers against using the drug. Kratom’s side effects on the heart are based on its effect at slowing electrical conduction in the heart, thereby provoking arrhythmias (irregular heart rhythms) that can be fatal.

Kratom Overdose

Can you overdose on kratom? Yes. Taking the equivalent of more than 15g of raw leaf puts people at an exceptionally high risk of overdose. At these doses, users usually show additional symptoms:

  • Stupor
  • Excessive sweating (diaphoresis)
  • An uncomfortable feeling of unease (dysphoria)

According to the CDC, the most common symptoms causing people to call poison control centers after using kratom are:

  • Rapid heart rate
  • Agitation or irritability
  • Drowsiness
  • Nausea
  • High blood pressure

Fatalities from kratom do not necessarily occur from an overdose; the toxicities from kratom can cause fatalities even when used within the usual dosing ranges. The CDC reported that between July 2016 and December 2017, the most recent years for which data are available, 152 deaths attributed to drug use tested positive for kratom, and for most of them, kratom was determined to be a cause of death. However, this data was collected from only 32 states.

Most kratom overdose deaths appear to be due to adulterated products or from taking kratom concurrently with other drugs of abuse.

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How Addictive Is Kratom?

There is not enough data to know for sure how addictive kratom is. However, kratom can cause some similar types of effects that make other substances addictive, including:

  • Cravings
  • Compulsive use
  • Tolerance
  • Withdrawal symptoms

Further, some case reports suggest that users notice their kratom use progresses over time, and attempts to cut back are met with cravings and withdrawal symptoms.

Kratom Abuse Facts & Statistics

Kratom use statistics are not widely available nationally, as the drug is difficult to track, and its use is still relatively small. However, studies have shown that:

  • About 0.8% of the U.S. population used kratom in the previous year.
  • The average age of a person who takes kratom is 35 years old.
  • Men, students and healthcare professionals are more likely than others to use kratom.
  • More than one-third of kratom users also have misused opioids.
  • More than two-thirds of kratom users also have used cannabis.

Kratom Abuse & Treatment Trends in South Florida

Little information on kratom misuse and treatment is available for Florida. Kratom is banned in Sarasota County, and in May 2023, the Florida legislature approved a ban on kratom sales to people under 21. The bill has not yet been signed into law as of May 2023.

Help Someone With a Kratom Addiction

It can be very difficult to help someone with a substance addiction who does not want help. The psychology of addiction includes a strong tendency to be secretive about drug use and conceal, lie about and attempt to rationalize it.

People who become addicted to substances of abuse such as kratom get caught in the cycle of addiction:

  1. Using the drug, getting high (for effect or to escape mental health symptoms, uncomfortable thoughts and feelings or life’s stresses)
  2. Withdrawing from the drug
  3. Obsessive thoughts about using the drug and a need to use to stop or prevent the withdrawal, and back to one)

However, kratom can be easily rationalized by people addicted to it by claiming they need it for a medical reason, they are using it to help withdraw from other drug use, or it is legal, natural and therefore safe.

As such, it is best to let a friend who may be addicted to kratom know that you are approachable if they ever wish to discuss the matter and that kratom addiction help is available.

Kratom Addiction Treatment Options

Withdrawal from kratom can be difficult, so many people wanting to stop their kratom use may wish to consider attending a kratom medical detox program. In a medical detox program, medical support and medication reduce withdrawal symptoms and make the experience more comfortable.

Following medical detox to cleanse your system of kratom, rehab helps you stay off the drug for good. Our Palm Beach location offers both inpatient rehab and a partial hospitalization program, while our Miami location offers outpatient and intensive outpatient options to help support you every step of the way in your recovery from kratom addiction.

If you or a loved one struggles with kratom, contact us at The Recovery Village at Baptist Health to speak with one of our Recovery Advocates. Don’t wait — call today to learn more.

Although not a controlled substance, kratom is used nationwide and is considered a drug of concern by the Drug Enforcement Administration, and certain states like Florida have moved to restrict kratom sales. If you or a loved one take kratom, you should be aware of the risks involved with the drug.

What Is Kratom?

Kratom is the common name for Mitragyna speciosa, a type of evergreen tree related to coffee. Kratom — the drug — is made by grinding the leaves of the tree, which contain psychoactive chemicals.

Kratom has recently become popular as a novel substance of abuse in the U.S. It is viewed by many as a legal way to get high and as an alternative to opioids, as it is not illegal at the federal level. However, the Drug Enforcement Administration considers kratom a drug of concern, and some states, including Florida restrict kratom sales.

Kratom can be smoked, but the amount of leaf required is too large to be easily smoked. Some people dehydrate the tea to produce a resin that can be smoked.

Kratom is usually used orally. Locals in Southeast Asia sometimes chew the leaves off the trees or put them in their food. In the U.S., kratom is available in several formats, all based on M. speciosa leaves, either whole or ground up:

  • Powder: The powder is made by grinding the dried leaves and is usually sold in packets labeled “not for human consumption.”
  • Capsules or tablets: The powder is packaged into capsules or pressed into tablets.
  • Tea: Tea is made by brewing dried or powdered leaves.
  • Gum: Sometimes, the tree gum (resin) is chewed.

Kratom tastes bitter, so it is usually consumed with a sweetener. A popular drink in Southeast Asia — known as 4X100 — is a mixture of kratom tea, Coca-Cola, ice and codeine cough syrup.

Kratom Withdrawal Symptoms

Some former kratom users described kratom withdrawal as worse than when they withdrew from opioids. Kratom withdrawal typically produces symptoms very similar to those of opioid withdrawal, including:

  • “Goose flesh” (piloerection)
  • Hot and cold chills, shivering
  • Muscle aches
  • Insomnia
  • Irritability, agitation, aggression
  • Depression, anxiety
  • Runny nose
  • Jerky movements
  • Intense cravings

Signs and Symptoms of Kratom Addiction

When someone struggles with a substance like kratom, signs and symptoms of addiction often occur. Friends and loved ones may begin to notice changes in the person. Although not everyone addicted to kratom will display all signs and symptoms, showing some of the symptoms can indicate a problem.

  • Problems controlling kratom use
    • Taking more kratom than intended or for longer than intended
    • Inability to cut back or stop kratom
  • Social issues
    • Problems with work, school or relationships due to kratom
    • No longer participating in activities because of kratom
    • Problems keeping up with responsibilities because of kratom
  • Risky kratom use
    • Using kratom even when doing so might be risky
    • Taking kratom even though doing so is causing problems
  • Physical need for kratom
    • Needing more kratom to achieve the same effects as before
    • Withdrawal symptoms when the person tries to stop kratom

Kratom Side Effects

Kratom affects individuals differently, and there is variation in the chemical content between kratom products, depending on the type of kratom tree that it came from.

Generally, the side effects of kratom mimic those of opioids and, to a lesser extent, those of a mild stimulant. Available data suggest that most kratom users also use other substances of abuse concurrently with kratom, which may cause some of the side effects to be additive.

The stimulant kratom effects are uncomfortable for some people and can produce:

  • Anxiety
  • Irritability
  • Aggressive behavior

One side effect of kratom is the tainting of the uncontrolled substance. Already, the FDA has had to respond to batches of the drug that were poisoned with Salmonella, and some were found laced with heavy metals.

Short-Term Effects

How does kratom make you feel? Users report that kratom’s high effects give a feeling of being stimulated and relaxed simultaneously. The short-term side effects of kratom use include:

Nausea

  • A very common immediate side effect of kratom is nausea. Repeated use can cause anorexia and unhealthy weight loss.

Constipation

  • The digestive tract is lined with opioid receptors, and activating these by kratom’s opioid-like effects causes constipation.

Headache

  • Being a brain-altering drug, kratom has known adverse effects on the brain, including seizures, coma and kratom headaches.

Diarrhea

  • Kratom diarrhea is a rebound effect when the drug wears off. The digestive system tries to compensate for the drug’s constipating effects, resulting in diarrhea once the constipating effects wear off.

Blood Pressure

  • Kratom can cause blood pressure to rise to dangerous levels. Kratom’s effect on blood pressure is one of the leading reasons that kratom users call poison control centers in the U.S.

Long-Term Effects

Because kratom has received very little study in human subjects and the drug is a relatively small player in the illicit drug market, we don’t know all the long-term effects of kratom use. However, long-term or high-dose use of kratom has thus far been associated with:

Hyperpigmentation

  • Dark discoloration of the skin on the cheeks (malar hyperpigmentation) is a known effect of long-term kratom use.

Tremor

  • Uncontrollable and persistent shaking of the extremities and even seizures may occur with kratom.

Weight Loss

  • Kratom weight loss appears to be due to its nauseating and anorexic (appetite-reducing) effects, which can become chronic.

Tolerance to Drug

  • Kratom tolerance develops with even short-term use; users must use increasingly larger amounts of the drug to get the same effect. This is one of the characteristics of addiction.

Sexual Side Effects

  • Kratom is known to cause abnormal elevations of the pituitary hormone prolactin, which results in sexual side effects in men and women. In women, changes in menstrual cycles (ranging from ceasing to increased frequency), breast milk production, infertility and loss of libido can occur. In men, impotence, infertility, loss of libido and the development of breast tissue can occur with kratom use.

Liver Problems

  • Is kratom bad for your liver? Kratom is known to be hepatotoxic (poisonous to the liver) and has been documented in animal and human cases to cause liver injury and illness.

Heart Problems

  • Kratom has been documented as being cardiotoxic, which is one of the reasons that the FDA has warned consumers against using the drug. Kratom’s side effects on the heart are based on its effect at slowing electrical conduction in the heart, thereby provoking arrhythmias (irregular heart rhythms) that can be fatal.

Kratom Overdose

Can you overdose on kratom? Yes. Taking the equivalent of more than 15g of raw leaf puts people at an exceptionally high risk of overdose. At these doses, users usually show additional symptoms:

  • Stupor
  • Excessive sweating (diaphoresis)
  • An uncomfortable feeling of unease (dysphoria)

According to the CDC, the most common symptoms causing people to call poison control centers after using kratom are:

  • Rapid heart rate
  • Agitation or irritability
  • Drowsiness
  • Nausea
  • High blood pressure

Fatalities from kratom do not necessarily occur from an overdose; the toxicities from kratom can cause fatalities even when used within the usual dosing ranges. The CDC reported that between July 2016 and December 2017, the most recent years for which data are available, 152 deaths attributed to drug use tested positive for kratom, and for most of them, kratom was determined to be a cause of death. However, this data was collected from only 32 states.

Most kratom overdose deaths appear to be due to adulterated products or from taking kratom concurrently with other drugs of abuse.

How Addictive Is Kratom?

There is not enough data to know for sure how addictive kratom is. However, kratom can cause some similar types of effects that make other substances addictive, including:

  • Cravings
  • Compulsive use
  • Tolerance
  • Withdrawal symptoms

Further, some case reports suggest that users notice their kratom use progresses over time, and attempts to cut back are met with cravings and withdrawal symptoms.

Kratom Abuse Facts & Statistics

Kratom use statistics are not widely available nationally, as the drug is difficult to track, and its use is still relatively small. However, studies have shown that:

  • About 0.8% of the U.S. population used kratom in the previous year.
  • The average age of a person who takes kratom is 35 years old.
  • Men, students and healthcare professionals are more likely than others to use kratom.
  • More than one-third of kratom users also have misused opioids.
  • More than two-thirds of kratom users also have used cannabis.

Kratom Abuse & Treatment Trends in South Florida

Little information on kratom misuse and treatment is available for Florida. Kratom is banned in Sarasota County, and in May 2023, the Florida legislature approved a ban on kratom sales to people under 21. The bill has not yet been signed into law as of May 2023.

Help Someone With a Kratom Addiction

It can be very difficult to help someone with a substance addiction who does not want help. The psychology of addiction includes a strong tendency to be secretive about drug use and conceal, lie about and attempt to rationalize it.

People who become addicted to substances of abuse such as kratom get caught in the cycle of addiction:

  1. Using the drug, getting high (for effect or to escape mental health symptoms, uncomfortable thoughts and feelings or life’s stresses)
  2. Withdrawing from the drug
  3. Obsessive thoughts about using the drug and a need to use to stop or prevent the withdrawal, and back to one)

However, kratom can be easily rationalized by people addicted to it by claiming they need it for a medical reason, they are using it to help withdraw from other drug use, or it is legal, natural and therefore safe.

As such, it is best to let a friend who may be addicted to kratom know that you are approachable if they ever wish to discuss the matter and that kratom addiction help is available.

Kratom Addiction Treatment Options

Withdrawal from kratom can be difficult, so many people wanting to stop their kratom use may wish to consider attending a kratom medical detox program. In a medical detox program, medical support and medication reduce withdrawal symptoms and make the experience more comfortable.

Following medical detox to cleanse your system of kratom, rehab helps you stay off the drug for good. Our Palm Beach location offers both inpatient rehab and a partial hospitalization program, while our Miami location offers outpatient and intensive outpatient options to help support you every step of the way in your recovery from kratom addiction.

If you or a loved one struggles with kratom, contact us at The Recovery Village at Baptist Health to speak with one of our Recovery Advocates. Don’t wait — call today to learn more.

View Sources

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Lu, Jun; Wei, Heming; Wu, Jianjun; et al. “Evaluation of the Cardiotoxicity of Mitragynine and Its Analogues Using Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes.” PLoS One, December 2014. Accessed May 17, 2023.

Olsen, Emily; O’Donnell, Julie; Mattson, Christine; et al. “Notes from the field: Unintentional Drug Overdose Deaths with Kratom Detected — 27 States, July 2016–December 2017.” CDC Morbidity and Mortality Weekly Reports, April 12, 2019. Accessed May 17, 2023.

Substance Abuse and Mental Health Services Administration (SAMHSA). “Urgent and Emerging Issues in Prevention: Marijuana, Kratom, E-cigarettes.” 2019. Accessed May 17, 2023.

Fluyau, Dimy; Revadigar, Neelambika. “Biochemical Benefits, Diagnosis, and Clinical Risks Evaluation of Kratom.” Frontiers in Psychiatry, April 24, 2017. Accessed May 17, 2023.

Anwar, Mehruba; Law, Royal; Schier, Josh. “Notes from the Field. Kratom (Mitragyna speciosa) Exposures Reported to Poison Centers — United States, 2010—2015.” CDC Morbidity and Mortality Weekly Reports, July 29, 2016. Accessed May 17, 2023.

Leow, Cynthia. “Kratom.” Texas Tech University Infant Risk Center, 2019. Accessed May 17, 2023.

Galbis-Reig, David. “A Case Report of Kratom Addiction and Withdrawal.” Wisconsin Medical Journal, February 2016. Accessed May 17, 2023.

LaBryer, Lauren; Sharma, Rohan; Chaudhari, Kaustubh; et al. “Kratom, an Emerging Drug of Abuse, Raises Prolactin and Causes Secondary Hypogonadism: Case Report.” Journal of Investigative Medicine, High Impact Case Reports, March 16, 2018. Accessed May 17, 2023.

Food and Drug Administration (FDA). “Laboratory analysis of Kratom Products for Heavy Metals.” April 3, 2019. Accessed May 17, 2023.

Afzal, Hasnainl; Esang, Michael; Rahman, Sabreen. “A Case of Kratom-induced Seizures.” Cureus, January 7, 2020. Accessed May 17, 2023.

Powell, Landon R.; Ryser, Ted J.; Morey, Gabriel Eli; Cole, Ryan. “Kratom as a novel cause of photodistributed hyperpigmentation.” JAAD Case Reports, August 9, 2022. Accessed May 17, 2023.

National Center for Complementary and Integrative Health. “In the news: Kratom (Mitragyna speciosa).” April 2022. Accessed May 17, 2023.

Smith, Kirsten; Lawson, Thomas. “Prevalence and motivations for kratom use in a sample of substance users enrolled in a residential treatment program.” Drug and Alcohol Dependence, September 2017. Accessed May 17, 2023.

Addiction Policy Forum. “DSM-5 Criteria for Addiction Simplified.” Accessed May 17, 2023.

Drug Enforcement Administration. “Drug Fact Sheet: Kratom.” October 2022. Accessed May 17, 2023.

Schimmel, Jonathan; Amioka, Elise; Rockhill, Karilynn; et al. “Prevalence and description of kratom (Mitragyna speciosa) use in the United States: a cross-sectional study.” Addiction, January 2021. Accessed May 17, 2023.

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