The use of Kratom has skyrocketed, with 1.7 million Americans reporting use of this opioid-stimulant-like drug native to Southeast Asia. Many Americans report using kratom to self-medicate for chronic pain, anxiety, and insomnia, as it can be easily purchased at gas stations, vape shops, and convenience stores. However, this has led to increased rates of dependence and addiction [1].
Quitting kratom cold turkey, especially if products contain higher levels of the active kratom alkaloid 7-OH, can lead to distressing physical effects similar to those with Opioid Use Disorder, such as nausea, vomiting, cravings, and anxiety [2].
Read on to understand what to expect during kratom withdrawal and when you or a loved one should seek help from kratom use.
What is Kratom and 7-Hydroxymitragynine (7-OH)?
Kratom is a tropical plant historically used by indigenous populations to increase stamina, reduce fatigue, and relieve pain. 7-hydroxymitragynine (7-OH) is the active compound in kratom leaves that acts on opioid receptors. According to Johns Hopkins Medicine, 7-OH is 14 to 22 times more potent than morphine, with a high risk potential for abuse [2].
Historically, most kratom products were sold with trace amounts of this alkaloid, but now more are being marketed as “Extra Strength” with higher levels of 7-OH, raising public health concerns. As of 2025, lawmakers are currently looking to regulate this legal, but uncontrolled substance.
How Does Kratom Affect The Brain?
Kratom, with its 7-OH compound, affects the brain similarly to opioids, which can complicate the detox process as many struggle with physical symptoms of dependence, such as craving and withdrawal. A few ways kratom affects the brain include [2][3]:
- Biased Agonism: Kratom alkaloids selectively trigger certain neural pathways and opioid receptors, although the effect profile is narrower than standard opioids. However, in kratom products with a higher level of 7-OH
- u-Opioid Receptor Activity: Kratom acts specifically on the u-opioid receptor sites, which are associated with pain relief, euphoria, relaxation, and sedation.
- Keap1-Nrf2 Pathway: Kratom alkaloids influence the cellular pathways of the Keap-1. While this can be helpful for managing inflammation in low doses, in high doses, Kratom may damage neurons and contribute to changes in brain structure.
- Non-Opioid Receptor Activity: Kratom alkaloids interact with serotonergic, adrenergic, dopaminergic, and GABA receptors. These play a role in functions such as mood, sleep, appetite, energy, motivation, and stress relief.
Warning Signs of Kratom Abuse and When to Seek Help
Because kratom is legal and sold so easily over the counter, many people do not realize the risks associated with it until it’s too late. If you or a loved one is on kratom, watch for concerning signs that may point to dependence or addiction. The signs of kratom use can look different depending on the dose, individual biological factors, and whether other drugs are present.
At low doses, 1 to 5 mg, signs of kratom use often resemble more stimulant-like effects:
- High energy
- Increased ability to focus
- Extra social, talkative
- Lack of appetite
- Mild euphoria
- Heightened sex drive
At higher doses, 5 to 10 mg, signs of kratom use often resemble opioid-like effects:
- Sedation, drowsiness
- Pain relief, muscle relaxation
- Dreamlike state and intense euphoria
- Lower anxiety
At all doses, side effects can occur, and there is still a risk for abuse. These include:
- Nausea/vomiting
- Dizziness
- Sweating/trembling
- Dry mouth
- Increased need to urinate
- Insomnia
- Significant weight/nutrient loss
- Long-term use can lead to hair loss, darkened patches of skin, liver toxicity, seizures, and psychosis.
Kratom Withdrawal Timeline
Withdrawal from kratom or “7 OH withdrawal” causes both physical and psychological symptoms, similar to those of opioid withdrawal but often less intense. However, it can still be strong enough to make quitting on your own difficult without professional support.
The general withdrawal timeline is different for everyone, but symptoms tend to peak in 2-4. Factors such as dosing, frequency of use, individual metabolism, and polydrug use (using multiple drugs) can complicate the withdrawal timeline.
Onset (12 to 48 Hours)
Starting anywhere from 6 to 12 hours after the last dose, you may begin to sweat and be shaky, feel anxiety, irritability, muscle aches, and tension. Mild cravings also begin to set in.
Days 1-4 (Peak)
This is known as the acute withdrawal stage, and here symptoms peak at their most intense. You may experience severe body pain, nausea, vomiting, insomnia, mood swings, and intense cravings. In severe cases or where polydrug use is present, dehydration, seizures, and heart attack can be a risk.
Days 5-7
Physical symptoms begin to reduce in intensity, however, mental symptoms such as depression, anxiety, and cravings persist. During this period and the following weeks it’s important to connect with therapy, peer support, and other treatment services to help prevent relapse after withdrawal.
Weeks 2+
This is known as the post-acute withdrawal stage, and often by this time physical symptoms have subsided. You may have lingering mood swings, brain fog (e.g., inability to concentrate, short-term memory loss), and occasional cravings, especially if under stress or around triggers.
Can You Detox from Kratom at Home?
Detox from kratom can be accomplished at home for those with mild dependence, but the risks are still there, and you may experience symptoms such as vomiting, nausea, and diarrhea. For severe cases, especially if you are abusing a kratom product with high levels of 7-OH, it’s highly recommended that you connect with a supervised detox program.
If you do choose to detox from kratom on your own, below are a few tips to help you stay safe and alleviate pain or discomfort.
- Drink lots of water and stay hydrated. This is especially important if you are vomiting or have diarrhea to prevent dehydration.
- Eat nutritious, bland foods that are easy on your stomach, such as toast, yogurt, chicken noodle soup, or a banana.
- Stay active and engage in activities to manage stress, such as walking, hiking, yoga, watching movies, or connecting with trusted loved ones.
- Take over-the-counter antinflammatories, or antinausea medication if necessary, to reduce inflammation and symptoms such as headaches, muscle pain, and vomiting.
Treating Kratom Dependence and Addressing Self-Medication
A majority of kratom users report using it to self-medicate and treat chronic pain, anxiety, sleep difficulties, and craving or withdrawal pain from other opioids [4]. This highlights the importance of dual diagnosis in recovery from kratom abuse, addressing co-occurring mental health challenges, trauma, and chronic pain.
Substance abuse counseling and co-occurring mental health treatment can help you address the reasons behind your kratom abuse, develop positive coping skills to manage triggers, and prevent relapse. Some helpful treatment options for kratom abuse include:
- Medication Assistance: Although there is no medication specifically for kratom dependence, some medications used in Opioid Use Disorder (OUD), such as buprenorphine, buprenorphine-naloxone, and clonidine, are used to alleviate post-acute withdrawal pain and cravings.
- Behavioral Therapies such as Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are first-line treatments for challenges such as anxiety, depression, bipolar disorder, and complex trauma. These help you reframe negative thoughts that drive substance abuse and can address symptoms of anxiety, depression, and inability to sleep.
- 12-Step Programs, NA, AA, SMART Recovery, and group therapy provide ongoing support and a space to foster connections, take accountability, and share or learn insights that contribute to recovery success.
Structured Outpatient Programs for Substance Abuse at Anchor Behavioral Health, NM
At Anchor Behavioral Health, we are dedicated to providing comprehensive care and counseling to those who are struggling with kratom abuse, opioid addiction, and co-occurring mental health disorders. Our team addresses the roots of addiction to understand your triggers, needs, and goals.
Through a blend of evidence-based therapies, trauma-informed care, peer support specialists, and licensed therapists, we combine clinical excellence with the power of lived experience to ensure you are successful in your long-term recovery.
Contact our admissions team today to learn how we can support you or a loved one struggling with kratom abuse.
Sources
[1] US Food and Drug Administration. FDA and Kratom. 2024.
[2] Smith, K. 2025. Emerging Use of Kratom in US: Kratom Use Disorder Experts Propose Decision-Making Algorithm for Clinicians. Johns Hopkins Medicine.
[3] Rahman, A. (2023). A Critical Review of the Neuropharmacological Effects of Kratom: An Insight from the Functional Array of Identified Natural Compounds. Molecules (Basel, Switzerland), 28(21), 7372.
[4] Suhaimi, F. et al. 2025. Exploring the cognitive effects of kratom: A review. Science Direct.