Kratom Dependency and Use Disorder
When Kratom Becomes Difficult to Stop
Many people begin using kratom without expecting to become dependent on it.
Some first encounter kratom as a plant-based or “natural” product used for energy, mood, pain, or relief from opioid withdrawal. What begins as occasional use can gradually become regular or daily use, sometimes with increasing amounts and uncomfortable symptoms when the person tries to reduce or stop.
Kratom contains compounds that interact with opioid receptors, and regular use can lead to tolerance, physical dependence, withdrawal, and, for some people, a substance use disorder.
Patients often discover something they did not anticipate:
Stopping Kratom can be much harder than starting it.
Dependence Is Not Necessarily Addiction
As with other substances and medications, physical dependence and substance use disorder are related but not identical.
A person may develop withdrawal symptoms after regular kratom use without necessarily having a kratom use disorder. Others may experience loss of control, strong cravings, repeated unsuccessful attempts to stop, escalating use, or continued use despite significant consequences.
Understanding which problem—or combination of problems—is present helps determine what kind of treatment is appropriate.
Kratom withdrawal can include:
- Anxiety or restlessness
- Insomnia
- Irritability
- Muscle aches or physical discomfort
- Gastrointestinal symptoms
- Sweating
- Cravings
- Low mood
- Other physical or emotional symptoms
The severity and duration of symptoms can vary considerably depending on the products being used, amount and frequency of use, duration, other substances or medications, and the individual's medical and psychiatric history.
Why Did Kratom Become Important?
Before deciding how to stop kratom, we want to understand why the patient started using it and what role it now plays.
Some people began kratom because of chronic pain. Others were trying to stop or avoid opioids. Some found that it temporarily relieved anxiety, low mood, fatigue, or other symptoms.
That history matters because removing kratom does not automatically remove the problem the person was trying to solve.
A sustainable treatment strategy therefore needs to consider:
What will fill the gap when kratom is removed?
Treatment for Kratom Dependence and Kratom Use Disorder
Salubre Care begins by understanding what the patient is actually taking, how much and how often it is used, why kratom was started, how use has changed over time, what happens during attempts to reduce or stop, and what other medical, psychiatric, pain, or substance-use concerns may be involved.
Depending on the individual, treatment may include:
- Physician-guided withdrawal management
- Symptom-directed medications
- Counseling and behavioral health treatment
- Treatment of anxiety, depression, insomnia, chronic pain, or other underlying concerns
- Family involvement and education
- Recovery monitoring and support
- Aftercare and longer-term recovery planning
In selected circumstances, medications commonly used in the treatment of opioid use disorder may also be considered when clinically appropriate.
Not everyone who uses kratom has an addiction, and not everyone who has become physically dependent requires the same treatment.
Our first task is to understand the problem accurately. Then we can build a plan for getting out of it.
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