Kratom (Mitragyna speciosa) is an evergreen tree from the Rubiaceae (coffee) family that produces leaves containing numerous psychoactive compounds, most notably including indole alkaloids: 7-hydroxymitragynine, mitraphylline, and mitragynine. When ingested by humans, the aforestated indole alkaloids significantly modulate CNS activity primarily via partial agonism of mu-opioid receptors (MORs). In addition, evidence from pharmacodynamic investigations suggests that kratom’s alkaloids also: antagonize kappa-opioid receptors (KORs) and delta-opioid receptors (DORs); agonize alpha-2 receptors; antagonize 5-HT2A receptors; and antagonize adenosine A2A receptors.
The cumulative physiologic effect of the aforestated pharmacodynamics tends to induce [a combination of]: analgesia, sedation, and/or stimulation. Interestingly, the dose-response curve of kratom is thought to [generally] yield greater analgesia/sedation than stimulation at high doses, but greater stimulation than analgesia/sedation at low doses. While kratom is not scientifically-substantiated as an intervention for any medical condition, its popularity has skyrocketed in recent years as an alternative treatment for chronic pain, opiate/opioid dependence, and opiate/opioid withdrawal.
It has also garnered popularity for the management of neuropsychiatric conditions such as generalized anxiety disorder, major depressive disorder, and social phobia – and remains commonly utilized as a recreational euphoriant/intoxicant. Since kratom is classified as an herbal supplement and remains legal in many states, a subset of individuals mistakenly assume that it can be used regularly and eventually discontinued without any withdrawal symptoms. In reality, most individuals who use kratom on a regular basis will experience some withdrawal symptoms following cessation.
Kratom Withdrawal Symptoms: List of Possibilities
Although many pharmaceutical drugs are heavily criticized by former users for their oft-debilitating withdrawal symptoms, it is less common for “all natural” and/or herbal supplements like kratom to receive similar criticism – even if warranted. What’s worse, in some cases, individuals who report kratom side effects and/or withdrawal symptoms online are condemned by kratom advocates who suggest that such experiences are an impossibility. Various [invalid] reasons that kratom withdrawal is said not to occur include: because kratom is 100% natural; because there are no published data documenting kratom withdrawal; because kratom is [technically] not an opioid/opiate; and/or because they (the kratom advocates) have never [personally] experienced any unwanted effects after stopping kratom.
That said, a simplistic analysis of kratom’s pharmacodynamic profile underscores the fact that its alkaloidal constituents exert a potent psychoactive effect through the opioid system. With regular or consistent administration of kratom over a long-term, physiologic adaptations will occur, including: upregulation and/or downregulation of receptors, altered secretion of neurotransmitters and/or hormones; and upregulation of hepatic isoenzymes implicated in kratom metabolism. As a result, when an individual ceases kratom usage after a long-term, his/her physiology transitions from “kratom-adapted” to [pre-kratom] homeostasis.
During the aforementioned transitory period, withdrawal symptoms are likely to occur in any regular kratom user. For most, kratom withdrawal symptoms will be of greatest severities in the early days and/or weeks of cessation, but less severe the longer a person has maintained abstinence. Moreover, countless anecdotes are circulating online to support the idea that withdrawal symptoms can occur after kratom discontinuation. Included below is a comprehensive list of kratom withdrawal symptoms that have been reported by former users.
- Agitation: After quitting kratom, don’t be surprised if you experience surges of agitation. Agitation is best described as internal nervousness and/or excitable discomfort that’s generally associated with anxiety and restlessness. During withdrawal, you may end up frustrated that you feel completely fatigued, yet simultaneously so agitated that you cannot stop fidgeting or pacing around the house. Although agitation may seem most severe in early stages of withdrawal, it generally becomes more manageable after the first few weeks of cessation. To cope with agitation during kratom withdrawal, some will find it helpful to: utilize relaxation techniques (e.g. meditation) and/or to engage in mild physical exercise (e.g. going for a walk outside) – each of which can help reduce sympathetic tone and corresponding agitation. Others may only find relief from agitation with prescription medications and/or dietary supplements.
- Aggression: While under the influence of kratom, some individuals experience a serenic effect characterized by internal peace, social tolerance, and patience with others. That said, following kratom discontinuation, many will experience the opposite of serenity such that they become aggressive and/or hostile. In most cases, aggression and/or hostility tends to emerge within the first few weeks of kratom withdrawal and slowly diminishes thereafter. The cause of aggression may be due to a combination of: neurochemical imbalances, autonomic dysfunction, and/or other withdrawal symptoms (e.g. sleep disturbances). Nevertheless, if you become aggressive during kratom withdrawal, you may want to develop a plan to ensure that the aggression is handled before it escalates to [potential] verbal abuse and/or physical assaults – each of which may damage relationships and/or reputation. In other words, know how you’re going to cope with aggression, so that when it occurs, you don’t go through with a regrettable action. Examples of ways in which you may be able to manage withdrawal-related aggression include: going for a walk, lifting weights, boxing at the gym, deep breathing, meditation, or listening to peaceful music.
- Anger: In most cases, individuals will report feeling calm and relaxed under the influence of kratom. However, when kratom is discontinued after an extended duration of regular ingestion, strong unwanted or negative emotions such as anger may emerge. The emergence of anger likely stems from a combination of excessive excitatory transmission (particularly norepinephrine) and overactivation of the sympathetic nervous system. As a result, a subset of persons will feel short-tempered and more angry than usual during kratom withdrawal. Because anger is caused by withdrawal-related physiologic imbalances, it may be difficult to control. That said, if you’re experiencing anger as a withdrawal symptom, you may want to make a list of attenuation strategies to implement so that it doesn’t escalate to complete rage and/or lead to the mistreatment of others. Moreover, anyone dealing with excessive anger should be encouraged to seek professional help from a psychotherapist and/or psychiatrist.
- Anxiety: Though kratom is regarded by many as an effective anxiolytic, its anxiolytic effect usually diminishes over time due to onset of physiologic tolerance. As tolerance develops, neurobiology adjusts such that the locus coeruleus upregulates its transmission of norepinephrine [to offset CNS depression induced by mu-opioid receptor agonism]. When kratom usage ceases, the former-user no longer exhibits mu-opioid receptor-induced CNS suppression, but retains upregulated noradrenergic signaling with excessive sympathetic activation. Predictably, this leads to a combination of psychological and physical symptoms of anxiety during withdrawal until noradrenergic transmission normalizes. While many individuals will experience varying degrees of anxiety during withdrawal, the withdrawal-related anxiety may be most severe for persons with preexisting anxiety disorders. To cope with the anxiety, it may be necessary to utilize relaxation techniques (e.g. deep breathing), stay physically active, and/or consult a psychiatrist for prescription anti-anxiety medications.
- Appetite changes: You may experience a subtle or significant shift in appetite during kratom withdrawal. In some cases, appetite shifts during withdrawal are the exact opposite of appetite while under the influence of kratom. For example, certain individuals who experience an increased appetite while taking kratom may experience appetite suppression during withdrawal; and vice-versa. Appetite changes may also be contingent upon specific symptoms that emerge throughout withdrawal. In other words, someone with severe nausea and dizziness during withdrawal may struggle with food consumption. Moreover, any appetite changes that occur during withdrawal may lead to noticeable changes in body weight. Nonetheless, within several months of kratom cessation most individuals will experience stabilization of appetite.
- Brain fog: Another extremely common symptom that emerges after kratom cessation is brain fog. If you feel as though you’re constantly spaced-out, zombie-like, as if your head is in the clouds – you’ve experienced the brain fog. Some describe brain fog as though their brain is operating at 50% or even 25% of its normal speed such that they feel mentally slow, stuck in a daydream-like state around others. The cause of brain fog during kratom withdrawal is imbalanced physiology. With enough time kratom-free, the fog should gradually lift and your thinking will become clearer.
- Chills: Experiencing the “chills” and/or shivers is a relatively common during kratom withdrawal. Many speculate that withdrawal-related chills are a byproduct of thermoregulatory abnormalities associated with irregular neurotransmitter and/or hormone secretion. As a result, body temperature may fluctuate significantly, sweat production may increase, and chills may result. If you’re sweating a lot, it’s likely that the excessive sweat is directly contributing to the chilled feelings. Furthermore, since kratom’s action can increase body temperature (via mu-opioid receptor agonism and kappa-opioid receptor antagonism), it’s possible that there’s an adaptive physiologic effect of upregulated internal cooling. It’s possible that increased internal cooling lingers during withdrawal, and without action of kratom on opioid receptors to induce mild hyperthermia, individuals may feel chilled or downright cold during withdrawal. For a majority of individuals, the chills reach a peak in the first couple weeks of kratom detox and improve thereafter. Some claim that taking a hot shower, using a sauna, or taking a bath with Epsom salts can reduce the chills. Staying hydrated, maintaining electrolyte balance, eating a balanced diet, and/or using pharmacological interventions may also prove helpful.
- Cognitive deficits: Among academics and/or persons involved in cognitively-demanding occupations, the most frustrating of all kratom withdrawal symptoms may be cognitive deficits. Those experiencing cognitive deficits during withdrawal may notice that aspects of executive function such as: attention, critical thinking, planning, reasoning, self-regulation, working memory, etc. – are impaired. It is likely that a majority of cognitive deficits occurring during withdrawal are primarily due to imbalanced neurochemistry. Furthermore, preoccupation with certain withdrawal symptoms (e.g. jitters) may directly interfere with aspects of cognition. As neurochemistry reverts back to homeostasis and other withdrawal symptoms become less noticeable, cognitive function should improve and stabilize. Because cognitive impairment during withdrawal could compromise academic or occupational performance, it may be smart to: take some time off from work/school, utilize supplements that support brain function, and/or seek pharmacological interventions from a psychiatrist.
- Confusion: In the acute stages of kratom withdrawal, you might experience confusion where you find it difficult to make sense of conversations and/or learn new material. The confusion goes hand-in-hand with the other symptoms of brain fog and cognitive deficits. Some claim that their thoughts and/or speech seems incoherent due to the confusion and corresponding lack of mental clarity. Although the confusion may be frustrating, realize that with enough time and proper recovery efforts, your neurochemistry should recover and the incoherent or blurred consciousness should abate.
- Cravings: The alkaloids within kratom are known to modulate neurochemistry such that, with each high-dose, the reward center of the brain is activated. As a result, individuals who use kratom regularly associate it with pleasurable feelings of intoxication. When these same individuals discontinue kratom, many will experience psychological cravings, urges, and desires to reinstate usage. This is because their reward center is no longer receiving the supraphysiologic stimulation provided by the kratom. Moreover, signaling of dopamine is reduced during withdrawal, leading the user’s brain to initiate cravings for more kratom – which would temporarily augment dopaminergic signaling. If you’re struggling to deal with cravings during withdrawal, it is recommended to seek out the help of a licensed psychologist and/or psychiatrist. To avoid a craving-induced relapse after discontinuation, avoid keeping extra kratom around the house, get rid of possessions you’ve mentally associated with kratom, and avoid persons who may pressure you to into using kratom. In general, the longer you’ve maintained abstinence, the lesser your cravings should be. Someone who’s been kratom-free for 6 months probably won’t experience many cravings compared to someone who’s been kratom-free for just 1-month.
- Delirium: Although rare, a person may experience delirium characterized by abnormal speech, bizarre perceptions, grossly disorganized thinking, and restlessness. Most individuals who experience delirium as a withdrawal symptom will have discontinued kratom too rapidly after long-term and/or high-dose usage. Some suspect that persons with preexisting neuropsychiatric conditions and/or age-related cognitive decline may be more vulnerable to delirium during withdrawal than others. That said, in most cases the delirium will be short-lived and shouldn’t persist for more than a week. Anyone who experiences delirium in withdrawal is recommended to seek emergency medical evaluation and care.
- Depersonalization: At some point during kratom withdrawal, you may experience depersonalization. If you’re depersonalized, you may feel unlike your normal self and may actually panic because your current state of consciousness and/or perception of reality seems skewed. The problem with panicking and/or becoming anxious about feeling depersonalized during withdrawal is that increased anxiety tends to exacerbate the depersonalization. It is recommended to avoid dwelling on the depersonalization, as this can also lead to anxiety. Staying active, using relaxation techniques to counteract stress, and/or dietary supplements may prove useful for mitigating depersonalized feelings. Symptoms that are synonymous with depersonalization include: derealization (feeling as if your surroundings are not real) and dissociation (feeling disconnected from reality).
- Depression: Kratom can enhance mood and/or generate an antidepressant effect through modulation of many neurotransmitter systems. For example, kratom-induced activation of mu-opioid receptors stimulates the ventral tegmental area (VTA) within the mesolimbic reward pathway to release dopamine in the nucleus accumbens (NAc). As a result, individuals experience a sense of euphoria and/or pleasure. Over time, the brain adapts to this effect and becomes less responsive to mu-opioid receptor activation (possibly via receptor upregulation) whereby the antidepressant and/or mood enhancing effects subside unless the dosage is increased. When kratom is discontinued, the neuroadaptation that diminished kratom’s antidepressant effect lingers, and since kratom is no longer generating mood enhancement, former users are prone to apathy and/or bouts of depression. Individuals with preexisting neuropsychiatric conditions, especially major depressive disorder, may be most vulnerable to withdrawal-related depression. If the depression feels overwhelming and/or leads to suicidal thoughts, do not hesitate to seek immediate medical attention from a psychiatrist. Staying socially engaged, physically active, eating a balanced diet, maintaining a sleep regimen, and utilizing specific supportive supplements may expedite recovery from lingering depression in withdrawal.
- Diarrhea: Another extremely common kratom withdrawal symptom that you may experience is diarrhea. Some claim that the diarrhea during withdrawal is so extreme, that failure to administer an antidiarrheal agent (e.g. Imodium) could lead to an embarrassing intra-pants disaster. For a majority of former kratom users, the diarrhea that emerges during withdrawal is most severe within the first few weeks of cessation and slowly subsides thereafter. It is thought that diarrhea is results from numerous physiologic adaptations to kratom that remain after its discontinuation, including: upregulation of peripheral mu-opioid receptors, enhanced noradrenergic firing and sympathetic tone, and possibly changes in gut microbiota. If you’re experiencing severe diarrhea after kratom discontinuation, it is recommended to utilize a safe and effective antidiarrheal agent. In conjunction with an antidiarrheal agent, it is recommended to stay hydrated, maintain electrolyte balance, avoid excessive fiber, and eat specific foods that won’t exacerbate diarrhea (e.g. bananas, rice, applesauce, toast). Some individuals claim that supplementation with probiotics is also helpful to ameliorate the diarrhea. Know that with adequate duration kratom-free, your gastrointestinal function will return to homeostasis and the diarrhea will subside.
- Dizziness: Among the most common of kratom withdrawal symptoms is dizziness. If you feel extremely dizzy, as if your equilibrium is imbalanced or your head is spinning after kratom cessation, understand that this is fairly normal. In most cases, the withdrawal-related dizziness is most severe among persons who discontinue kratom usage too abruptly after a long-term. While the severity of withdrawal-related dizziness usually diminishes within a month of discontinuation, low-grade (i.e. mild) dizziness may linger for months after your final dose. There are many potential causes of dizziness in withdrawal, including: changes in vestibular apparatus activation, blood pressure fluctuations, neurochemical adjustments, and sympathetic overactivation. Perhaps the most effective way to avoid excessive dizziness during kratom withdrawal is to conduct an extremely slow taper (e.g. 10% per month). Some claim that certain supplements and/or over-the-counter medications for motion sickness (e.g. Dramamine) improve their dizziness. If your dizziness is severe, it is recommended to avoid operating a motor vehicle and/or heavy machinery due to the fact that you may be more likely to injure yourself and/or others.
- Fatigue: Don’t be surprised if, at some point during kratom withdrawal, you feel extremely fatigued. Certain individuals have reported feeling so fatigued that it seems nearly impossible to maintain personal health and hygiene (e.g. cooking, showering, getting dressed) or perform necessary household chores (e.g. cleaning dishes, vacuuming, making the bed, etc.). If your fatigue is overwhelming, you may want to take a week or two off from work until energy returns. There are many possible causes of withdrawal-related fatigue, including: irregular neurotransmission, atypical hormone secretion, and/or the effort of your CNS to transition back to pre-kratom homeostasis. The fatigue may not be identical in withdrawal among all kratom users due to the fact that not all types of kratom exert the same effect. Hypothetically, a person who’s physiologically adapted to Red Vein Maeng Da may experience fatigue from excessive sympathetic activation [and corresponding anxiety] during withdrawal, whereas someone adapted to White Vein Thai may experience fatigue from lack of sympathetic activation [and corresponding depression] during withdrawal. In most cases, energy levels significantly increase within a few weeks of kratom discontinuation, however, it may take several months for energy to fully recover. Engaging in mild physical activity, eating a healthy diet, and using certain dietary supplements and/or prescription medications may prove useful for attenuating withdrawal-related fatigue.
- Flu-like symptoms: Withdrawal from any opioidergic drug, including kratom, tends to yield flu-like symptoms such as: chills, fatigue, headaches, muscle aches, and runny nose. Individuals who have used kratom regularly over a long-term who discontinue abruptly [without tapering] will likely experience the most severe flu-like symptoms. For some individuals, the flu-like symptoms that emerge during kratom withdrawal may seem just as wicked (perhaps even more so) than the actual flu. Coping with flu-like symptoms of kratom withdrawal generally involves utilizing over-the-counter medications, eating foods that won’t irritate the GI tract, and getting extra rest. Analogous to detoxification from opiates/opioids, flu-like symptoms that emerge kratom withdrawal tend to be most severe within the first 3 to 7 days of discontinuation.
- Frequent urination: Kratom is known to cause urinary incontinence (retention) as a side effect, yet during withdrawal, many individuals experience the opposite whereby they urinate frequently. Some have claimed that the frequent urination interferes with their sleep and productivity at work because they end up running to the bathroom every 20 minutes. Although frequent urination will eventually subside, it may be highly frustrating to manage in the first month of withdrawal. To cope with increased urinary frequency (and diarrhea), some former kratom users have jokingly suggested wearing an adult diaper. The cause of frequent urination during kratom withdrawal is likely partly due to sustained noradrenergic signaling and sympathetic activation. When the sympathetic nervous system is overactive compared to the parasympathetic, muscle tension occurs which can put additional pressure on your bladder whereby you secrete more urine. It’s also thought that the freeze-fight-flight response directly induces urinary secretion as an evolutionary adaptation. Moreover, during withdrawal, your body may process fluids and/or nutrients differently than usual such that water passes through your body quicker and you urinate more often. To manage frequent urination in withdrawal, it may be helpful to practice relaxation regularly (e.g. twice per day) and/or consult a doctor about temporary pharmacological interventions. If you are urinating frequently, ensure that you’re replenishing electrolytes and staying hydrated – while avoiding overhydration.
- Headaches or Migraines: Another extremely common kratom withdrawal symptom is headache or migraine. Headaches are usually caused by intracranial blood vessel constriction, whereas migraines are typically caused by intracranial blood vessel dilation. Your specific neurochemistry, as well as the type of kratom you were using may influence whether you’re more susceptible to headache or migraine during withdrawal. That said, it is thought that severe headaches in withdrawal may be related to overactivation of the sympathetic nervous system and excessive norepinephrine signaling. Though an over-the-counter medication for headaches may prove useful, in some cases it may be more effective to engage in relaxation exercises and/or administer supplements that facilitate parasympathetic upregulation to balance autonomic activity. If you’re experiencing migraine, talk to your doctor about prophylactic strategies and/or abortive options. Decreasing oxidative stress with specific supplemental antioxidants could prove useful at preventing certain types of headache/migraine as well. Since headaches and migraines can be caused by dehydration and/or electrolyte imbalances, you’ll want to ensure that you’re staying hydrated and maintaining adequate electrolyte intake.
- Hot flashes: Hot flashes, or sudden (usually unexpected) surges of feverish heat, are also fairly typical during kratom withdrawal. In many cases, the hot flashes that occur throughout kratom withdrawal may be accompanied by increased sweating, flushing or redness of the skin, and/or paresthesia (tingling of the skin). A combination of changes in neurotransmitter signaling, hormone levels, and/or activation of brain regions implicated in thermoregulation – all of which are exhibited during withdrawal – might be culpable for hot flashes. Some individuals will experience a combination of hot flashes and cold flashes such that bursts of feverish heat occur one day, then surges of coldness emerge another. If you’re noticing hot flashes (or cold flashes), it’s possible that your thermoregulatory systems are attempting to normalize post-kratom. With enough time kratom-free, the flashes of warmth and/or other temperature fluctuations should subside. To reduce likelihood of hot flashes, it is recommended to avoid alcohol, caffeine, smoking, and spicy foods – each of which can trigger and/or exacerbate them. Furthermore, some find it helpful to minimize stress, wear loose and/or baggy clothing, and/or utilize an icepack or sip ice water when the flashes occur.
- Increased blood pressure: While withdrawing from kratom, you may want to monitor your blood pressure for spikes and/or increases. If you were using kratom at a high-dose for an extended-term, chances are that your physiology adapted to its CNS depressant effect. As part of this adaptation noradrenergic signaling likely increased, and after kratom cessation, it will likely remain increased. The sustained increase of noradrenergic signaling coupled with lack of kratom-induced CNS depression may yield excessive sympathetic activation and corresponding high blood pressure. In vulnerable populations, spikes in blood pressure following kratom cessation could lead to serious medical complications such as: aneurysm, cognitive deficits, heart attack or failure, stroke, and/or torn blood vessels. Should you notice irregular blood pressure during kratom withdrawal, seek immediate medical attention. Fortunately, most withdrawal-related blood pressure spikes tend to diminish within a few weeks.
- Insomnia: During kratom withdrawal, some individuals will swing between bouts of excessive sleep and insomnia. For example, a high-dose and/or long-term kratom user may abruptly discontinue administration and sleep excessively the first few days, but find it impossible to sleep in subsequent days or weeks. As a withdrawal symptom, insomnia may be highly frustrating in that it might cause other circadian and/or sleep disturbances, each of which could alter physiology to exacerbate unwanted withdrawal symptoms (e.g. cognitive deficits). Excessive noradrenergic activity and/or lack of inhibitory transmission are likely causally implicated in withdrawal-related insomnia. Furthermore, it’s possible that specific withdrawal symptoms such as agitation, diarrhea, frequent urination, heart palpitations, restless legs – directly induce insomnia in certain individuals. While some insomnia should be expected during withdrawal, some interventions may attenuate its severity, including: daytime sunlight exposure, mild exercise in the morning, avoidance of blue light in the evening, maintaining a dark room or using a sleep mask, relaxation exercises, dietary supplements, and/or prescription sleeping pills.
- Irritability: A kratom withdrawal symptom that goes hand-in-hand with anxiety, agitation, anger, aggression, and depression – is irritability. At some point during withdrawal, you may find it difficult to control your emotions in social situations and/or around others. Every little action, behavior, or conversation may make you irritable or incite frustration. While experiencing the irritability, it may seem as though it’s never going to improve – or as if you’re doomed to a life of being irritable. What’s likely is that your neurochemistry adjusted itself to receiving the peaceful, serenic effect induced by kratom, and upon discontinuation of kratom, you experience the opposite such that you’re highly irritable. In the event that the irritability is overwhelming, you may want to consider seeking the help of a psychologist for CBT and/or a psychiatrist for pharmacological interventions. Assuming you don’t have an exceptionally irritable homeostatic demeanor, it’s likely that – with adequate sleep, proper nutrition, daily relaxation, exercise, and enough time – the irritability will eventually wane.
- Itching: Interestingly, kratom can cause itching as a side effect and a withdrawal symptom. The itching that occurs while under the influence of kratom is associated with central activation of mu-opioid receptor (1D) which transmits signaling of itch sensations via the spinal cord. It’s also thought that activation of other opioid receptors and histamine release while using kratom can cause itching. The itchiness that emerges during withdrawal may be a byproduct of abrupt changes in central and peripheral opioid receptor activation, and potentially from altered histaminergic signaling. It’s also possible that individuals may exhibit shifts in peripheral blood flow during withdrawal that are conducive to itching. In the event that you’re excessively itchy during kratom detox and are constantly clawing your skin, you may want to inquire a doctor about some useful anti-itch interventions.
- Jitteriness: Within a week or two of kicking kratom, you might exhibit the jitters or extreme nervousness accompanied by shakiness, tremor, or unsteadiness. Some researchers believe that jitters occurring in withdrawal stem from excessive release of norepinephrine within the locus coeruleus to activate the sympathetic nervous system. Withdrawal-related may be exacerbated by unmanaged anxiety and/or environmental stressors, but may be attenuated with relaxation techniques, a bit of exercise, and/or sedative substances. Though the jitters can be somewhat disconcerting, they are usually not a big deal compared to most other withdrawal symptoms.
- Lack of motivation: Even if kratom didn’t boost your motivation while under its influence, you may notice that your motivation takes a significant hit during withdrawal. Motivation is largely a byproduct of regional brain activity, neurotransmission, and autonomic activation. When certain regions of the brain are underactive and/or neurotransmitter signaling decreases, we feel less motivated. Similarly, if the autonomic nervous system is dysregulated such that we’re overly stressed due to excessive sympathetic activity – it may be challenging to summon up motivation. During kratom withdrawal, a person’s brain activity, neurotransmission, and autonomic nervous system activity can be considered abnormal, and culpable for low motivation. With concerted recovery efforts and enough time, physiology should revert back to pre-kratom homeostasis and motivation will return.
- Memory impairment: Anyone that’s used a high-dose of kratom likely has exhibited some degree of memory impairment. High doses of kratom induce CNS depression whereby alertness declines and it becomes more challenging to store and retrieve memories. That said, during kratom withdrawal individuals may experience equally severe (or potentially more severe) memory impairment as they did while under kratom’s influence. During withdrawal, neurochemistry is generally aberrant and aspects of cognition, particularly memory, are detrimentally affected. Assuming you didn’t use kratom in excess for an extended period of time, your memory is likely to make a full recovery with enough time kratom-free.
- Muscle aches, pains, tension: After an extended-term of regular kratom usage followed by discontinuation, individuals commonly experience muscle aches, muscle pains, and/or muscle tension. Persons with pain conditions prior to taking kratom may notice that the severity of pain during withdrawal is much greater than the severity prior to using kratom. This might be due to the fact that the body’s ability to provide endogenous pain relief is downregulated as an adaptation to long-term kratom administration. As a result, when kratom is discontinued, not only is there no analgesic effect generated by kratom, but the body is less equipped to facilitate endogenous pain relief – leading to substantial muscle pain. It’s also likely that excessive excitatory transmission in the CNS and PNS induce sympathetic overactivation to increase muscle tension, which can cause aches and pains. It may be helpful to use an over-the-counter pain medication and/or ask your doctor about pain relief during kratom withdrawal. Potentially useful strategies to mitigate withdrawal-related muscle aches, pains, and tension includes: hot baths (possibly with Epsom salts), saunas, hot showers, or basking in the sun. Various dietary supplements, medications, and essential oils for anxiety may also decrease muscle tension.
- Nausea: In the first week of taking kratom, you may have experienced some nausea from its activation of mu-opioid receptors located within chemoreceptor trigger zone (CTZ) of the brain. The chemoreceptor trigger zone induces emetic effects such as nausea and vomiting. Eventually, most individuals continue taking kratom regularly, the nausea that once occurred subsides. However, the nausea may return with a vengeance during the acute stages of kratom withdrawal, especially within the first couple weeks. In some cases, the withdrawal-related nausea will be so severe that it leads to vomiting. It’s possible that nausea is due to altered activity once again in the chemoreceptor trigger zone. It’s also possible that the nausea is related to changes in gastrointestinal function that occur following kratom cessation and/or that it stems from particularly severe withdrawal symptoms (e.g. anxiety). If you’re experiencing nausea, you may find it helpful to administer an antiemetic. Avoiding foods that cause gastric distress, staying hydrated, and simply lying down to rest can often help nausea.
- Palpitations: If you sense that your heart is fluttering, skipping a beat, and/or perceive that your heart is beating with intense force – you may be experiencing palpitations from kratom withdrawal. Heart palpitations are thought to occur due to the fact that, over an extended duration of kratom administration, noradrenergic signaling increases in the locus coeruleus to offset excessive CNS depression. When a person ceases kratom intake, the increased noradrenergic signaling remains, but there’s no longer a depressant effect facilitated by kratom. As a result, individuals end up with an overactive sympathetic branch of the autonomic nervous system whereby they experience predictable physical manifestations such as palpitations. If you’ve never experienced palpitations before, they can induce anxiety, leading to a vicious circle in which palpitations cause anxiety and anxiety causes palpitations. To cope with palpitations, it is often helpful to accept them and welcome them when they arrive, knowing they are nothing more than a withdrawal symptom that will eventually cease. It may also help to engage in some sort of psychological relaxation (e.g. deep breathing) to upregulate parasympathetic tone. All that said, if you’ve ever been diagnosed with a heart condition or hypertension, consult a cardiologist to ensure normative cardiac function during withdrawal.
- Restless legs: If you’ve used kratom for a long-term and/or at high doses, there’s a good chance you may experience “restless leg” as a symptom of withdrawal. Restless leg is characterized by an irresistible urge to move the legs and is often most severe in the late afternoon or evening. Many report that restless leg that emerges during kratom discontinuation is most debilitating just before falling asleep, ultimately leading to insomnia. Some claim that restless leg actually wakes them up from a sound sleep in the middle of the night such that it interferes with sleep quality and duration. Although the cause of restless leg during kratom withdrawal isn’t fully known, it likely results from irregular central and peripheral chemical signaling. Assuming you weren’t formally diagnosed with restless leg syndrome (RLS) prior to taking kratom, the restless leg should eventually cease with adequate duration of kratom abstinence. If you’re struggling to cope with withdrawal-related restless leg, strategies that may prove useful include: physical activity or pressure (e.g. walking, moving, massaging, stretching, etc.) and/or mental stimulation (e.g. playing a video game, solving a puzzle, etc.). It is also recommended to avoid caffeine, nicotine, and alcohol – as each of these can exacerbate restless leg. Keep in mind that some medications you may be using to curb kratom withdrawal symptoms such as antihistamines, antiemetic agents, antidepressants, and neuroleptics – can each provoke restless leg. In severe cases of restless leg, medical professionals may prescribe a benzodiazepine or dopamine agonist – both of which may attenuate the restlessness.
- Restlessness: In addition to restless leg, many individuals exhibit a general sense of restlessness after ceasing kratom in which the entire body is restless – not just the legs. The restlessness that occurs post-cessation may be associated with symptoms of anxiety, agitation, and irritability – and may stem from overactivation of the sympathetic nervous system. It’s also possible that the restlessness may be related to transiently low dopamine signaling in certain areas of the brain. With enough time kratom-free, sympathetic tone should diminish and dopamine signaling should increase, each of which may counteract restless tendencies. To manage restlessness, it is recommended to stay physically active and take some time for psychological relaxation each day. If you find the restlessness unbearable to the extent that it’s interfering with your career and/or studies – consult a medical professional about possible [temporary] treatments.
- Runny nose: Some individuals will notice rhinorrhea or an exceptionally runny nose when they stop using kratom. In fact, certain persons have claimed that a runny nose is among the very first withdrawal symptoms noticed. There are many lay hypotheses regarding the causes of runny nose during kratom withdrawal, including: altered immune function, changes in histamine secretion, and/or adaptations of mucous membranes. Perhaps the most likely the cause of runny nose during kratom withdrawal is intranasal vasodilation. Thankfully, in most cases, the severity of runny nose in kratom withdrawal tends to peak within the first several days of discontinuation and subsides within 1-2 weeks. It has been suggested that nasal sprays, physical exercise, and over-the-counter medications could be helpful for rhinorrhea in kratom withdrawal.
- Sleep problems: It is common to experience major sleep problems when quitting kratom after a long-term. Examples of withdrawal-related sleep problems include: insomnia, frequently waking throughout the night, excessive tossing-and-turning, and/or upsetting dreams (e.g. nightmares). Most individuals will find that their sleep quality is poor and their sleep quantity is reduced at various stages of kratom withdrawal. In some cases, it may be difficult to maintain a normative sleep schedule, leaving you groggy and/or tired during the daytime and abnormally restless at night. The cause(s) of sleep problems during kratom withdrawal may include things like: neurochemical and/or hormone imbalances, circadian rhythm dysfunction, and/or specific withdrawal symptoms (e.g. restless leg, palpitations, etc.). As physiology readjusts itself from kratom-adapted to homeostasis, sleep will normalize. That said, it helps to make a concerted effort to get your sleep back on track. Possibly useful strategies for doing so may include: adhering to a strict sleep schedule (for bedtime and waking); avoiding electronics / blue light at night; avoiding sleep-disrupting substances (e.g. caffeine, nicotine, alcohol); get plenty of sunlight in the morning and afternoon (to optimize your circadian rhythm); exercise early in the day; and engage in relaxation to minimize sympathetic tone (e.g. deep breathing) before bed. It may also prove beneficial to ask your doctor about supplements and/or medications that you could use to ameliorate withdrawal-related sleep disturbances.
- Sneezing: Another physiologic reaction to kratom withdrawal is increased sneezing. It is known that sneezes are generally an adaptive semi-autonomic response intended to rid the nasal mucosa of irritating particles. Some research suggests that sneezing is linked to bright light exposure, sudden drops in temperature, and/or gastrointestinal function. During kratom withdrawal, it may be that thermoregulatory, gastrointestinal, and/or neurochemical reduce the threshold for a sneeze reflex whereby sneezes occur with increased frequency during withdrawal. Avoidance of cold temperatures, minimizing exposure to [indoor and/or outdoor] air pollution with a purifier, and maintaining adequate humidity may reduce sneeze in withdrawal. Perhaps intranasal blood vessel dilation associated with rhinorrhea also [directly or indirectly] leads to sneezing.
- Spasms or Tremor: Though withdrawal from kratom is not known to cause seizure, it may provoke muscle spasms or tremor. Spasms are considered sudden involuntary muscular contractions, whereas tremor is considered an involuntary quivering movement. It is possible to experience both spasms and tremor, especially if you discontinued kratom too quickly after a long-term. Both spasms and tremor may occur as a result of increased excitatory transmission (norepinephrine, glutamate, and/or acetylcholine) and simultaneous decreased inhibitory transmission (GABA). Spasms and tremor tend to be most severe within the first couple weeks of kratom discontinuation, but should subside within the first month. Anyone who experiences spasms or tremor may benefit from taking steps to reduce psychological anxiety and physical muscle tension. Taking a warm bath, staying physically active, and/or implementing a stretching routine may improve these symptoms. Substances that enhance GABA signaling (e.g. benzodiazepines) and/or dopamine synthesis may attenuate some of the spasms and/or tremor.
- Stomach aches: While under the influence of kratom, it is common for food to move slower through the GI tract, leading to constipation and/or indigestion. However, when an individual stops using kratom after an extended duration, it is common for food to move quicker through the GI tract, leading to gastric distress and diarrhea. As a result, it is relatively common to experience severe stomach aches as a withdrawal symptom. Stomach aches that emerge during kratom detox may also be due to adjustments in gut bacteria, micronutrient or electrolyte deficits, and/or dehydration. To cope with withdrawal-induced stomach aches, it is recommended to avoid stimulants (e.g. caffeine) and foods that provoke GI distress (e.g. high-fiber). Staying hydrated, replenishing healthy gut bacteria, and maintaining electrolyte intake may prove useful in counteracting these stomach aches.
- Suicidal thoughts: Although somewhat uncommon, certain individuals will experience suicidal thoughts and/or ideation after stopping kratom. In the event that you’re experiencing suicidal thoughts, it is recommended to seek immediate medical care, preferably from a psychiatrist who’s familiar with kratom and/or opiate detoxification. Assuming you have no preexisting neuropsychiatric disorder, the suicidal thoughts that occur following kratom withdrawal are likely due to a transient imbalance in neurochemistry. With enough time kratom-free, neurotransmitter secretion and receptor counts should readjust such that suicidal thoughts and depressive emotions subside. It is necessary to note that persons with preexisting neuropsychiatric disorders are at greatest risk of experiencing suicidal thoughts following kratom cessation and careful monitoring is recommended.
- Sweating: For certain individuals, the most problematic kratom withdrawal symptom is excessive sweating. The sweat production that occurs during withdrawal may be so extreme, that shirts and/or bedsheets end up completely drenched. Excessive sweat production is often accompanied by chills, hot flashes, cold flashes, and dehydration. Most speculate that an overactive sympathetic nervous system and/or hormonal imbalances that emerge during withdrawal disrupt thermoregulation, which causes increased sweating. Regardless of the underlying cause of sweating, it is recommended to ensure that you’re staying hydrated and replenishing lost electrolytes. Intensification of withdrawal symptoms such as anxiety may potentiate [the already-overactive] sympathetic tone, leading to further sweating. Keeping your stress to a minimum and proactively managing your anxiety might help with the sweats. Realize that while the excessive sweating will eventually stop, it may be among the last of withdrawal symptoms to fade.
- Tiredness: In various stages of kratom withdrawal, it is possible to experience unbearable tiredness such that you feel extremely sluggish or fatigued. Because the tiredness does not always subside quickly, some may assume that they’ve suddenly developed chronic fatigue syndrome. There are many reasons you may feel tired after stopping kratom, including: broken sleep, circadian disturbances, and excessive stress and/or anxiety. Moreover, the CNS is attempting to revert back to homeostasis which can be physiologically-taxing. In most cases, tiredness will reach a peak intensity within the first few days or weeks of cessation. Within a month of quitting kratom, most will notice a returning of some energy – in some cases a little bit, in other cases a substantial amount. Doing your best to practice good sleep hygiene, consuming enough calories, and engaging in low-level physical activity can often help mitigate tiredness during withdrawal.
- Visual changes: Yet another withdrawal symptom that many will notice after discontinuing kratom is a perceived change in vision. Examples of visual changes that may occur during kratom withdrawal include: blurred vision, “floaters” in the visual field, visual sensitivity (especially to bright light), pupillary dilation, and/or increased eye pressure. The visual changes that arise in kratom withdrawal may be due to a combination of: increased sympathetic tone, altered neurotransmission (particularly in the visual cortex), and/or tear duct blockage. If you’re worried about your vision during withdrawal from kratom, it is recommended to get your eyes checked by an ophthalmologist. Assuming the eye doctor cannot pinpoint any problems with your eyes, it will probably be a matter of time before your altered vision reverts back to normal.
- Vomiting: Onset of nausea followed by vomiting can occur during kratom withdrawal, especially if discontinued suddenly (i.e. “cold turkey”) after high-dose/long-term use. It’s somewhat unclear as to why individuals experience such severe nausea as to provoke vomiting during withdrawal. While under the influence of kratom, it is known that mu-opioid receptors in the chemoreceptor trigger zone can induce nausea and the vomiting reflex. It is also known that kratom can alter GI function such that individuals feel nauseous and may vomit. Following discontinuation, it is possible that activity in the chemoreceptor trigger zone and/or gastrointestinal tract induce nausea that causes vomiting. Tapering kratom at a slow pace can usually prevent most vomiting in withdrawal. If vomiting occurs in withdrawal, it typically doesn’t persist for more than a few days. To prevent nausea and vomiting after kratom cessation, you may want to ask your doctor about using antiemetics. If you’ve already vomited, be sure to replenish lost fluids and electrolytes, and eat foods that are easy on your gastrointestinal tract.
- Watery eyes: It may seem as though your eye sockets are flooded with water when ceasing kratom. The watery eyes tend to go hand-in-hand with other withdrawal symptoms such as rhinorrhea (runny nose) and sneezing – relatively analogous to an allergic reaction. Usually watery eyes improve significantly within just a week or two of your last kratom dose. The cause of watery eyes during withdrawal may be associated with blockage of tear ducts, corneal irritation, or inflammation. Keep in mind that certain supplements and/or medications you’re using to manage other withdrawal symptoms may potentiate the preexisting watering. Some claim that it helps to lie down and make a warm “eye compress” (i.e. a warm washcloth) to place over the eyes.
- Weight changes: The effect of kratom on body weight is generally unknown, but is probably subject to variation based on the specific user, type of kratom, dosage, and term of administration. Nonetheless, it is logical to suspect that if you gained weight while taking kratom, you may end up losing weight when you discontinue. On the other hand, if you lose weight while taking kratom, you may end up gaining weight when you discontinue. The weight change during withdrawal may be due to alterations in appetite (and corresponding caloric intake) and/or physical activity levels (and corresponding caloric expenditure). Various hormones may change after discontinuation as well, possibly leading to noticeable differences in body composition (e.g. increased muscle and less fat).
- Yawning: Excessive yawning is another extremely common sign of kratom withdrawal. While most people assume that the increased yawning during withdrawal is related to fatigue and/or tiredness, it’s more likely to be associated with changes in thermoregulation. Most available evidence indicates that yawning occurs as an adaptive response to reduce elevations in brain temperature. In other words, we yawn (involuntarily inhale [cooler] air) to keep the brain from overheating. While not confirmed, it’s possible that the brain is more prone to overheating during withdrawal from opioidergic drugs like kratom than usual. As central and peripheral transmission implicated in thermoregulation recalibrates post-discontinuation, yawning should decrease.
Note: Although the above list of kratom withdrawal symptoms is comprehensive, it may be incomplete. If you experience a symptom that was not listed, be sure to share it in the comments section below. Moreover, if you have any questions about a specific symptom and need some advice, it is recommended to consult a licensed medical doctor.
Variables that influence Kratom withdrawal symptoms
Understand that specific symptoms, the severity of each symptom, and total number of symptoms that you experience during kratom withdrawal will be largely subject to individual variation based on influential variables. Variables that are known to influence kratom withdrawal include: rate of discontinuation, kratom specifics (dosage, strain, potency, additives); frequency of use (e.g. twice daily); term of administration (e.g. 1 year); and individual factors (e.g. age, genetics, recovery efforts). For this reason, it is recommended to avoid assuming that your withdrawal experience will be the same as, or automatically similar to, someone else’s.
Rate of discontinuation
The rate at which an individual discontinues kratom may have a profound effect upon the severity of his/her withdrawal symptoms. Quitting kratom cold turkey without tapering down typically yields the most numerous and severe withdrawal symptoms. A fast taper over a period of days may also yield numerous and severe withdrawal symptoms, but they should be less debilitating than sudden “cold turkey” discontinuation. Comparatively, a slow taper over a period of weeks, or even months, tends to yield the least numerous and severe symptoms.
- Cold turkey: Most agree that discontinuation of kratom “cold turkey” after a long-term of administration induces intense withdrawal symptoms and prolongs recovery. This is because a person’s physiology has adapted to kratom (neurotransmitter and hormone production, receptor densities, autonomic activation, et al.), and when kratom is discontinued, these adaptations remain – creating significant physiologic imbalances. The reason cold turkey discontinuation tends to be more debilitating than tapering has to do with the degree of physiologic imbalances after the final kratom dose. With tapering, physiology has extra time to recalibrate to functioning with lower quantities of kratom – receptor densities shift, neurotransmitter/hormone secretion change, and autonomic activation readjusts. Cold turkey discontinuation gives zero time to adjust, meaning the person’s CNS is markedly more imbalanced such that more numerous and severe withdrawal symptoms occur. Moreover, since tapering was not conducted, some speculate that this shocks and/or acts as a minor trauma to the CNS. Cold turkey discontinuation is analogous to someone who’s adapted to a diet of 5,000 calories per day cutting down to 1,500 immediately rather than gradually scaling back and allowing their body time to readjust. If you quit kratom cold turkey, expect both more severe withdrawal symptoms and a longer-term recovery.
- Rapid: If you taper off of kratom at a rapid pace, it’s likely that your withdrawal symptoms will be less numerous and/or severe than had you discontinued cold turkey, but more numerous and/or severe than had you slowly tapered. To keep things understandable, it may be helpful to classify a taper duration ranging from 2 to 7 days as “ultra-rapid” and 1 to 2 weeks as “rapid.” Since individuals engaging in ultra-rapid tapering are reducing their dosage quicker than those engaging in rapid tapering, we should expect the former group to experience more severe withdrawal symptoms than the latter. Individuals who are least at risk of experiencing unwanted withdrawal symptoms following a rapid taper include short-term and/or low-dose kratom users.
- Slow: It is thought that anyone who tapers off of kratom at a slow pace should experience the least numerous and/or severe withdrawal symptoms – especially compared to persons who discontinue rapid and/or cold turkey. This is because when kratom’s dosage is gradually reduced over an extended duration, it gives physiology time to recalibrate to functioning under less of its influence, which in turn brings physiology closer to pre-kratom homeostasis before complete cessation. It may be helpful to understand how slow tapering facilitates quicker recovery if we discuss one specific physiologic adaptation to kratom that’s likely implicated in withdrawal. With consistent kratom administration, neurons in the locus coeruleus secrete more norepinephrine than usual to offset the inhibitory effect of kratom. If the kratom dosage is gradually tapered prior to complete cessation, the brain will detect less of an inhibitory effect and should slightly downregulate the excess noradrenergic signaling before the final dose. Compared to cold turkey or rapid discontinuation, ceasing kratom after a slow withdrawal should yield markedly lower noradrenergic signaling and corresponding withdrawal symptoms of anxiety, agitation, restlessness, etc. To recapitulate: The slower the taper, the less significant the physiologic gap between kratom-induced CNS adaptations and homeostasis – which should be conducive to a quicker recovery.
Note: For those who wish to be cautious with their withdrawal and experience the least numerous and/or severe symptoms as possible, it is often recommended to taper at a rate of 10% per month. That said, preliminary data indicate that there may be an optimal discontinuation rate in terms of facilitating the quickest reversion to pre-kratom homeostasis. Nonetheless, anyone who’s fully tolerant to kratom will likely experience fewer withdrawal symptoms by tapering over a duration of at least 30 days prior to complete cessation. Moreover, individuals who used kratom at a low dosage and/or for a short-term will likely have an easier time managing symptoms of cold turkey and/or rapid discontinuation.
The strain of kratom that you most consistently ingested, as well as the supplier from whom you attained kratom, will determine the specific physiologic adaptations that were incurred over time to alkaloids – as well as the degree of their significance. For this reason, it is necessary to account for kratom strain and supplier as influencing the significance of your withdrawal symptoms. Someone using a highly-potent opioidergic strain of kratom from “Supplier X” may exhibit markedly different withdrawal symptoms than had the same individual been using a low-potency stimulating strain of kratom from “Supplier Y.”
- Vein type: It is thought that the specific physiologic effect induced by kratom may be predictable based upon its vein color. There are three major vein colors for kratom, including: red vein, white vein, and green vein. Red vein kratom is thought to generate sedative, analgesic, and opioidergic effects; white vein is thought to generate stimulatory effects; and green vein is thought to generate a combination of opioidergic and stimulatory effects. These general effects are likely due to vein-specific differences in alkaloids. Because of vein-specific alkaloidal differences, physiologic adaptations to kratom may be contingent upon vein color, ultimately influencing withdrawal symptoms upon discontinuation. Assuming red vein kratom facilitates a more robust sedative effect, the CNS may adapt by upregulating stimulatory transmission, such that when it’s discontinued, the individual may be prone to symptoms of overstimulation (e.g. anxiety, agitation, anger, etc.). Oppositely, assuming white vein kratom facilitates a more robust stimulatory effect, the CNS may adapt by upregulating inhibitor transmission, such that when it’s discontinued, the individual may be prone to symptoms of understimulation (e.g. drowsiness, sedation, foggy thinking, etc.).
- Strain: While vein type may be used to predict general physiologic adaptations to kratom and may explain certain withdrawal symptoms, it’s also necessary to consider the specific strain of kratom administered. Alkaloidal constituents of kratom can differ significantly among strains, even among strains exhibiting the same vein color. For example, red-vein Maeng Da may contain different levels of alkaloids than red-vein Bali, thereby leading to strain-specific physiologic adaptations and withdrawal symptoms. Examples of kratom strains include: Bali, Borneo, Indo, Kali, Maeng Da, Malaysian, Thai, etc. – each with various permutations of vein colors (e.g. Red Vein Kali, Green Vein Kali, et al.). You should expect to experience strain-specific physiologic adaptations due to alkaloid content, and predictably, strain-specific withdrawal symptoms and severities.
- Suppliers: Even if the strain sold by distinct suppliers is the same, it cannot be guaranteed that the alkaloidal constituents within each batch of kratom will be identical. It’s possible that one kratom supplier implements superior cultivation techniques than another such that the kratom they sell contains more alkaloids and is of greater potency – than the same strain of kratom sold by another supplier. Moreover, how each supplier stores their kratom, how quickly they sell it to customers, and whether they add ingredients – could influence alkaloid content and/or physiologic effects, adaptations, as well as withdrawal symptoms.
Note: The way in which your physiology adapts to kratom over time will be contingent upon the quantities of psychoactive alkaloids that you consistently ingest. Since vein type/strain and supplier affect alkaloid content, alkaloid content determines physiologic adaptations, and physiologic adaptations predict withdrawal symptoms – vein type/strain and supplier warrant consideration when contemplating number and/or severity of withdrawal symptoms.
The dosage of kratom that you consistently administer will have a substantial influence on the degree to which your physiology shifts away from homeostatic baseline as an adaptation to the influence of kratom. Those who are physiologically adapted to high-doses of kratom can expect more severe withdrawal symptoms and/or a more prolonged recovery than persons who are physiologically adapted to low doses. In other words, if your physiology adapted to receiving 6 grams of red-vein Maeng Da kratom per day, withdrawal symptoms will likely be less numerous/severe after an equivalent taper duration (e.g. 2 weeks) than if your physiology adapted to receiving 12 grams of the same kratom per day.
- Low-dose: The lower the dose of kratom you consistently administered, the less your physiology had to shift away from pre-kratom homeostasis to adapt to its influence. As a result, there’s a smaller gap to bridge between kratom-adapted physiology and homeostatic kratom-free physiology. For this reason, we should expect low-dose kratom users to experience more manageable withdrawal symptoms and require less time to make a full recovery.
- High-dose: The higher the dose of kratom you consistently administered, the greater your physiology had to shift away from pre-kratom homeostasis to adapt to its influence. In brief, hormone production, neurotransmitter production, receptor densities, et al. – will each have shifted more substantially after consistent usage of a high kratom dose than a low one. Because of the more substantial physiologic shift away from pre-kratom homeostasis after taking a high dose, you’ll probably endure more severe withdrawal symptoms and require more time to make a full recovery. For this reason, high-dose users are recommended to conduct a much slower taper than low-dose users.
Term of Administration
The cumulative term over which you’ve administered kratom could also have a profound affect upon your withdrawal symptoms. In most cases, short-term kratom users: exhibit fewer physiologic adaptations to the kratom, have a lower tolerance threshold, and administer lower dosages of kratom – than long-term users. For this reason, it’s logical to suspect that a short-term user will endure less severe withdrawal and experience quicker recovery from his/her withdrawal symptoms than long-term users.
- Short-term: The shorter the term over which you’ve been using kratom, the less likely your physiology will have adapted to its regular influence. Furthermore, since most short-term users have low tolerance thresholds, they tend to use smaller doses. Smaller doses exert a less substantial physiologic effect such that, when discontinued, physiology quickly reverts back to homeostasis. Extremely short-term users, such as someone who uses kratom for just a few days and then quits, may not notice any withdrawal symptoms – especially if ingested at a low dose. Short-term users should have a much easier time tolerating cold turkey and/or rapid discontinuation than longer-term users.
- Long-term: The longer the term over which you’ve been using kratom, the more likely your physiology will have adapted to is regular influence. The number and significance of physiologic adaptations are thought to increase with a longer-term of kratom usage. Someone who’s been using kratom daily for a 5-year term will likely exhibit more profound physiologic adaptation to kratom than someone who’s been using kratom for a 5-week term. Moreover, the longer the term of usage, the more likely an individual will have increased his/her daily dose to offset tolerance. Because long-term users will exhibit more adaptations to kratom, and are often adjusted to receiving a high-dose, withdrawal symptoms may be markedly more debilitating. Long-term users will likely struggle with cold turkey and/or rapid discontinuation methods as compared to shorter-term users.
Note: The aforestated discussion regarding the influence of administration term upon withdrawal symptoms is assuming regular kratom administration. If kratom is used infrequently (e.g. once or twice a week), acute withdrawal symptoms may be negligible or nonexistent – even if administered for a long-term. The greater the frequency of kratom usage, the more relevant the term of administration in terms of influencing withdrawal.
Withdrawal symptoms may also be contingent upon individual factors such as a person’s: age, drug/supplement administration, genetics, preexisting medical conditions, and recovery efforts. Hypothetically, let’s assume that you and your friend began using the exact same strain of kratom [from the same supplier], at equal doses, on the same date. Let’s also assume that you both continued using the same daily dose of kratom for a 3-month duration, and that each of you conducted an identically-paced 2-week taper prior to complete cessation.
Although numerous variables that influence withdrawal symptoms (rate of discontinuation; kratom specifics; dosage; term of administration) were identical in the aforestated hypothetical scenario, it may turn out that your withdrawal experience is much different than your friend’s. For example, you may end up experiencing debilitating symptoms of nausea, fatigue, and insomnia that persist for a month, whereas your friend may experience none of your symptoms, but may end up with mild symptoms of chills, dizziness, and headache that clear up within just 2 weeks. The differences in withdrawal experiences between you and your friend are probably attributable to individual factors.
- Age: It is thought that a person’s age may influence the severity and duration of kratom withdrawal. Individuals who used kratom prior to reaching adulthood without fully developed brains may have a tougher time discontinuing kratom than persons who began using kratom after their brain reached maturity in the mid/late 20s and/or early 30s. Assuming a teenager and/or young adult regularly administered kratom during critical stages of his/her physiologic development, it’s possible that the resulting physiologic adaptation to kratom may be significantly more prominent than in a middle aged adult. For this reason, it’s logical to hypothesize that teens and/or young adults may endure the most severe kratom withdrawal symptoms in comparison to other age groups. Still, perhaps a counter-argument to the aforestated hypothesis is that younger kratom users (teens and young adults) are more likely to exhibit superior physiologic function, health, and plasticity – as compared to adults, possibly allowing them to recover quicker with less substantial withdrawal symptoms. Besides young adults, it’s reasonable to suspect that elderly kratom users (age 65+) may endure severe withdrawal symptoms due to age-related physiologic deterioration that prolongs the transition from kratom-adapted to homeostasis. Though mere speculation, it’s likely that fully matured, middle-aged adults should have an easier time managing kratom withdrawal than younger persons and/or elderly.
- Drugs + Supplements: If you’re using pharmaceutical drugs, illicit drugs, and/or dietary supplements – each may influence the severity of your kratom withdrawal. Certain drugs and/or supplements may attenuate withdrawal symptoms, others may exacerbate them, and others may have no effect whatsoever on withdrawal symptom severity. An example of a withdrawal symptom attenuator might be a prescription sleep medication (e.g. zolpidem). Someone who’s taking zolpidem may not experience insomnia or sleep disturbances during kratom withdrawal – or may find that they are relatively easy to manage. Had the person not been taking zolpidem, the withdrawal-related insomnia and sleep disturbances may have been severe. An example of a withdrawal symptom potentiator might be using a prescription ADHD medication (e.g. mixed amphetamine salts). If you happen to be using mixed amphetamine salts, which are known to exert a psychostimulant effect, this may potentiate kratom withdrawal symptoms such as agitation, anxiety, and restlessness – making them even more difficult to manage. Understand that certain drugs and/or supplements may also facilitate attenuation of certain withdrawal symptoms, yet potentiation of others. For example, a benzodiazepine may mitigate the symptom of restlessness, but may potentiate your symptom of cognitive dysfunction. Also keep in mind that other substances may have no direct effect on kratom withdrawal symptoms, but could augment homeostatic recovery and/or our ability to psychologically cope.
- Genetics: Your genetics and epigenetics may determine the speed by which your physiology transitions from kratom-adapted to homeostasis. It’s possible that certain genes are implicated in physiologic resilience and/or homeostatic rebound such that certain persons experience a much shorter withdrawal duration than others. Furthermore, it’s also reasonable to suspect that epigenetic expression may be implicated in determining the severity of withdrawal symptoms and rate of post-kratom physiologic recovery. It should be underscored that the allelic expression of hepatic CYP450 enzymes implicated in kratom metabolism will influence the effect of alkaloids upon a person’s physiology. Because of this, we might hypothesize that physiologic adaptations to kratom may differ depending on metabolism speed: ultra-rapid, extensive, intermediate, poor. Genetics may play a larger role than many suspect in terms of subjectively-perceived withdrawal symptom severity and rate of recovery.
- Medical conditions: If you have preexisting medical diagnoses and/or a history of medical conditions, you may be more at risk of experiencing more severe and/or specific withdrawal symptoms. For example, someone who’s been diagnosed with hypertension may be more at risk of experiencing blood pressure spikes during kratom withdrawal than someone without a history of blood pressure irregularities. Other examples could be persons who’ve been diagnosed with major depressive disorder or chronic pain who claim to experience crippling depression and muscle pain, respectively, during withdrawal. While some of the depression and pain can be attributed to kratom withdrawal, the severity of each is amplified due to preexisting medical diagnoses. It’s also possible that preexisting medical conditions prevent the emergence of certain withdrawal symptoms and/or have no effect upon symptoms.
- Recovery efforts: A person’s lifestyle and efforts made to recover after quitting kratom may have a significant impact on withdrawal symptom severity and total duration prior to symptom cessation. Making concerted effort to recover during withdrawal may involve: minimizing stress (e.g. meditating), staying socially connected, getting sufficient sunlight (to maintain normative circadian function), exercising (to reduce stress and burn up extra energy), going to therapy (for professional psychological support), and maintaining a sleep schedule. Someone who puts forth serious effort to recover will probably have an easier time managing withdrawal symptoms and/or reverting to pre-kratom homeostasis – than someone who puts forth zero effort.
Note: Some of these individual factors (e.g. age, genetics, drugs/supplements) may affect how long kratom stays in your system. The longer kratom stays in your system after your final dose, the greater the gap between your final dose and the onset of withdrawal symptoms.
How long does kratom withdrawal last? (Duration + Timeline)
If you recently discontinued kratom, you probably want to know how long your withdrawal is going to last. The truth is that, while everyone wants a definitive answer for the sake of certainty, there’s no telling exactly how long you’ll experience symptoms. As was already mentioned, the severity and duration of withdrawal will be contingent upon variables such as: rate of discontinuation, specific kratom used, the dosage, term of administration, and the individual.
Moreover, analysis of kratom’s pharmacokinetics indicates that its alkaloidal constituents up to 6 days for complete systemic elimination. While certain kratom alkaloids are fully eliminated from the body within 1-2 days, mitragynine (the primary psychoactive alkaloid of kratom) exhibits an elimination half-life that exceeds 23 hours, meaning it could take up to 6 days for its complete elimination. While most will notice withdrawal symptoms emerge within a couple days of their final dose, symptomatic severity may increase after 6 or 7 days of abstinence.
In any regard, some believe that the symptoms of kratom withdrawal can be categorized into three major stages: the acute stage, intermediary stage, and the post-acute stage. The acute stage tends to be characterized by the most severe symptoms. Intermediary and post-acute stages tend to be more manageable than the acute stage, however, each may present unique difficulties and frustrations.
- Stage #1 (Acute): For most, the acute stage of kratom withdrawal begins between Day 1 and Day 7 post-discontinuation. Commencement of the acute stage of kratom withdrawal may be contingent upon alkaloid content and the final dose ingested. In most cases, the acute stage will emerge by Day 7 post-discontinuation and persist for an additional 3 to 10 days. The acute stage is characterized by the most debilitating and/or severe withdrawal symptoms. Symptoms that commonly emerge during the acute stage of withdrawal include: anxiety, chills, depression, diarrhea, dizziness, fluctuations in body temperature, headaches, insomnia, nausea, sensory hypersensitivity, hypersomnia, restless leg, runny nose, stomach pain, sweats, tremor, twitching, vomiting, and watery eyes. Within 3 days of kratom leaving a person’s system, acute symptoms tend to be the worst. Some individuals will be through with the acute symptoms of kratom withdrawal in as quickly as 10 days post-cessation, whereas others may experience acute symptoms that persist for nearly 17 days post-cessation.
- Stage #2 (Intermediary): Once you’ve endured the acute stage of kratom withdrawal, and begin the intermediary stage, you should feel markedly better and more functional. Most will know exactly when the acute stage of kratom withdrawal ends because they’ll no longer feel extremely sick and won’t be bedridden. Many symptoms from the acute stage of withdrawal will linger in the intermediary stage, but they’re usually less intense than in the acute stage. Common symptoms that are reported in the intermediary stage of withdrawal include: anxiety, depression, fatigue, headache, insomnia, and muscle cramps. In most cases, the intermediary stage of withdrawal starts between Day 10 and Day 17 post-cessation, and persists for an additional 2 to 6 weeks. During the intermediary stage of withdrawal, it’s easy to get discouraged and/or feel as though the withdrawal symptoms will never end. For this reason, it’s important to continue taking good care of yourself, focus on recovery efforts, and remain optimistic.
- Stage #3 (Post-Acute): If you’ve been off of kratom for 1-2 months, you’ve been through the acute stage of withdrawal, as well as the intermediary stage. At this point, you may be feeling as though you’re nearly 100% recovered to homeostatic pre-kratom physiology. Most low-dose kratom users and/or individuals who didn’t use kratom for a long-term should be recovered at this point and may not need to worry about the third stage of withdrawal, referred to as “post-acute.” That said, long-term high-dose kratom users will probably experience lingering, unwanted symptoms. Medical literature refers to long-lasting discontinuation symptoms under the acronym PAWS (Post Acute Withdrawal Syndrome). There’s no telling exactly how long withdrawal symptoms will linger in the post-acute stage. A majority of individuals who experience symptoms in the post-acute stage will notice that they improve within 3 additional months. After 5 to 6 months of being kratom free and maintaining abstinence from all substances, it’s usually rare to still be experiencing withdrawal symptoms. Still, some former kratom users have reported that, after long-term/high-dose usage, full physiologic recovery required 6 months to 1 year.
For most, it may be helpful to avoid expecting a quick and/or rapid recovery from kratom withdrawal symptoms – especially if you were a long-term/high-dose user. A good rule of thumb is to expect that withdrawal symptoms will last at least 90 days. By assuming a 90-day minimum term of kratom withdrawal, you won’t be upset or anxious if your withdrawal symptoms don’t seem to improve much within the initial weeks or first couple months after discontinuation.
In most cases, assuming abstinence from kratom (and other drugs) is maintained, withdrawal symptoms will either be: completely abolished, extremely manageable, and/or less intense after 90 days of abstinence – than in earlier weeks and/or months. Even if you aren’t fully recovered within 90 days, you’ll probably feel much better than in early days of kratom cessation. Moreover, the longer the term you’ve been kratom-free, the less intense and numerous your withdrawal symptoms should be.
Because it’s often difficult to accurately remember how we felt a month ago, a week ago, and sometimes even a day ago – it is recommended to track your recovery from kratom withdrawal by maintaining a daily journal. In your journal, you can document how you’re feeling (i.e. mood), the kratom withdrawal symptoms that you’re experiencing, as well as the severity of each withdrawal symptom. Journaling can also serve as a useful outlet of expression such that it allows you to vent any anger and/or frustration that you’re experiencing throughout the kratom withdrawal process.
Human memory retrieval (i.e. recall) is often more erroneous than we believe. If you don’t maintain a journal or keep any documentation of your day-to-day symptoms during withdrawal, you may not realize how much you’ve improved over a period of several weeks and/or months following your final dose. For example, you may have quit kratom 5 weeks ago, and based on memory, you may believe that your withdrawal symptoms haven’t improved at all. Had you kept a journal, you’d realize that your memory was slightly inaccurate and/or you had forgotten than various debilitating symptoms in the early stages of withdrawal are now nonexistent.
How to Minimize Kratom Withdrawal Symptoms: Strategies to Consider
Everyone who discontinues kratom hopes that withdrawal symptoms will be limited in number, severity, and duration. If you’ve recently stopped taking kratom and are in the midst of detox and/or are planning on quitting kratom and want to minimize your withdrawal symptoms, you may benefit from implementing strategies aimed at attenuating the burden of withdrawal and/or expediting recovery. Examples of such strategies include: conducting a slow taper, seeking professional support, using certain substances to treat withdrawal symptoms, avoiding substances that may exacerbate withdrawal symptoms, and making lifestyle changes.
Prior to implementing any of the strategies listed below, it is recommended to consult a medical professional to verify their hypothesized efficacy and/or safety in accordance with your current medical status and/or medication regimen. Moreover, understand that the degree of benefit derived from these strategies will be subject to individual variation. Some individuals may find that certain withdrawal symptom mitigation strategies are highly effective, whereas others may find that they yield negligible benefit.
- Implement a slow taper: Arguably the most effective way to minimize the severity of kratom withdrawal symptoms is to implement a slow or gradual taper whereby you reduce your daily dose slightly over a period of weeks and/or months prior to complete cessation. When you gradually reduce your dose over an extended duration (as occurs in a slow taper), your physiology has some time to adapt to the dosage reduction, such that after your final dose, your physiology will be closer to homeostasis. The closer your physiology is to pre-kratom homeostasis prior to your final dose, the less intense your withdrawal symptoms should be. Comparatively, if you discontinue kratom “cold turkey” without a taper, your physiology will be further from homeostasis prior to your final dose, probably increasing odds of a severe withdrawal. Generally, slower the taper, the more manageable withdrawal symptoms should be. An ultra-conservative rate of taper for high-dose/long-term kratom users is a dosage reduction of 10% per month. In other words, if you were taking 5 grams of kratom per day, you’d drop your dose by 0.5 grams (10%) to 4.5 grams per day for the first month of your taper. Thereafter, you’d drop to 4.05 grams per day for the second month, and so on, until you’re down to nothing. If you don’t know how much kratom you’ve been taking and/or how to implement this tapering method – it is recommended to purchase a cheap digital scale and weigh the kratom. Think of a slow taper like gradually cutting back on calories to lose weight. The slower the rate of calorie cutting, the easier the process for most people.
- Seek professional support: After you’ve began gradually tapering off of kratom at a rate that suits your liking, it is recommended to book an appointment with a medical professional and, if possible, regularly see a psychologist. It is important to discuss the fact that you’re discontinuing kratom with a doctor and/or psychiatrist, and receive regular checkups to ensure that you aren’t at risk of any adverse reactions during detox (e.g. rebound hypertension). In addition to monitoring your health during tapering and withdrawal, a medical professional is qualified to recommend certain over-the-counter drugs and/or supplements, as well as prescribe various drugs to help you manage your most debilitating kratom withdrawal symptoms. If you can afford it, seeing a psychologist at regular intervals (e.g. once per week, once every other week, once a month) during your kratom withdrawal should help you cope with the psychological aspects of discontinuation and prevent relapse – especially if you were a long-term user.
- Drugs or supplements: As is known, various drugs and/or dietary supplements can be extremely beneficial for the management of kratom withdrawal symptoms, as well as for expediting recovery to homeostasis. The drugs and/or supplements that you use should be verified by a medical professional as safe in accordance with your medical status and/or history. Moreover, the drugs and/or supplements that you decide to use during withdrawal should be evidence-based and contingent upon the specific symptoms that you experience. Some individuals may need drugs and/or supplements to help while tapering off of kratom, others may need them only after they’re completely kratom-free, and another subset may not need any drugs or supplements during withdrawal.
- Discontinue unnecessary substances: While certain drugs and supplements can attenuate the severity of kratom withdrawal symptoms, others may exacerbate them. If you’re taking drugs and/or supplements that aren’t medically-necessary, and that may potentiate the severity of kratom withdrawal symptoms, you may want to discontinue them. For example, someone in the habit of drinking caffeine in the morning may find that, during kratom withdrawal, the caffeine intake amplifies anxiety, agitation, irritability, and restlessness. In this case, it’s probably a good idea to stop drinking caffeine until you’re through kratom withdrawal. That said, if your physiology is adapted to a high-dose of a psychoactive substance [in addition to kratom], you may want to reconsider complete discontinuation. Abrupt discontinuation of another psychoactive substance while simultaneously withdrawing from kratom may complicate the entire process, possibly yielding withdrawal symptom overlap or potentiation and more substantial debilitation than sole discontinuation of kratom.
- Lifestyle modifications: Another way to minimize the severity of kratom withdrawal symptoms is to modify your lifestyle in ways that are conducive to general health and recovery. Aspects of your lifestyle that you may want to modify could include: diet, physical activity, sleep, social, and sunlight exposure. Someone who: eats a healthy diet, stays physically active, endeavors to get enough sleep, stays socially engaged, and avoids excess stress – should recover much quicker than someone who neglects diet, physical activity, sleep, etc.
- Diet: Reflect upon whether you’re consuming a healthy, balanced diet with plenty of vegetables, fruits, complex carbohydrates, and protein. Dietary imbalances can affect physiologic function, hormone secretion, and neurotransmitter production – each of which could alter your recovery speed in withdrawal. Also be sure that you’re consuming an optimal amount of calories such that you’re not consistently overeating or undereating. Some will find that elimination of unhealthy fats, excessive sugar, artificial sweeteners, etc. – improve their recovery. Also, be sure that you’re maintaining optimal hydration and electrolyte intake. Deficits in specific micronutrients and/or macronutrients could lead to problems. Lastly, you may want to tweak your diet based on specific symptoms that you’re experiencing. For example, avoid high-fiber foods if you’re experiencing severe diarrhea and GI distress in withdrawal – as this may exacerbate each symptom.
- Physical activity: Getting some regular physical exercise can often promote healing and expedite recovery during kratom withdrawal. In the early stages of withdrawal, you may want to keep physical activity to a minimum due to the fact that your CNS will be extra sensitive. Avoid taxing your CNS with heavy lifting or intense cardio. After the first week or two of withdrawal, you may want to engage in some low-level physical activity (e.g. walking) each day. When you feel up for it, you can gradually increase the intensity of your exercise such as by jogging for a bit or lifting weights. Physical activity not only helps mitigate various withdrawal symptoms (e.g. restlessness), but it can serve as a temporary distraction from them. Furthermore, lack of physical activity (e.g. excessive sitting or lying in bed) may exacerbate certain withdrawal symptoms (e.g. muscle aches, restlessness, etc.) and/or prolong recovery.
- Sleep: While it may be difficult to control your sleep during withdrawal, it’s worth attempting. Doing things like: avoiding stimulants in the afternoon and evening, installing black-out curtains and/or wearing a sleep mask, minimizing blue light exposure, administering supplements, and [possibly] reducing EMF radiation – may improve both your sleep quality and quantity during withdrawal. Moreover, it may be helpful to maintain a specific sleep schedule such as falling asleep at ~9:00 PM each night and waking each morning at 6:00 AM. Maintenance of a set sleep schedule can help minimize circadian irregularities [and corresponding deleterious physiologic effects] associated with ever-changing sleep/wake schedules.
- Social engagement: Though professional social support from a psychologist or psychotherapist is recommended during kratom withdrawal, social support from friends and family is also beneficial. Staying socially engaged can help keep the focus off of your withdrawal symptoms, and may provide a bit of beneficial brain stimulation during recovery. That said, you’ll want to avoid socializing with emotionally-volatile persons and/or individuals who are likely to cause stress. For most, social engagement and positive social support is probably more conducive to recovery than social isolation.
- Stress reduction: At some point during kratom withdrawal, you’re probably going to experience an increase in stress. Increased stress may stem from excessive activation of the sympathetic nervous system, imbalanced neurotransmission, and/or the fact that you’re experiencing uncomfortable symptoms or sensations throughout detox. Although the stress may seem impossible to manage, if left unmanaged it could exacerbate certain withdrawal symptoms and/or prolong your recovery. For this reason, it is recommended to be proactive in managing stress such as by avoiding environmental stressors whenever possible and taking some time to relax each day for at least 10 to 20 minutes. Stress reduction may involve things like: deep breathing, exercise, hot tubs, meditation, napping, paced breathing, sauna, self-hypnosis, and/or warm baths.
- Sunlight / Fresh air: Although many individuals will feel incapacitated in the acute stage of kratom withdrawal such that they are rendered to a bed or couch, when the acute stage passes, it’s generally easier to move around. If you can manage to drag yourself outside and get some sunlight plus fresh air, the combination should expedite your recovery. Adequate exposure to UVB sunlight will increase vitamin D synthesis, which could expedite recovery and enhance: bone health, cognition, immune function, mood, et al. Moreover, sunlight regulates the circadian rhythm and corresponding neurotransmitter and hormone production. Insufficient sunlight exposure throughout withdrawal may leave your circadian rhythm dysregulated, ultimately exacerbating withdrawal symptoms and prolonging recovery. If you aren’t already doing so, get outside and soak up a bit of sun each day along with fresh (unpolluted) air.
- Stay busy: After quitting kratom, some claim that the most effective way to cope with discontinuation symptoms is by keeping themselves as busy as possible. Keeping busy can help mitigate the severity of withdrawal by shifting one’s primary mental focus away from disconcerting symptoms or sensations. When you’re engaged in a specific task (e.g. vacuuming the house), you may temporarily forget about your withdrawal symptoms and/or they may seem less severe because you’re not dwelling on them. If you don’t know how to stay busy, you may want to start by making a small checklist of several tasks that you need to complete each day. When you’ve consistently completed your small checklist each day for a week or two, add a few items. You may start out with a basic checklist like: journal, cook myself breakfast, clean the dishes, shower, and make my bed. When you’ve been consistent with this checklist for a week, you might add things like: go for a walk around the block, meditate for 10 minutes, and/or do 1 hour of work. In the process of “staying busy,” listen to your body so that you aren’t overdoing as to induce stress. In any regard, staying busy and completing tasks each day should help distract you from your miserable withdrawal while simultaneously giving you a sense of accomplishment and preventing boredom that, if excessive, might lead to relapse.
Drugs & Supplements for Kratom Withdrawal Symptoms
To minimize the severity of kratom withdrawal, many find it helpful to strategically administer over-the-counter drugs, dietary supplements, and/or pharmaceutical drugs. Foremost, it should be stated that, if you use any substance to attenuate the severity of kratom withdrawal, there’s a chance that it may yield withdrawal symptoms of its own when discontinued. For example, many individuals report zero withdrawal from kratom after receiving a prescription for buprenorphine from their doctor, yet when the buprenorphine is discontinued, withdrawal symptoms are severe.
Also understand that many people successfully endure kratom withdrawal without using any drugs or supplements to attenuate symptoms. Nevertheless, assuming your symptoms are severe enough to warrant treatment, you’ll first need to pinpoint the specific symptoms that are most debilitating. After you’ve identified the most debilitating withdrawal symptoms, then you can start researching drugs and/or supplements for treatment.
Prior to purchasing and/or ingesting any drugs or supplements to ease kratom withdrawal, it is recommended to consult a medical professional to discuss whether the substances you’ve considered are safe [in accordance with your medical status] and evidence-based for the treatment of your symptoms. Moreover, medical professionals should be knowledgeable enough to ensure that the combination of substances recommended will not provoke an adverse interaction effect. Below are lists of supplements, over-the-counter medications, and pharmaceutical drugs that may attenuate the severity of kratom withdrawal.
Always verify with a doctor to ensure that the dietary supplement(s) you’ve decided to administer during kratom withdrawal are safe. Additionally, ensure that you’re purchasing each from a quality source and follow proper dosing instructions. Know that combining too many supplements and/or dosing errors may provoke serious adverse reactions and/or interactions.
Full disclosure: Links to each of the supplements below are “affiliate” links, meaning the author of this post will earn a small commission if you purchase products by clicking through these links. (The prices of the products are the exact same as they would normally be if you didn’t click through the affiliate link). By purchasing supplements through the affiliate links below, you help support the upkeep of this website.
- Adaptogenic herbs: Any herbs classified as “adaptogenic” are thought to restore physiologic balance from an imbalanced state. After discontinuing kratom, the cause of withdrawal symptoms is imbalanced physiology. Specific aspects of physiology that are imbalanced include: the autonomic nervous system, neurotransmission, and hormone secretion. Regular administration of an adaptogen could ameliorate the aforestated imbalances so that withdrawal symptoms are less severe. Moreover, most adaptogens are thought to act as neuroprotective agents and promote optimal brain health. Examples of adaptogens include: Rhodiola rosea, Ginseng (Panax and Siberian), Holy basil, Ashwagandha, Bacopa monnieri, and Astragalus root.
- Alpha-lipoic-acid (ALA): Alpha lipoic acid is a supplement that functions primarily as an antioxidant, but also exerts an anti-inflammatory effect. Preliminary evidence suggests that alpha lipoic acid enhances brain health by reducing oxidative stress and reversing deficits in acetylcholine transmission. In animal models of drug detox, biomarkers indicative of oxidative stress are significantly increased, however, administration of alpha-lipoic acid reduces them. The reduction in oxidative stress biomarkers via alpha lipoic acid administration attenuates detox symptoms. While alpha lipoic acid hasn’t been investigated in humans for the management of kratom withdrawal, there’s reason to suspect that it might help.
- Curcumin: Curcumin is a principal [curcuminoid] constituent of the spice turmeric that’s been shown to facilitate a host of favorable physiologic changes, some of which might prove beneficial during kratom withdrawal by attenuating withdrawal symptoms. Emerging evidence suggests that curcumin may: lower inflammation; protect neurons from damage; regulate BDNF and CREB; decrease oxidative stress; upregulate central DHA; modulate glutathione concentrations; and restore gut health. The aforestated hypothesized benefits considered, it’s reasonable to suspect that regular curcumin supplementation during kratom withdrawal could mitigate certain withdrawal symptoms, including: cognitive deficits, depression, joint pain, muscle aches, et al. What’s more, an animal model study by Motaghinejad, Bangash, Hosseini, et al. (2015) discovered that curcumin dose-dependently attenuates symptoms of morphine withdrawal. Though the aforestated results from animals cannot be extrapolated to humans withdrawing from kratom, it’s possible that humans would respond similarly such that curcumin counteracts opioid and/or adrenergic imbalances in the human brain to ameliorate symptoms of kratom withdrawal. Curcumin may be worth trying during kratom withdrawal, however, because it can cause gastric irritation, anyone experiencing symptoms of diarrhea, loose stools, and/or upset stomach – may want to avoid it. (Source: https://www.ncbi.nlm.nih.gov/pubmed/25821292).
- Electrolytes: While withdrawing from kratom, many individuals experience diarrhea and/or vomiting, each of which dehydrate the body and deplete electrolytes. Moreover, even if diarrhea and vomiting aren’t experienced, a subset of persons will drink excessive quantities of water throughout withdrawal in attempt to detoxify. Though it’s important to stay hydrated, excess hydration can lead to electrolyte imbalances and exacerbation of withdrawal symptoms. To avoid electrolyte imbalances, you may want to use an electrolyte supplement throughout withdrawal that guarantees a balanced intake of magnesium, sodium, potassium, and chloride ions. Many claim that electrolytes significantly reduce symptoms such as dizziness, headaches, muscle aches, and cramps.
- Glutathione (GSH): Glutathione is often regarded as the “master antioxidant” within the body on the basis that it significantly reduces oxidative stress and can aid in detoxification of heavy metals. By reducing oxidative stress and bolstering antioxidant status, glutathione may attenuate severe symptoms of kratom withdrawal and/or enhance recovery efforts. Research by Xu, Wang, Li, et al. (2006) discovered that opioidergic drugs increase dopamine and dopamine oxidative metabolism, which leads to upregulation of reactive oxygen species. Elevated reactive oxygen species damage cells (including neurons) and interfere with normative CNS activity. Furthermore, in animal models, high oxidative stress appears to exacerbate withdrawal symptoms from opioidergic drugs and prolong the withdrawal process. Administration of exogenous glutathione has been shown to attenuate withdrawal symptoms in heroin-dependent mice by reducing oxidative damage. This considered, one might speculate that exogenous glutathione (or substances that upregulate glutathione synthesis) would provide benefit in kratom withdrawal. (Source: https://www.ncbi.nlm.nih.gov/pubmed/16918717).
- Krill oil or Fish oil: Krill oil and fish oil contain the omega-3 fatty acids DHA and EPA, each of which play a role the maintenance of healthy brain function. Preliminary evidence suggests that DHA and EPA may: reduce inflammation, enhance mood, correct neurotransmitter imbalances, and bolster cognitive function. Because the brain derives substantial benefit from a regular supply of omega-3 fatty acids, supplementation with a high-quality krill oil or fish oil during kratom withdrawal may attenuate certain withdrawal symptoms. Even better than supplementation would be consuming some wild-caught seafood (devoid of mercury) 2 to 3 times per week.
- Green tea: Although many people who quit kratom are coffee drinkers, continuing to drink coffee throughout withdrawal may exacerbate certain withdrawal symptoms. In withdrawal, noradrenergic transmission may be excessive and the sympathetic nervous system may be overactive. If coffee is consumed during withdrawal, metaphorically, it may be like pouring gasoline on an already-blazing fire whereby symptoms of anxiety, jitters, insomnia, and restlessness are exacerbated. Because you probably won’t want to cease caffeine cold turkey right after stopping kratom (partly because this could confound your withdrawal symptoms), it may be smarter to reduce caffeine intake by drinking green tea. Not only does green tea contain caffeine to promote alertness, but it contains L-theanine which can help induce relaxation. That said, green tea and all caffeinated beverages should be avoided by persons experiencing diarrhea or gastrointestinal distress during withdrawal.
- L-theanine: A supplement that some individuals swear by when discontinuing kratom is L-theanine. L-theanine functions by modulating the neurotransmission of dopamine, GABA, and serotonin; altering activation of AMPA, NMDA, and kainate receptors; and upregulating alpha brain waves. While withdrawing from kratom, supplementation with L-theanine may: enhance aspects of cognitive function (attention and memory); treat insomnia or improve sleep quality; reduce anxiety; and minimize restless leg. If you’re struggling with anxiety, agitation, and/or restlessness, L-theanine is worth considering. That said, if you’re already using CNS depressants (e.g. anxiolytics, sedatives, etc.) or are extremely drowsy/fatigued, L-theanine should be avoided.
- Magnesium: Some sources suggest that nearly 80% of the United States populace is deficient in magnesium. A preexisting magnesium deficiency can provoke symptoms of anxiety, depression, restlessness, etc. – all of which overlap with kratom withdrawal. While withdrawing from kratom, your body may require additional magnesium due to excessive sympathetic tone and stress. If you’re eating plenty of dark green vegetables each day, you may not need to supplement with magnesium, however, many still find it beneficial. Many claim that magnesium is a godsend in terms of reducing restless leg, migraine, headache, insomnia, and anxiety during detox. If you decide to supplement with magnesium, avoid high dosages – as this may cause diarrhea. Because there are many types of magnesium on the market, it is important to know which are likely to prove most beneficial during withdrawal. Various types of magnesium you may want to consider include: magnesium glycinate, magnesium-l-threonate, magnesium taurate, and magnesium citrate (e.g. Natural Calm). Avoid magnesium oxide – as this lacks the bioavailability necessary to facilitate benefit.
- Melatonin (Low-dose): Another supplement that can be highly effective for mitigating insomnia and enhancing sleep during kratom withdrawal is melatonin. It should be noted that most individuals unknowingly take too much melatonin for their own good. The optimal dose of melatonin for most individuals is small – just 0.3 mg – which should help you fall asleep, but may not keep you asleep. Taking a standard dose of melatonin (e.g. 3 mg+) will quickly desensitize your receptors, making it more difficult to sleep with continued use.
Note: The above list of supplements is far from comprehensive and is intended to be minimalistic. Most people will benefit from the strategic usage of just a few supplements – not all of them. Additionally, it is recommended to only use supplements that are considered safe by a medical doctor and also to avoid taking a combination of [multiple] supplements without first investigating and ruling out interactions.
Over-the-Counter (OTC) Drugs
In addition to using dietary supplements, many will administer over-the-counter (OTC) drugs during kratom withdrawal to ameliorate specific withdrawal symptoms. For example, someone experiencing symptoms such as debilitating muscle pain, a splitting headache, and diarrhea [during kratom withdrawal] may benefit from using an acetaminophen-containing agent (e.g. Tylenol) which should reduce the muscle pain plus headache, as well as a loperamide-containing agent (e.g. Imodium) which should combat the diarrhea. Although over-the-counter drugs are available for purchase without a prescription, it is recommended to confirm their safety with your doctor prior to usage during withdrawal.
- Antiemetics: Antiemetics are drugs aimed specifically at reducing symptoms of nausea and vomiting, however, they can also be helpful for the management of dizziness and/or motion sickness. Since many people experience nausea, vomiting, dizzy throughout their kratom withdrawal, it often helps to have a supply of antiemetics to attenuate these symptoms. Over-the-counter antiemetics tend to include: Bismuth Subsalicylate-containing agents (e.g. Pepto-Bismol) and Ginger. Some claim that antihistamines (e.g. Benadryl) and/or antidiarrheal agents (e.g. Imodium) are also capable of facilitating an antiemetic effect.
- Antihistamines: Antihistamines block the neurotransmission of histamine, making them useful in the management of allergic reactions. That said, many individuals find them helpful in counteracting symptoms of kratom withdrawal, including: anxiety, gastric distress, headaches, insomnia, itchiness, motion sickness, nausea, and sleep disturbances. Likely the most popular of antihistamines utilized in the management of kratom withdrawal symptoms are diphenhydramine-containing agents (e.g. Benadryl).
- Antidiarrheal agents: Because kratom withdrawal is associated with diarrhea, frequent bowel movements, and loose stools – it’s helpful to use an antidiarrheal agent when needed. Most high-dose/long-term kratom users claim that loperamide-containing products (e.g. Imodium) seem to prove most effective. Not only do antidiarrheal agents prevent onset of diarrhea, but they sometimes alleviate gastric distress, stomach aches, and muscle pain. Moreover, loperamide-containing products might ameliorate a host of other kratom withdrawal symptoms via agonism of the mu-opioid receptor.
- NSAIDs or acetaminophen: Over-the-counter pain relievers such as NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) and acetaminophen (or paracetamol) are often extremely helpful during kratom withdrawal. NSAIDs are capable of facilitating a combination of analgesic, antipyretic, and anti-inflammatory effects. Examples of popular NSAIDs include: Aspirin, Ibuprofen, and Naproxen. Acetaminophen facilitates an analgesic effect, but is less efficacious in alleviating inflammation. Regardless of the specific pain reliever used during withdrawal, it should help treat withdrawal symptoms such as fever, headache, and muscle aches.
Prescription Medications (Rx-only)
Among those experiencing severe symptoms of kratom withdrawal, it may be necessary to treat symptoms with prescription medications. In extreme cases of kratom withdrawal, a medical professional may decide that it would be best for a patient to transition from kratom to an opioid-replacement drug. Opioid-replacement drugs such as buprenorphine and/or methadone not only manage symptoms of kratom withdrawal, but they can usually prevent relapse or reversion to kratom, opiate, and/or opioid ingestion.
If a professional and/or patient agree that it’s best to avoid all opioidergic agents during withdrawal, individuals will probably receive prescription medications that can manage their most debilitating symptoms. For example, someone experiencing anxiety, depression, insomnia, and restlessness may find that a prescription antidepressant alleviates all of the aforestated symptoms. Someone who’s experiencing just insomnia may benefit more from prescription sleeping medications (e.g. nonbenzodiazepines). Below is a list of prescription drugs that individuals may receive and/or find helpful during kratom detox.
- Antiemetics: Over-the-counter antiemetics aren’t always effective for the treatment of withdrawal-related nausea and vomiting, and for this reason, prescription antiemetics may be needed. Useful prescription antiemetics could include: 5-HT3 receptor antagonists (e.g. mirtazapine), dopamine receptor antagonists (e.g. olanzapine), and GABA modulators (e.g. lorazepam).
- Antihistamines: It is known that many individuals experience allergy-like symptoms after discontinuing kratom such as: headache, itchiness, runny nose, and watery eyes. These allergy-like symptoms sometimes improve with the strategic administration of antihistamines. If there are no over-the-counter antihistamines that seem to reduce certain symptoms of kratom withdrawal, prescription antihistamines may do the trick. Examples of prescription antihistamines include: Astelin, Clarinex, and Xyzal. That said, usually over-the-counter antihistamines work just as well as those needing a prescription.
- Anxiolytics: Many individuals will experience uncontrollable anxiety throughout kratom withdrawal. The anxiety is thought to occur mostly due to excessive sympathetic activation stemming from upregulated noradrenergic transmission. Although dietary supplements can sometimes lower anxiety, they are not as potent as prescription anxiolytics. If your anxiety is interfering with your quality of life and/or ability to function, it may be helpful to use a daily or “as-needed” prescription anxiolytic. Examples of prescription anxiolytics include: benzodiazepines, beta blockers, SSRIs, and tricyclic antidepressants.
- Antidepressants: Persons who experience extreme apathy and/or depression throughout kratom withdrawal may benefit from prescription antidepressants. If the depression a person experiences is so severe that they cannot seem to function and/or are contemplating suicide – prescription antidepressants are generally regarded as a necessary intervention. Prescription antidepressants predominantly modulate monoaminergic transmission to enhance mood. In addition to reversing a depressive mood, prescription antidepressants often help with anxiety, fatigue, insomnia, and sleep.
- Benzodiazepines: Benzodiazepines exhibit a combination of anxiolytic, sedative, and hypnotic effects. Though they may exacerbate kratom withdrawal symptoms of drowsiness, fatigue, and/or somnolence – they often alleviate anxiety, insomnia, and restlessness. Although benzodiazepines are generally among the most dangerous psychiatric drugs when used at high-doses and/or for a long-term, monitored usage on an “as-needed” basis for a few weeks during kratom withdrawal may prove highly beneficial for a subset of individuals who struggle with overarousal-related symptoms.
- Alpha-2 agonists: In some cases, alpha-2 adrenergic receptor agonists are among the most useful interventions for the management of kratom withdrawal. Stimulation of alpha-2 receptors in the brain is known to reduce sympathetic tone, which in turn tends to attenuate withdrawal symptoms such as: anxiety, heart palpitations, high blood pressure, hot flashes, restlessness, sweating, and tachycardia. Additionally, alpha-2 adrenergic agonists like clonidine and guanfacine can modulate noradrenergic tone in the prefrontal cortex, possibly offsetting withdrawal-related cognitive deficits. (There’s a plethora of research supporting the usage of clonidine for opiate withdrawal). For some individuals, an alpha-2 adrenergic agonist is all that’s necessary to get them through the roughest stages of kratom withdrawal.
- Opioid-replacement medications: As was noted, if someone is really struggling with his/her kratom withdrawal symptoms and/or has a history of opiate dependence, it may be smart to utilize an opioid-replacement medication. Opioid-replacement medications consist of buprenorphine-containing agents (e.g. Suboxone) or methadone. Because kratom is relatively similar to buprenorphine in its mechanism of action, perhaps buprenorphine-containing agents will be the most helpful. By switching to an opioid-replacement medication from kratom, it’s easier to conduct a gradual taper and minimize withdrawal symptoms.
- Opioid receptor antagonists: Administration of a mu-opioid receptor antagonist after quitting kratom may slightly exacerbate certain withdrawal symptoms, but may help restore homeostatic opioidergic transmission at a faster pace. Antagonism of the mu-opioid receptor with a drug like naltrexone can lead to receptor downregulation and may aid in the maintenance of abstinence from kratom by reducing cravings that could lead to relapse.
- Sleeping pills: If restless leg before bed, insomnia, and/or sleep disturbances are reducing your total sleep duration and sleep quality – you may benefit from transient usage of sleeping pills for a few weeks of withdrawal. Most commonly prescribed for sleep induction and maintenance are nonbenzodiazepines or “Z-drugs” such as eszopiclone (Lunesta) and zolpidem (Ambien). Other possibly useful agents for sleep induction may include: doxepin, estazolam, quetiapine, ramelteon, temazepam, and trazodone.
Note: Understand that not everyone will benefit from the same drugs and/or supplements during withdrawal. A substance or combination that works well for you may be ineffective and/or problematic for someone else. Furthermore, while using any drug and/or supplement, it is important to observe how your body responds. If you’ve been using a drug and/or supplement for a reasonable duration and aren’t deriving any therapeutic benefit – you may want to discontinue. Keep your doctor updated regarding how you’re tolerating certain substances and whether they’re actually effective in the management of your withdrawal symptoms.
Have you experienced Kratom withdrawal symptoms?
If you’ve ever used kratom regularly for a reasonable duration and then discontinued, share whether you experienced any withdrawal symptoms in the comments section below – as well as how long they persisted. Assuming you experienced some withdrawal symptoms, which specific symptoms did you find most severe and/or debilitating? If you had to rate the severity of your most noticeable kratom symptoms on a numeric scale ranging from 1 to 10 (with “1” indicating least severe and “10” indicating maximal severity), what number would you assign each?
To help others get a better understanding of your kratom withdrawal experience, provide additional details such as: the cumulative duration over which you had regularly used kratom (e.g. 2-years); your average daily dose (e.g. 5 grams); the specific strain of kratom you administered (e.g. Red Vein Maeng Da) and the rate at which you discontinued (e.g. cold turkey). When did your withdrawal symptoms emerge after your final dose of kratom (e.g. within 24 hours) and when did the symptoms peak in terms of severity (e.g. Day 5 of withdrawal). Be sure to also mention whether you used specific substances such as dietary supplements, prescription medications, and/or illicit drugs – to attenuate kratom withdrawal symptoms.
In the event that you used substances to attenuate withdrawal symptoms, document the substances you used and discuss the effectiveness of each. Moreover, share any other nonpharmacological tactics or strategies (e.g. psychotherapy, sauna, meditation, exercise, etc.) that helped you cope with kratom withdrawal. If you’re finished withdrawing from kratom, how long have you been abstinent? Having experienced kratom withdrawal first-hand, knowing what you know now, if you could go back in time, would you still decide to use kratom?