Kratom is one of the latest substances touted as a treatment for opioid withdrawal. Discover its potential benefits, risks, and medical expert opinions.
Opioid withdrawal can be physically grueling and emotionally exhausting, and the fear of going through it is one of the biggest reasons people delay or avoid getting help at all. That fear is exactly why so many people start searching for something that might soften the process before they're ready to face it head-on.
Kratom is one of the latest substances touted online as a way to do just that: an herbal extract, sometimes sold or discussed under the names "biak" or "katum," traditionally used as medicine in Southeast Asia. It isn't approved by the FDA as a drug, dietary supplement, or food additive, so there's no federal oversight of how it's made, labeled, or sold, and most doctors and government agencies still warn against self-medicating with it. One important note upfront: “kratom” can mean very different products. Traditional kratom leaf (powder/tea) is not the same as high-potency kratom extracts or products containing 7-hydroxymitragynine (7-OH), which can behave more like opioids. So does it actually work? Traditional kratom leaf may reduce some opioid withdrawal symptoms for some people, but it isn’t FDA-approved for this purpose, carries real risks of its own, and isn’t considered a first-line treatment for opioid use disorder (OUD). High-potency kratom products (extracts/concentrates), especially those containing 7-OH, can carry a much higher risk.
Searching TikTok and YouTube for kratom will result in a bulk of conflicting, confusing, and even misleading information. Between warnings of the dangers of kratom and claims that it can save lives, it’s hard to get a clear answer. As a trusted medication-assisted treatment (MAT) provider, we at Ophelia want our patients to be informed about their options and alternative therapies. Below, we explain why kratom is used for withdrawal, its potential harm, and what medical experts say.
Why do people use kratom for withdrawal?
Kratom is not a commonly used substance. According to a study in the American Journal of Preventive Medicine, only 0.7% of the U.S. population uses kratom, compared to the estimated 3.8% with opioid use disorder (OUD). However, many people who use kratom also suffer from OUD. 1 in 10 people who struggle with opioids reported using kratom in a recent report. So why this substance? When someone cuts back on or stops using opioids after long periods, they often experience withdrawal. Symptoms of withdrawal can be uncomfortable and include:
- Anxiety and agitation
- Insomnia
- Sweating
- Muscle aches
- Abdominal pain
- Dilated pupils
- Nausea and vomiting
- Diarrhea
To cope with these symptoms, some people with OUD try to self-medicate with kratom. Kratom stimulates the opioid receptors in the brain, but to a lesser extent than pure opioids. In low doses, it acts as a stimulant. In high doses, it can relieve pain. For this reason, some individuals may try to use it as an alternative to opioids and to alleviate withdrawal symptoms.
The compound responsible for kratom's effects is mitragynine, a naturally occurring alkaloid found in the leaves of Mitragyna speciosa, a tree native to Southeast Asia. Mitragynine binds to the same mu-opioid receptors that drugs like oxycodone, heroin, and fentanyl act on, which explains the overlap in effects and why some people perceive it as a substitute during withdrawal. Effects are typically felt within 5–10 minutes of taking kratom and can last 2–5 hours, depending on the dose. Unlike an FDA-approved drug, however, kratom products aren't standardized; the concentration of mitragynine can swing dramatically between brands, batches, and even individual plants, so there's no reliable way to know the actual strength of a given dose.
What research says about kratom for withdrawal
Researchers were initially hopeful about this natural alternative to opioids, but results from formal studies aren’t promising. There isn’t much reliable evidence supporting kratom’s benefits for withdrawal. Instead, kratom has the potential to be addictive and cause harmful side effects. In one study, patients taking kratom for over six months experienced withdrawal symptoms similar to opioid withdrawal. Individuals dependent on kratom may benefit from clinical support; medication like buprenorphine (including Suboxone) is an option, but not a requirement.
Is it risky to self-medicate?
Unfortunately, rather than treating OUD and withdrawal, self-medicating with kratom may lead to a new addiction. Kratom interacts with opioid receptors and produces both stimulant- and opioid-like effects, especially in high doses. But it’s hard to tell just how strong the dose you’re getting is — the proportion of active ingredients in kratom plants can vary wildly and are not reliably labeled. High dosages combined with existing health issues can have dangerous physical results. In addition to dependence, using kratom can have many adverse outcomes, such as:
- Muscle pain
- Dry mouth
- Anorexia and/or weight loss
- Chills
- Nausea and vomiting
- Constipation
- Liver damage
- Dizziness
- Insomnia
- Hallucinations
- Seizure
Kratom use during pregnancy carries an additional risk that's easy to overlook: infants born to mothers who used kratom regularly can show their own withdrawal symptoms after birth, similar to neonatal opioid withdrawal. If you're pregnant or planning to be, talk to a healthcare provider before using kratom for any reason.
From 2011 to 2017, poison control received about 1,800 reports involving kratom. Half of these cases resulted in serious side effects like seizures. The impact of chronic kratom use hasn’t been studied extensively, so it’s uncertain how it can affect individuals in the long term. However, cases of severe addiction and withdrawal have been reported nationwide.
Kratom's legal status adds another layer of risk. It's fully banned in several states, loosely regulated under Kratom Consumer Protection Act–style laws in others, and unregulated in the rest; and the map keeps shifting as more states pass new restrictions. If you're using kratom to manage withdrawal and then move, travel, or lose access because your state changes its laws, you could be left without warning and without a safer alternative in place. Relying on a substance whose availability isn't guaranteed adds real instability to an already fragile treatment process.
What to do in a kratom overdose: Kratom overdose is treated the same way as an opioid overdose with naloxone (Narcan, Kloxxado) and immediate medical attention. If you or someone else shows signs of overdose (slowed or stopped breathing, extreme drowsiness, unresponsiveness), call 911 right away. Naloxone is available without a prescription at most pharmacies and is worth keeping on hand if you or someone in your household uses kratom or opioids.
What about 7-OH? A more dangerous kratom product
Not all "kratom" products are the same. In recent years, a concentrated compound called 7-hydroxymitragynine, usually shortened to 7-OH, has shown up in pill, tablet, and shot form, often sold alongside or marketed similarly to traditional kratom. The difference matters: research shows 7-OH is several times more potent than morphine and acts much more like a full opioid than the mitragynine found in regular kratom leaf, making it functionally closer to a synthetic opioid than an herbal supplement.
That potency comes with real consequences. 7-OH has been linked to a higher risk of dependence, a stronger withdrawal syndrome of its own, and overdoses serious enough to require naloxone. It behaves pharmacologically like a full opioid agonist, which is part of why public health agencies, including NIDA and the DEA, have flagged it as carrying high abuse potential. Because concentrated 7-OH products aren't consistently labeled, someone buying what's marketed as "kratom extract" can't always be sure how much of it they're actually getting, or how strong it really is.
Bottom line: if you're considering kratom for withdrawal, avoid concentrated 7-OH products specifically. They carry a meaningfully higher risk profile than traditional kratom leaf or tea, and regulators, including the DEA, which has evaluated scheduling 7-OH, are actively scrutinizing them.
For a deeper comparison of how kratom and 7-OH stack up against FDA-approved Suboxone, see our full breakdown: Suboxone vs. kratom vs. 7-OH: what's the difference?
What actually works for opioid withdrawal
If kratom isn't a safe substitute, what is? Even when kratom or 7-OH provides some short-term symptom relief, they only mask the physical side of withdrawal; they don't address the psychological, social, and behavioral aspects of addiction that shape long-term stability.
The right approach isn't the same for everyone, and it starts with a clinical evaluation, not a prescription. A licenced clinician assesses the severity of dependence, what you've been using (plant kratom vs. concentrated products like 7-OH), and any co-occurring conditions, then helps determine which path fits:
- Comfort medication support — for milder dependence, or for people who prefer to avoid Suboxone, a short-term taper using comfort medications can support withdrawal, paired with ongoing clinical check-ins.
- Short-course buprenorphine — for people using high-potency concentrates like 7-OH, or those who need more support through withdrawal, a time-limited course of Suboxone can ease the transition off kratom, with the option to continue longer-term if that's the right fit.
- Long-term medication maintenance — for some patients, ongoing Suboxone or methadone is the most effective path to stability. For others, daily medication could end up being more disruptive than the kratom-leaf use itself, which is exactly why this isn't a one-size-fits-all decision.
Whichever path applies, a few things matter regardless:
- Clinical supervision — a licensed provider can monitor symptoms, adjust the plan, and catch complications early, something that's impossible with an unregulated product like kratom.
- Ongoing behavioral support — counseling and check-ins help address the underlying patterns that contribute to substance use, improving long-term outcomes.
- Telehealth access — virtual care like Ophelia's has made it possible to get evaluated and start treatment from home, removing many of the access barriers that drive people toward unregulated alternatives in the first place.
CTA: Ophelia offers online Suboxone treatment from licensed clinicians, so you can start care without an in-person visit.
Kratom vs. evidence-based treatment: how they compare
Choosing evidence-based treatment over self-medicating isn't just a safety preference; it shows up in outcomes. Patients on FDA-approved medication consistently show better treatment retention and lower overdose risk than those who try to manage withdrawal on their own.
Get Support That Actually Works
If you're going through opioid withdrawal or trying to get off kratom itself, you don't have to navigate it alone or gamble on an unregulated product. Ophelia's licensed clinicians start with an evaluation, not an assumption, to figure out what you actually need, whether that's a short comfort-medication taper, a course of Suboxone, or longer-term support. This matters most if you're using more than one substance, have relapsed before, or are pregnant.
Answer a few quick questions to see if Ophelia is right for you, and set up a 15-minute welcome call to get started.
FAQ
Is kratom legal?
Kratom is legal federally, but seven states — Alabama, Arkansas, Connecticut, Indiana, Louisiana, Vermont, and Wisconsin — ban it outright. Many others regulate it (age limits, lab testing, labeling), while some leave it unregulated, and cities can add their own bans. Laws change often, so check your state and local rules.
Is it safe to stop kratom cold turkey?
Stopping kratom suddenly can trigger uncomfortable withdrawal symptoms, and in heavier or long-term users, the process can be more intense than expected. A gradual, supervised taper is generally safer than stopping abruptly on your own, especially if you've been using kratom heavily or for an extended period.
What happens if you mix kratom with alcohol or other substances?
Combining kratom with alcohol, benzodiazepines, or other sedatives increases the risk of dangerous side effects, including slowed breathing and overdose. Most kratom-related deaths reported by poison control involve it being mixed with other substances rather than kratom alone.
Does insurance cover treatment for kratom or opioid dependence?
Many insurance plans, including Medicaid in most states, cover medication-assisted treatment for opioid use disorder, and some providers also treat kratom dependence under the same coverage. Checking with your specific plan or provider is the best way to confirm what's covered.
Can kratom be dangerous for children or pets if accidentally ingested?
Yes. Because kratom products are often sold as loose powder or in unmarked packaging, accidental ingestion by children or pets is a real risk and can cause serious symptoms. If accidental exposure happens, contact poison control or seek emergency care immediately.
How can you tell if a kratom product actually contains 7-OH?
You often can't, just from the label. Because kratom extracts aren't regulated or independently verified, products marketed as standard "kratom" can contain added or concentrated 7-OH without disclosing it. This is one of the main reasons unregulated kratom products carry more risk than their labeling suggests.
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