Kratom Withdrawal and Detox
Kratom is an herb that is indigenous to Southeast Asia. Its leaves contain alkaloids with psychotropic properties. Among these alkaloids, mitragynine and hydroxymitragynine are considered to be responsible for most of the plant’s mind-altering properties. Mitragynine has stimulant properties at low doses but has opioid-like properties at higher doses. This effect is because mitragynine binds to receptors for neurotransmitters like dopamine, serotonin and norepinephrine to produce stimulant effects at low doses, whereas at higher doses it binds to opioid receptors to produce analgesic and sedative effects.
Kratom’s leaves have been traditionally used because of its stimulant effects to counter tiredness and work longer hours, as well as to relieve pain. More recently, kratom has been used recreationally in Western countries due to the lack of regulations and its easy availability over the internet. Kratom may also be used by individuals with addiction as a form of self-medication to cope with the withdrawal symptoms due to abstinence from other opioids.
Long-term use of kratom can result in physical dependence on the drug. Abstinence from kratom use leads to withdrawal symptoms in long-term users that are generally unpleasant and may lead to a setback. Treatment at a medical detox can help the individual to cope with the adverse symptoms of kratom withdrawal.
How Long Does Kratom Stay in Your System?
The duration for which kratom may last in the body may vary according to the duration of use and physiological characteristics (i.e., the metabolism) of the individual. A study in individuals who used kratom for a week reported a half-life of one day. Animal studies conducted in rats show that a single dose of kratom has a half-life of 4 to 10 hours. However, traces of mitragynine may remain detectable until 10 to 14 days after cessation of drug use. This prolonged duration of the presence of kratom in the body may be due to the absorption and accumulation of kratom by tissues like the liver.
Symptoms of Kratom Withdrawal
Consistent with the opioid-like properties of kratom, many of the symptoms of kratom withdrawal are similar to those observed with other opioids. Long-term use of kratom leads to the development of physical dependence on the drug. This results in adaptations in the brain in response to regular use, and abstinence from drug use results in a reaction in the form of adverse withdrawal symptoms.
The physiological symptoms of kratom withdrawal include:
- Body aches
- Muscle pain and cramps
- Abdominal pain
- Decreased appetite
- Hot or cold flashes
- Increased sensitivity to pain
- Watery eyes and nose
- Hyperthermia (high body temperature) or fever
Some of the psychological symptoms of kratom withdrawal include:
- Aggression and hostility
- Drug cravings
Kratom Withdrawal Timeline
The symptoms of kratom withdrawal generally appear within 12 to 24 hours of abstinence. These symptoms of kratom withdrawal generally last for about three to four days, but may last longer in the case of severe kratom dependence (10 days). Sleep disturbances and drug cravings may persist for more than two weeks after cessation of drug intake.
Factors Impacting Kratom Withdrawal
The most important factors determining the severity and the duration of kratom withdrawal include the drug use history and physiological characteristics (i.e., metabolism) of the individual. Longer duration of drug use at high doses can result in the development of tolerance for the drug, characterized by needing larger quantities of the drug to produce previously experienced effects.
Long-term use can also result in the development of physical dependence on the drug. The severity of drug dependence and the amount and frequency of drug use tend to determine the intensity and duration of withdrawal symptoms. The co-use of kratom with other substances can also result in more severe withdrawal symptoms that may last longer. Physiological or metabolic characteristics determined by various factors such as age, genes and overall health also determine the duration of withdrawal symptoms.
Dangers of Kratom Withdrawal
The symptoms of kratom withdrawal are similar to those of other opioids. Although in most cases, the symptoms of opioid withdrawal are not life-threatening, the withdrawal symptoms are very unpleasant. These symptoms can be very difficult to cope with in the absence of medical supervision and may lead to relapse. According to a subjective report, the symptoms of kratom withdrawal are worse than those observed during withdrawal from alcohol. In very rare cases, withdrawal from opioids may lead to severe dehydration due to vomiting and diarrhea. This can result in hyponatremia (increased sodium levels in the blood), which may, in turn, lead to cardiac arrest and death.
The symptoms due to kratom withdrawal, like those due to other opioids, are very unpleasant and are often described as being similar to a very bad flu. These unpleasant symptoms can lead to a relapse and undergoing detoxification at home is not recommended. Pharmacological treatments provided by medical professionals can help to alleviate these withdrawal symptoms. Treatment at an inpatient medical detox can provide the necessary intensive care to cope with the symptoms of kratom withdrawal.
Medically Assisted Detox
Medical detox involves round-the-clock supervision and care provided by trained medical staff. Treatment at a medical detox involves the use of medications and behavioral therapy to help the individual cope with the symptoms of kratom withdrawal. The medications used for kratom withdrawal may involve the use of opioids such as buprenorphine and dihydrocodeine. These opioids can help to alleviate the withdrawal symptoms and reduce cravings for kratom. Opioids, including kratom, act by inhibiting norepinephrine neurons in the brainstem, which generally have a stimulating effect. The cessation of kratom use can result in the disinhibition of these neurons and cause overstimulation, characterized by symptoms such as insomnia, diarrhea, chills and anxiety. Drugs like clonidine and lofexidine may be used to reduce the hyperactivity of these neurons and their consequent symptoms. Benzodiazepines may also be used to manage the symptoms of anxiety, whereas non-steroidal anti-inflammatory drugs may be used to treat symptoms like muscle cramps.
Detoxing at Home
Although the symptoms of kratom withdrawal are not life-threatening, detoxification at home is not recommended due to the unpleasantness of withdrawal symptoms. The discomfort experienced during this period often leads to relapse. In case of undertaking detoxification at home, this must be done in a calm and safe environment with the help of a family member.
Medications, as prescribed by a physician for specific symptoms, can help in reducing the intensity of the withdrawal symptoms. Intake of plenty of fluids is recommended to prevent dehydration due to vomiting, diarrhea and excessive sweating. This can also help to flush out the drug.
Vitamins and mineral supplements are also generally recommended for home detox. Engaging in exercise yoga, or meditation may aid relaxation. Other soothing (for example, hot baths, tea) and enjoyable activities can help take the individual’s mind off the unpleasant withdrawal symptoms. Bright lights and loud noises should be avoided to prevent excessive stimulation. A support person should be present around the individual throughout this period, since serious adverse effects, although rare, may occur. The support person must immediately call 911 in such a scenario.
Tapering Off Kratom
Abstaining from kratom use all at once or drastically reducing the dosage can lead to severe withdrawal symptoms. The severity along with the unpleasantness of withdrawal symptoms can lead to a relapse. It is advisable not to quit cold-turkey but to gradually lower, or “taper”, the use of kratom to make the withdrawal symptoms more manageable.
Finding a Kratom Detox Center in Ohio
It is essential to remember that detoxification is only the first step in the treatment of kratom addiction. Detoxification only involves the elimination of the drug from the system and subsequent treatment in a rehab is essential to address the issues underlying the drug abuse. Choosing a detox center may be difficult with many facilities providing similar forms of treatment and advice from a medical professional may be sought.
The detox center should provide individualized care since the severity and complexity of withdrawal symptoms depend on the person’s drug use history, concomitant use of other substances and the presence of co-occurring mental health disorders. It is also essential to ensure that the treatment facility provides evidence-based (scientifically supported) care delivered by well-trained and experienced staff. Some treatment centers may provide both detoxification and rehabilitation treatments at the same facility. Treatment for substance use disorders can be expensive and making sure that treatment at a particular facility is covered under one’s insurance plan may be useful.
Contact The Recovery Village Columbus to speak with a representative about how professional addiction treatment can address a substance use disorder and any co-occurring mental health disorders. Take the first step toward a healthier future, call today.
Trakulsrichai, Satariya; et al. “Pharmacokinetics of mitragynine in man.” Drug design, development and therapy, April 2015. Accessed August 20, 2019.
Arizona Board of Osteopathic Examiners. “Kratom Fact Sheet for Healthcare Professionals.” March 2019. Accessed August 20, 2019.
National Institute on Drug Abuse. “Kratom.”. April 2019. Accessed August 20, 2019.
McWhirter, Laura, and Siobhan Morris. “A case report of inpatient detoxification after kratom (Mitragyna speciosa) dependence.” European addiction research, August 2010. Accessed August 20, 2019.
Galbis-Reig, David. “A case report of kratom addiction and withdrawal.” Wmj, February 2016. Accessed August 20, 2019.
Medical Disclaimer: The Recovery Village Columbus aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.