No clinical trial has tested kratom as a treatment for opioid withdrawal, and FDA has approved no kratom product for any use. Guides that hand you a strain and a dose are guessing.
Below: what the research shows, what the risks are, and which approved medicines have evidence behind them.
Does kratom help with opioid withdrawal?
Kratom’s two main alkaloids, mitragynine and 7-hydroxymitragynine, are partial agonists at the human mu-opioid receptor (Todd et al., 2020). That opioid-like action is why some people try it to ease withdrawal.
The published evidence is case reports. A 2008 case report in Addiction (Boyer et al.) describes a 43-year-old man who used kratom to manage withdrawal from the opioid hydromorphone. He spent $15,000 a year on it and was admitted for evaluation of a generalized tonic-clonic seizure.
A 2021 paper in the Journal of Addiction Medicine (Weiss and Douglas, 2021) reviewed the published cases and added two of its own, for 8 patients in total with kratom-related opioid use disorder who were treated with buprenorphine-naloxone. The authors state that kratom use can itself cause physical dependence and opioid use disorder, and that no guidelines exist for treating it.
What does FDA say about kratom?
FDA says no kratom product is approved as a drug and that kratom is not lawfully marketed as a dietary supplement or food additive. It notes that people self-treat opioid withdrawal with kratom and warns against using it for medical treatment.
Its safety concerns include liver toxicity, seizures and substance use disorder. Deaths linked to kratom have mostly involved other drugs, so kratom’s own role is hard to separate out.
Does the strain matter?
No. Guides often rank red, green and white strains for withdrawal, but the evidence doesn’t back that up.
In a 2023 survey of 644 kratom users, people described different effects for red, green and white products. But an independent lab found no significant difference in alkaloid content between strains. The authors say the reported differences may come from marketing and expectations (Huisman et al., 2023). Most respondents bought from the same vendor, so the study needs repeating with a wider group.
What are the risks of using kratom for withdrawal?
- Dependence. Kratom can cause its own physical dependence and opioid use disorder (Weiss and Douglas, 2021). FDA lists substance use disorder among its safety concerns.
- Seizures and liver toxicity. Both are on FDA’s list of kratom risks.
- Drug interactions. In lab tests, all three kratom alkaloids studied inhibited some cytochrome P450 enzymes, which clear many medicines from the body. The authors flag a risk of adverse interactions with drugs those enzymes metabolize (Todd et al., 2020).
- Pregnancy. FDA has documented neonatal abstinence syndrome in babies born to mothers who used kratom.
- Contamination. FDA has documented Salmonella and heavy metals in some kratom products.
- Concentrated 7-OH. FDA says 7-hydroxymitragynine is under 2% of the alkaloids in kratom leaf and is much more potent at the mu-opioid receptor than mitragynine. Products that concentrate it are a different thing from leaf.
Which medicines treat opioid withdrawal?
These medicines are FDA-approved for opioid use disorder or opioid withdrawal, according to NIDA:
| Medicine | Approved for | What it does |
|---|---|---|
| Buprenorphine (some products also contain naloxone) | Opioid use disorder | Reduces cravings and withdrawal. Comes as tablets, extended-release injections and implants. |
| Methadone | Opioid use disorder | Reduces withdrawal symptoms and cravings. Dispensed only through approved opioid treatment programs. |
| Naltrexone | Opioid use disorder | Blocks opioid receptors so opioids no longer produce pleasure. A monthly injection is available. |
| Lofexidine (Lucemyra) | Opioid withdrawal symptoms | Eases symptoms when people suddenly stop opioids. Not used for long-term treatment. |
A clinician can match one of these to your situation. Don’t stop a prescribed medicine on your own.
Already using kratom daily and want to stop? See our guide to quitting kratom.
When should you see a clinician?
See one instead of self-treating if any of these apply:
- You use fentanyl or inject drugs
- You have a serious medical condition
- You have tried to quit on your own and could not
- You also depend on alcohol or benzodiazepines
- You are pregnant
If you have thoughts of suicide, call or text 988. For treatment referrals, call the SAMHSA National Helpline at 1-800-662-HELP (4357). It’s free, confidential and open 24/7. You can also search FindTreatment.gov.
Is kratom legal?
FDA says kratom is not lawfully marketed as a drug, dietary supplement or food additive. Some states and cities also ban or restrict it, and the rules keep changing. Check your local law before you buy anything.
This content is for information only. It isn’t medical advice. Kratom is not FDA-approved. Talk to a healthcare provider before you use it.
Questions
Does kratom help with opioid withdrawal?
No clinical trial has tested it. The published evidence is case reports, and kratom can cause its own dependence.
What is the best kratom strain for opiate withdrawal?
No strain has been shown to work. In a 2023 study, lab analysis found no significant difference in alkaloid content between red, green and white products.
How much kratom for opiate withdrawal?
No dose has been shown to be safe or effective for opioid withdrawal. FDA gives no safe dose. A clinician can prescribe approved medicines that have established doses.
Can I use kratom with Suboxone?
Ask your prescriber first. Kratom’s alkaloids act on opioid receptors and inhibit some drug-metabolizing enzymes (Todd et al., 2020), so combining it with other medicines carries risk.
Is kratom addictive?
It can be. Kratom can cause physical dependence and opioid use disorder (Weiss and Douglas, 2021), and FDA lists substance use disorder among its safety concerns.
Where can I get help with opioid withdrawal?
Call the SAMHSA National Helpline at 1-800-662-HELP (4357) for free, confidential treatment referrals, 24/7. If you have thoughts of suicide, call or text 988.