The health department has recently issued a warning against the use of concentrated 7-OH products derived from kratom plant leaves. The warning addressed the risk of respiratory depression and seizures as well as the relatively high potential for addiction.
Naturally, the best way to avoid these adverse effects is to quit using kratom products entirely.
But does that mean you can stop abruptly? Can you do it at home safely? And if there are any withdrawal symptoms, are they mild enough to warrant using the product to help ease more intense drug cravings?
Even though kratom is natural, it can still lead to unpleasant physical and psychological withdrawal symptoms, ranging from irritation to cardiovascular instability.
Read on to understand kratom withdrawals and how to deal with them.
Why Kratom Withdrawals Happen
Scientists still don’t fully understand the pathophysiology of kratom use. Yet, we do know that the way kratom works isn’t all that different from opioids.
Granted, kratom’s withdrawals and psychological effects are way less intense than those of the average opioid substance. Still, there’s an overlap in the mechanisms of the two substances.
Let’s take a closer look.
Kratom Targets Opioid Receptors in the Brain
There are a few bioactive alkaloid compounds in kratom plants (Mitragyna speciosa). Mitragynine and 7-hydroxymitragynine (7-OH) are the two primary ones. Both interact with the mu-opioid receptors (small structures on nerve cells) in the brain, creating euphoric effects.
Of course, the good feelings that kratom produces don’t last long. Soon, the compounds get “used up,” and your brain returns to its normal state. So, you use again because you crave that high. And these compounds bind to the receptors, create euphoria, get used up, and so on.
Slowly, your brain adapts to the presence of mitragynine and 7-OH alkaloids as its baseline state. You now don’t simply want to use. You need these compounds to function properly, which is what healthcare professionals call physical dependence.
When you take away the kratom products suddenly from your routine, you experience unpleasant withdrawal symptoms. We’ll discuss the common symptoms and the worst-case scenarios in a minute.
Even Infants Are Susceptible to Kratom Withdrawals
It’s worth noting that the withdrawals can be passed on to babies from their mothers.
Studies show that when mothers use kratom regularly during pregnancy, their babies get exposed to the bioactive alkaloids. Once they’re born, their bodies no longer receive the alkaloids they were used to during gestation, which causes withdrawals.
Cases like this are referred to as Neonatal Abstinence Syndrome (NAS) in the medical community. And this is why physicians and expecting parents should be aware of the possible complications before recommending/using kratom tea or kratom supplements.
Adulterated and Concentrated 7-OH Products Make the Situation Worse
Kratom products in the market may be adulterated or manipulated to become more potent and addictive. Remember that kratom isn’t a lawfully marketed dietary supplement. There are even some local emergency bans on concentrated 7-OH products.
Some products even contain unsafe amounts of heavy metals. Lead and nickel concentrations, in particular, are particularly concerning.
Why Identifying Acute Kratom Withdrawal Can Be Tricky
Unless you’re in a treatment facility actively participating in detox, identifying the withdrawal symptoms can be challenging. You can’t always test for it in commercial blood and urine assays. It’s not even available in standard toxicology screens for babies in cases of NAS.
That’s why people can present to the emergency room with a range of symptoms. And yet healthcare professionals might not be able to identify the issue right away until the individual decides to come clean about their recreational kratom use.
But again, if you’re detoxifying from kratom in a rehab facility, it’s not going to be hard for the care team to figure out what your symptoms mean and how to handle the case properly.
What to Expect During the Withdrawals
Kratom withdrawals can look different on every individual due to differences in metabolism, substance abuse history, medical history, and dosing specifics.
But here’s a general look at both the common and rare symptoms:
Common Symptoms
- Tachycardia
- Muscle spasms
- Myalgia (muscle pain)
- Fatigue
- Decreased appetite
- Watery eyes
- Runny nose
- Hot flashes
- Chills
- Vomiting
- Gastrointestinal upset and diarrhea
- Restlessness
- Anxiety
- Mood changes
- Confusion
Not-So-Common Symptoms
Sometimes, the withdrawal symptoms are intense enough to put the patient’s life at risk. One case report highlights how things can go wrong quickly with prolonged kratom/7-OH use.
Let’s check out the kratom withdrawal timeline in this particular case and how it led to a potentially fatal cardiovascular event.
Case report: how a kratom withdrawal escalated
- Arrival at the ER. A man in his late 20s came to the emergency department. The patient did have a history of substance use disorders, and they were using kratom products daily. That said, their main complaints were nausea and vomiting persisting for about 3 days.
- First 12 hours. Within the first 12 hours of quitting kratom inside the hospital, the patient suffered from hypoxia (poor oxygenation), confusion, and lethargy. A rapid response team was called in to manage the symptoms. By that time, the patient was already suffering from tremors.
- Transfer to the ICU. The rapid response team managed to sedate the patient and put them on mechanical ventilation to boost the oxygenation level. Then, the patient was transferred to the intensive care unit (ICU) for further observation.
- First night in the ICU. The patient actually showed intense cardiovascular symptoms during their first night in the ICU. Eventually, they suffered from cardiac arrest.
- Recovery. Since they were already in an intensive care setting, the team managed to resuscitate the patient, who was then sedated for a week as they recovered from the withdrawal symptoms.
As it turns out, cardiovascular instability is a possible risk with kratom withdrawal.
Why? Well, besides activating the mu-opioid receptors, the kratom alkaloids work on alpha-2 adrenergic and k-opioid receptors. These two can either cause tachycardia or bradycardia depending on the dose, which is likely what happened in this case study.
Factors Affecting the Kratom Withdrawal Intensity
For many people, the withdrawals are unpleasant but mild to moderate in intensity. For others, the symptoms are outright life-threatening.
Here are some risk factors that can make the symptoms more intense and dangerous than average:
Take the patient who ended up with a cardiac arrest during the withdrawals in the case report mentioned earlier, for instance. They had a history of opioid use disorder that they were self-managing with high-dose kratom products.
Kratom Withdrawal Management
Now that we’ve covered why withdrawals happen and what this stage looks like on average, let’s check out what the management entails.
There’s No Universal Approach
Unfortunately, there are no published guidelines for kratom dependence. Management is mainly based on clinical judgment on a case-by-case basis.
Multifaceted teams have to consider the person as a whole (including both physical and psychological symptoms) before recommending treatment options.
For instance, tapering can ease the symptoms associated with the 7-OH alkaloids withdrawal for some people. Meanwhile, others may be able to safely quit abruptly.
Medications May Help
Pharmacological interventions can make the withdrawals much easier.
Research indicates that some of the drugs used for opioid withdrawal (mainly buprenorphine and naloxone) can be of benefit here, too. And that’s not really surprising when you consider that both kratom and opioids target similar receptors in the brain.
Buprenorphine (either alone or in combination with naloxone) prevents the binding of mitragynine and 7-OH to opioid receptors. As a result, they reduce cravings and deter the person from using kratom again.
However, the use of medication is still dependent on the case specifics.
Care teams at detox facilities might recommend mere symptomatic treatment. So, they might prescribe medications to target specific symptoms, such as muscle aches or insomnia.
For example, some reports reveal that dexmedetomidine (a powerful, non-opioid sedative and painkiller) can be helpful for managing acute kratom withdrawal.
Dexmedetomidine is an alpha-2 adrenergic receptor agonist. This might be why it can alleviate the agitation that comes after stopping kratom use.
Medically Supervised Detox Can Be a Safer Option
As we’ve covered, there are risk factors that make kratom withdrawals much more intense than usual. In cases like this, it’s safer to opt for medical detox rather than trying to quit at home.
Being supervised round-the-clock can reduce the risk of complications. Plus, the care team can walk you through the process.
The Role of Mental Health in Treatment and Withdrawal Management
Managing withdrawals and treating addictions, in general, shouldn’t follow a one-size-fits-all approach. Before you proceed into detox, your treatment providers must ask for information about your drug use patterns and do a thorough mental health screening.
After all, many people resort to kratom to deal with deeper problems, like chronic pain, depression, anxiety, or even a full-blown opioid addiction. Then, this self-medication tactic backfires when the kratom use itself leads to physical dependence.
Some of the questions to expect before getting admitted into medical detox are:
- When did you start using kratom products?
- What kratom products do you use?
- How often do you use kratom?
- Have you ever tried to quit before? What happened?
- Do you have a history of using any opioids?
- Do you have any medical conditions or chronic diseases?
Kratom Withdrawals vs. Opioid Withdrawals: Is One a Valid Replacement for the Other?
There are a few symptoms that can show up in both scenarios, including aches, anxiety, chills, diarrhea, tachycardia, nausea, and vomiting.
That said, withdrawing from kratom is generally milder than withdrawing from opioid drugs.
So, since kratom is a milder drug that targets the same mu-opioid receptor, is it wise to use commercial products derived from kratom leaves to deal with opioid cravings and withdrawals?
As we’ve mentioned, this is a form of self-medication that can backfire.
Even if kratom can help with opioid cravings, there’s still the risk that this use will actually turn into a new addiction, with its own set of complications, overdose risks (yes, people can OD on kratom!), side effects, and withdrawal symptoms.
Plus, there isn’t enough research yet to support the use of kratom medically.
For opioid use disorders, it’s better to seek professional help. In a licensed treatment facility, you can receive evidence-based treatments. If any drugs are used in the treatment plans, they are all FDA-approved and part of a supervised medication-assisted treatment (MAT) program.
Receive Coordinated Care, From Detox to Aftercare
To recap, kratom withdrawals happen when the body and mind no longer receive the dose of mitragynine and 7-hydroxymitragynine that it was used to. This can lead to several symptoms, the most common being agitation, tachycardia, drowsiness, and vomiting.
Withdrawals are often mild or moderate but can become quite intense in certain cases, especially with prolonged use of high-dose kratom and a history of prior addiction to opioids.
At Recreate Life Counseling, our multifaceted team offers personalized care at multiple levels, including partial hospitalization programs (PHPs), standard outpatient services, and intensive outpatient programs (IOP).
But we also understand how challenging and even dangerous withdrawals can be. That’s why we place clients who need medical detox in appropriate programs through the broader Recreate Behavioral Health Network, which operates on a multi-state level.
This way, our clients can move from one stage of treatment to another while still being covered by our coordinated care system. We also understand how mental health issues can be intertwined with substance abuse.
If you or a loved one needs help quitting kratom, don’t hesitate to get in touch with our team.
Written by: The Recreate Life Counseling Editorial Team
Published on: September 1, 2026
Updated on: September 2, 2026
