Can you become dependent on kratom?

Kratom is promoted as a natural energy booster and pain reliever, but is it also addictive? The answer is complex. While kratom’s effects resemble those of mild opioids, its risk profile is distinct. Scientists, clinicians, and long-term users continue to debate whether kratom addiction represents a clinical disorder or a milder form of dependence.

What Is Kratom and How Does It Work?

Kratom (Mitragyna speciosa) is a tropical tree native to Southeast Asia. Its leaves have long been used to reduce fatigue and relieve pain. For background on origins and history, see where kratom comes from.

Kratom’s principal alkaloids, mitragynine and 7-hydroxymitragynine (7-OH), interact with μ-opioid receptors; mitragynine behaves as a partial agonist and also influences adrenergic, serotonergic, and dopaminergic pathways. ^{1 2}

How Kratom Acts

• Partial μ-opioid receptor agonism (reduced respiratory depression vs. full opioids)
• Adrenergic, serotonergic, and dopaminergic modulation (stimulation and mood lift)
• 7-OH as an active metabolite with stronger μ-opioid affinity

Illustrative dose range

Because kratom engages reward pathways similar to opioids, dependence potential exists, though often slower in onset and milder in intensity. ³

Is Kratom Addiction Real? (DSM-5)

Whether kratom counts as “addictive” depends on how addiction is defined clinically. At a fundamental level, the criteria is broken down into the following:

• Addiction: Compulsive use despite harm.
• Dependence: Physical adaptation and withdrawal on cessation.
• Substance Use Disorder (SUD): Assessed via DSM-5, requiring functional impairment across 11 criteria. ⁴

Applying DSM-5 to Kratom

Recent expert reviews suggest some frequent users meet mild-to-moderate DSM-5 criteria. Typically, tolerance, unsuccessful cut-down attempts, and withdrawal occur, although the severity varies and measurement is challenging. ⁵

Clinical vs. Real-World Evidence

Surveys and ecological studies show that only a minority of users, often those using extracts, high doses, or substituting for opioids, report problematic use. ^{6 7} In most community samples, dependence resembles caffeine more than opioids.

Signs and Symptoms of Dependence

Dependence develops progressively with repeated exposure.

Survey estimates suggest roughly 10–15% of regular users report features consistent with mild kratom use disorder, though data quality varies. ⁹

Kratom Withdrawal: What to Expect

When regular use stops, symptoms typically begin within 12–24 hours, peak at 2–3 days, and resolve within approximately a week. ^{8 10}

Typical Symptoms

• Muscle aches, insomnia, irritability
• Runny nose, watery eyes
• Abdominal cramping or diarrhoea
• Restlessness, anxiety, low motivation

Less Common or Severe

• Goosebumps, yawning, chills
• Dysphoria or prolonged fatigue

Withdrawal is usually milder than that of opioids and roughly comparable to caffeine plus mild flu-like discomfort. ¹¹

How Addictive Is Kratom Compared to Other Substances?

Evidence places kratom between caffeine and opioids in both dependence risk and withdrawal severity. ^{6 13}

Extracts & 7-OH Warning: Concentrated extracts and products marketed for “7-OH” may carry a higher dependence risk due to stronger μ-opioid activity. Recent alerts note potent 7-OH or related compounds in retail kratom products. ^{12 13}

Can You Use Kratom with Lower Risk?

Any psychoactive substance can cause harm. Still, certain practices appear to reduce the likelihood of tolerance and withdrawal. For first-time guidance, see our kratom benefits, risks & safety overview and how to use kratom.

Lower-Risk Use Principles

• Many users report small amounts (e.g., 2–5 g of plain leaf) as sufficient.
• Avoid daily use; take rest days.
• Stick to plain leaf rather than extracts or enhanced powders.
• Stay hydrated and maintain good nutrition.
• Do not mix with depressants such as alcohol, opioids, or benzodiazepines. ³

For benefits, side effects, contraindications, and interactions, read our overview of kratom’s effects and risks.

What to Do If You Suspect Kratom Addiction

If stopping kratom feels difficult or withdrawal symptoms appear, professional guidance can help.

• Gradually reduce dose frequency rather than quitting abruptly.
• Support recovery with rest, hydration, and nutrition.
• Clinicians may suggest behavioural therapies such as CBT or motivational interviewing.
• In some case reports, medications like clonidine or buprenorphine have been used off-label. ¹⁵

If you're unsure whether kratom is starting to impact your daily life negatively, consider this checklist:

• Is kratom affecting your responsibilities or relationships?
• Have you tried to cut down but couldn’t?
• Do you experience cravings or withdrawal?

Two or more “yes” responses may indicate a use disorder. In this case, it's recommended that you speak to a healthcare professional for advice.

Understanding Kratom’s Risk Profile

Kratom exists in a grey zone, neither harmless nor inherently dangerous. For some, it offers pain or anxiety relief; for others, chronic use leads to dependence or withdrawal. Current evidence suggests moderate addiction potential: lower than opioids, higher than caffeine. If you or someone you know struggles with kratom dependence, seek professional or peer support; recovery is achievable.

References

1. Kruegel AC, Uprety R, Grinnell SG, et al. 7-Hydroxymitragynine Is an Active Metabolite of Mitragynine and a Key Mediator of Its Analgesic Effects. ACS Central Science. 2019;5(6):992-1001. doi:https://doi.org/10.1021/acscentsci.9b00141 ↩︎
2. Chakraborty S, DiBerto JF, Abdelfattah Faouzi, et al. A Novel Mitragynine Analog with Low-Efficacy Mu Opioid Receptor Agonism Displays Antinociception with Attenuated Adverse Effects. Journal of Medicinal Chemistry. 2021;64(18):13873-13892. doi:https://doi.org/10.1021/acs.jmedchem.1c01273 ↩︎
3. Henningfield JE, Grundmann O, Huestis MA, Smith KE. Kratom safety and toxicology in the public health context: research needs to better inform regulation. Frontiers in Pharmacology. 2024;15. doi:https://doi.org/10.3389/fphar.2024.1403140 ↩︎ ↩︎
4. American Psychiatric Association. Substance-Related and Addictive Disorders. 2013. PDF ↩︎
5. Smith KE, Epstein DH, Weiss ST. Controversies in Assessment, Diagnosis, and Treatment of Kratom Use Disorder. Current Psychiatry Reports. 2024;26(9):487-496. doi:https://doi.org/10.1007/s11920-024-01524-1 ↩︎
6. Garcia-Romeu A, Davis AK, Erowid F, Erowid E, Griffiths RR, Johnson MW. Cessation and reduction in alcohol consumption and misuse after psychedelic use. Journal of Psychopharmacology. 2019;33(9):1088-1101. doi:https://doi.org/10.1177/0269881119845793 ↩︎ ↩︎
7. Smith KE, Panlilio LV, Feldman JD, et al. Ecological Momentary Assessment of Self-Reported Kratom Use, Effects, and Motivations Among US Adults. JAMA Network Open. 2024;7(1):e2353401. doi:https://doi.org/10.1001/jamanetworkopen.2023.53401 ↩︎
8. Stanciu CN, Gnanasegaram SA, Ahmed S, Penders T. Kratom Withdrawal: A Systematic Review with Case Series. Journal of Psychoactive Drugs. 2019;51(1):12-18. doi:https://doi.org/10.1080/02791072.2018.1562133 ↩︎
9. Hill K, Grundmann O, Smith KE, Stanciu CN. Prevalence of Kratom Use Disorder Among Kratom Consumers. Journal of Addiction Medicine. 2024;18(3):306-312. doi:https://doi.org/10.1097/adm.0000000000001290 ↩︎
10. Nunez MB, Dhingra A, Dhingra M, Kossack R, Dhingra M. Kratom’s rising role in the potential exacerbation of mental health disorders: A case report and review of the literature. Psychiatry Research Case Reports. 2022;1(2):100069. doi:https://doi.org/10.1016/j.psycr.2022.100069 ↩︎
11. National Institute on Drug Abuse. Kratom. Published March 25, 2022. https://nida.nih.gov/research-topics/kratom ↩︎
12. EVALUATION of COMMERCIALLY AVAILABLE SMOKE SHOP PRODUCTS MARKETED as “7-HYDROXY MITRAGYNINE” & RELATED ALKALOIDS. Accessed November 6, 2025. Report (PDF) ↩︎
13. News: August 2025 - Emergence of potent kratom-related products containing 7-hydroxymitragynine and/or mitragynine pseudoindoxyl. UNODC. Accessed November 6, 2025. UNODC announcement ↩︎ ↩︎
14. American Kratom Association Applauds FDA Crackdown on Dangerous Chemically Manipulated 7-OH, Pseudoindoxyl and “M” Products. Reuters. Published July 1, 2025. Press release
15. Jett JD, Kordas G, Parent S, et al. Assessing Clinically Significant Cognitive Impairment Using the NIH Toolbox in Individuals with Co-occurring Serious Mental Illness and Alcohol Use Disorder. Journal of Addiction Medicine. 2022;17(3):305-311. doi:https://doi.org/10.1097/adm.0000000000001105 ↩︎