Is Kratom an Opioid?

Kratom is not technically an opioid, but it acts like one in your body. The active compounds in kratom bind to the same receptors in your brain that opioids target, which is why it produces similar effects like pain relief and euphoria.

This distinction matters more than you might think. When families come to our addiction treatment center asking about their loved one's kratom use, they're often confused by conflicting information online. Some sources call it a natural supplement. Others label it as dangerous as heroin. The truth sits somewhere in the middle, and understanding what kratom actually is can help you make informed decisions about treatment and recovery.

Kratom comes from the leaves of Mitragyna speciosa, a tropical tree native to Southeast Asia. For centuries, people in Thailand, Malaysia, and Indonesia have chewed kratom leaves or brewed them into tea for energy and pain relief.

The key active ingredients are mitragynine and 7-hydroxymitragynine. These alkaloids interact with opioid receptors in your brain, but they work differently than prescription painkillers or street drugs like heroin.

Here's what sets kratom apart:

Partial vs. Full Agonist Activity: Traditional opioids are full agonists, meaning they completely activate opioid receptors. Kratom's compounds are partial agonists, creating milder effects at lower doses. This is why some people argue kratom is safer, though this doesn't mean it's without risk.

Dose-Dependent Effects: At low doses (1-5 grams), kratom acts as a stimulant, similar to caffeine. At higher doses (5-15 grams), it produces opioid-like sedation and pain relief. This dual nature makes it unpredictable and easy to misuse.

Legal Status: Most opioids are strictly regulated as controlled substances. Kratom occupies a gray area, it's banned in seven states and several counties, but remains legal federally despite FDA warnings. This accessibility makes it appealing to people seeking alternatives to prescription medications.

I've worked with clients who started using kratom to manage chronic pain or to ease withdrawal from prescription opioids. They genuinely believed they were choosing a safer option. What they didn't realize was how quickly dependence could develop.

When you take kratom, mitragynine and 7-hydroxymitragynine cross the blood-brain barrier and attach to mu-opioid receptors. These are the same receptors that respond to morphine, oxycodone, and fentanyl.

The binding triggers a cascade of neurochemical changes:

• Your brain releases dopamine, creating feelings of pleasure and reward

• Pain signals get suppressed, providing temporary relief

• Respiratory function slows down (though less dramatically than with traditional opioids)

• Your body's natural opioid production begins to decrease with regular use

At stimulant doses, kratom also affects adrenergic and serotonin receptors, which explains the increased energy and alertness. But as you increase the dose, the opioid effects dominate.

One client, Sarah, described her first experience with kratom as "like taking a warm bath for my anxiety." She'd been struggling with panic attacks and found that a morning dose helped her feel calm and focused. Within three months, she was taking kratom five times daily and experiencing withdrawal symptoms if she went more than a few hours without it.

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Here's what concerns me most: people underestimate kratom because it's marketed as natural and sold in gas stations. But natural doesn't mean safe, and legal doesn't mean non-addictive.

Physical Dependence Develops Quickly: Regular use for just a few weeks can lead to withdrawal symptoms. These include muscle aches, insomnia, irritability, aggression, emotional changes, runny nose, and jerky movements.

Tolerance Builds Over Time: Your body adapts to kratom's presence, requiring higher doses to achieve the same effects. This escalation pattern mirrors traditional opioid addiction.

Psychological Dependence Is Real: Beyond physical withdrawal, many people become psychologically reliant on kratom to manage stress, pain, or emotional discomfort. Breaking this mental connection requires the same therapeutic work we use for other substance use disorders.

The withdrawal timeline typically looks like this:

1. 6-12 hours after last dose: Anxiety, cravings, restlessness begin

2. Days 2-4: Peak symptoms including muscle pain, insomnia, mood swings, nausea

3. Days 5-7: Physical symptoms ease, but psychological symptoms persist

4. Weeks 2-4: Post-acute withdrawal with lingering fatigue, depression, cravings

I've never seen someone detox from kratom and say, "That was easier than I expected." The discomfort is real, and trying to quit alone often leads to relapse.

Understanding kratom use means understanding what drives people to it. In my experience, most clients fall into one of these categories:

Chronic Pain Management: People with back pain, arthritis, fibromyalgia, or other conditions often turn to kratom when prescription options fail or seem too risky. They're searching for relief without the stigma or regulations attached to traditional painkillers.

Opioid Withdrawal Self-Treatment: Some people use kratom to ease withdrawal from prescription opioids or heroin. While it can temporarily reduce symptoms, it's essentially trading one dependency for another without addressing underlying issues.

Mental Health Self-Medication: Anxiety, depression, and PTSD symptoms sometimes improve temporarily with kratom use. This creates a dangerous cycle where the substance becomes the primary coping mechanism.

Recreational Use: Particularly among young adults, kratom offers accessible euphoria without requiring a prescription or street drug purchase. The casual availability makes experimentation seem low-risk.

Tom came to us after two years of daily kratom use. He'd started taking it for work-related stress and found it helped him feel more confident in social situations. By the time he sought treatment, he was spending $400 monthly on kratom and couldn't imagine facing a day without it. His story isn't unique.

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While kratom may be less immediately dangerous than fentanyl or heroin, it carries significant health risks that people often discover too late.

Liver Damage: Cases of kratom-induced liver injury have been documented, with some severe cases requiring evaluation for liver transplant. While completed transplants due to kratom are rare, the risk of serious liver injury appears higher with prolonged use or when kratom is combined with other substances.

Contamination Concerns: Because kratom isn't FDA-regulated, products may contain heavy metals, salmonella, or other contaminants. Some products labeled as kratom have been found to contain actual opioids.

Cardiovascular Effects: Reports include rapid heartbeat, high blood pressure, and in rare cases, heart problems. These risks increase when kratom is used with stimulants or other drugs.

Respiratory Depression: Though less common than with traditional opioids, high doses of kratom can slow breathing, especially when combined with alcohol or benzodiazepines.

Mental Health Impact: Long-term use is associated with increased anxiety, depression, irritability, and cognitive difficulties. Some people experience hallucinations or psychotic symptoms.

Between 2011 and 2017, poison control centers received 1,807 kratom-related calls. The FDA reported 44 deaths associated with kratom between 2011 and 2017, though subsequent studies have identified higher numbers of kratom-involved deaths, with most cases involving multiple substances.

If you're struggling with kratom use, please know that effective treatment exists. The approach we use mirrors what works for other substance use disorders, with some kratom-specific considerations.

Medical Detox: Supervised detox helps manage withdrawal symptoms safely. We may use medications to ease specific symptoms, clonidine for anxiety and restlessness, anti-nausea medications, sleep aids, or in some cases, a short-term opioid taper if symptoms are severe.

Behavioral Therapy: Cognitive-behavioral therapy (CBT) helps identify triggers and develop healthier coping strategies. We work on the thought patterns that maintain substance use and build skills for managing cravings.

Dual Diagnosis Treatment: Many people using kratom have underlying pain conditions or mental health issues. Comprehensive mental health treatment addresses both the addiction and these co-occurring concerns.

Family Support: Addiction affects entire families. We offer family therapy to rebuild trust, improve communication, and create a supportive home environment for recovery.

Aftercare Planning: Recovery doesn't end when formal treatment concludes. We develop continuing care plans including ongoing therapy, support groups, and lifestyle changes that support long-term sobriety.

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If someone you love is using kratom, you might feel confused about whether to be concerned. Here are signs that suggest professional help may be needed:

• Taking increasingly larger or more frequent doses

• Experiencing withdrawal symptoms when not using

• Failed attempts to cut back or quit

• Spending significant money on kratom despite financial stress

• Neglecting responsibilities at work, school, or home

• Continued use despite negative consequences

• Lying about or hiding kratom use

• Loss of interest in previously enjoyed activities

Your response matters. Approaching your loved one with judgment or ultimatums often backfires. Instead, express specific concerns using "I" statements: "I've noticed you seem tired all the time, and I'm worried about your health."

Research treatment options before the conversation so you can offer concrete next steps. Many people feel relieved when someone finally notices their struggle and offers a path forward.

Maria's daughter had been using kratom for 18 months before Maria learned what was happening. She'd noticed personality changes, irritability, isolation, financial problems, but didn't connect them to substance use. Once she understood what kratom was and approached her daughter with compassion rather than anger, they were able to get help together.

Recovery from kratom dependence is possible, and many people go on to build meaningful, substance-free lives. The journey isn't always linear, setbacks happen, but each step forward matters.

Some people successfully taper their kratom use gradually with professional guidance. Others benefit from residential treatment that provides intensive support away from daily triggers. Still others find that outpatient therapy combined with support groups gives them the structure they need.

What works depends on factors like how long you've been using, how much you're taking daily, what other substances may be involved, your support system, and any co-occurring mental health or medical conditions.

The most important thing is taking that first step. Reaching out for help doesn't mean you've failed, it means you're choosing a healthier future.

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If you're ready to address kratom use, several resources can guide you:

• Contact our treatment center: We offer free, confidential assessments to discuss your situation and explore options

• Talk to your doctor: Primary care physicians can assess your situation, screen for complications, and refer you to appropriate specialists

• Support groups: While there aren't kratom-specific groups everywhere, Narcotics Anonymous welcomes people struggling with any substance

You don't have to navigate this alone. Whether you're the person using kratom or someone who cares about someone who is, help is available.

The question "Is kratom an opioid?" matters less than understanding its effects on your life. If kratom has stopped being a choice and started being a necessity, that's when you know it's time to make a change. We're here when you're ready to take that step.

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If you or a loved one is struggling with addiction, there is hope. Our team can guide you on your journey to recovery. Call us today.

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