Kratom withdrawal is the set of physical and psychological symptoms that can happen when someone who has been using kratom regularly stops or significantly cuts back on their usage. This occurs because the body adapts to the regular exposure to kratom’s active compounds, a process called physical dependence.1

For what kratom is and how it affects the body in a broader sense, see Eleanor Health’s article: All About Kratom.

Why Does Kratom Withdrawal Happen?

Kratom’s two main compounds, mitragynine and 7-hydroxymitragynine, act on the same opioid receptors in the brain as opioid medications.1,2 With regular use, the body adjusts to their presence. When use stops, that adjustment temporarily falls out of balance. This is what can lead to withdrawal symptoms when regular use stops.

Dependence is a treatable medical condition, not a moral failing or a sign of weakness.3

What Are the Symptoms of Kratom Withdrawal?

CategoryCommonly reportedReported in some cases (less typical)
PhysicalMuscle aches, insomnia, runny nose, watery eyes, nausea, decreased appetite, sweating, gastrointestinal upset4Seizures, severe agitation (isolated case reports)5
PsychologicalAnxiety, irritability, mood changes, cravings4Hallucinations, delusions (atypical/severe case presentations)5

Because kratom withdrawal research is still limited, symptom severity and which symptoms occur can vary significantly from person to person.

How Long Does Kratom Withdrawal Last?

Research on kratom withdrawal is still limited, but available case reports and observational studies suggest symptoms often begin within the first day after stopping, are typically most intense over the next several days, and gradually improve over about a week. Individual experiences vary depending on factors such as dose, duration of use, product type, and use of other substances.

Kratom withdrawal duration data comes mostly from case reports and surveys rather than controlled studies.4 Available evidence suggests kratom withdrawal is often reported as milder and shorter than withdrawal from full opioid agonists such as heroin or fentanyl, although individual experiences vary considerably.4

How Severe Is Kratom Withdrawal, and What Affects It?

Severity appears to depend on several factors: how much and how long someone used kratom, whether they were using concentrated products, and whether other substances or health conditions are involved.

Concentrated 7-OH products are a distinct risk factor because they are far more potent than traditional kratom leaf and may produce a more intense, more opioid-like withdrawal.4 For what 7-OH is and its current regulatory status, see Eleanor Health’s article: What Is 7-OH?

Most reported overdose deaths involving kratom have also involved other substances, making it difficult to determine kratom’s specific contribution in many cases.6

Is Withdrawal From Concentrated 7-OH Different From Traditional Kratom Withdrawal?

Not all kratom products carry the same risk during withdrawal, and 7-OH products are a good example of why.

7-hydroxymitragynine (7-OH) is naturally present in kratom leaf, but only in small amounts. Concentrated or synthetic 7-OH extracts, often sold as tablets, shots, or vapes in gas stations and vape shops, isolate and amplify this compound to levels far beyond what occurs in traditional kratom leaf or tea. Research indicates 7-OH binds to opioid receptors much more strongly than mitragynine, kratom’s primary alkaloid.2 That difference in potency may help explain why withdrawal from concentrated 7-OH products can feel more intense and more opioid-like than withdrawal from traditional kratom leaf.1

Even though both come from the same plant, concentrated 7-OH products are considered pharmacologically distinct from traditional kratom leaf or tea.2 That distinction matters here: because 7-OH’s withdrawal course appears to run closer to opioid withdrawal, the general kratom withdrawal timeline described earlier in this article may not fully apply to you if you were using a concentrated 7-OH product.

7-OH withdrawal isn’t well studied yet, so we can’t point to a reliable day-by-day timeline. What matters more than the exact number of days is how severe your symptoms are. If you’re withdrawing from a concentrated 7-OH product, the guidance in “When Is Kratom Withdrawal Dangerous? When to Get Medical Care” below applies to you, too.

Several states have restricted concentrated 7-OH products. At the federal level, DEA temporarily placed three substances related to 7-OH — mitragynine pseudoindoxyl (MGPI), MGM-15, and MGM-16 — in Schedule I effective August 26, 2026.⁷ A separate federal process concerning 7-OH above a specified threshold remains underway.8,9

If you’re not sure whether what you used was traditional kratom or a concentrated 7-OH product, a conversation with a healthcare provider or an outpatient team like Eleanor Health can help you understand your risk and find the right next step.

When Is Kratom Withdrawal Dangerous? When to Get Medical Care

Seek prompt medical evaluation if withdrawal symptoms become severe, if you’re unable to keep fluids down, become confused, hallucinate, have seizures, chest pain, difficulty breathing, or if symptoms feel unmanageable.

Can Medication Help With Kratom Withdrawal?

Yes. Medications like buprenorphine (Suboxone) can help manage kratom withdrawal because kratom acts on opioid receptors and can produce withdrawal symptoms similar to opioid withdrawal.10,11,12 At Eleanor Health, clinicians regularly use Suboxone to treat kratom withdrawal and kratom use disorder, and it’s often effective. The published evidence is still limited to case reports and case series rather than large controlled trials, but Eleanor’s clinical experience supports it as a treatment option. An Eleanor clinician will tailor the approach to your specific symptoms and medical history.

For more on preparing to stop and what the decision process looks like, see Eleanor Health’s article: How to Quit Kratom.

Getting Support Through Withdrawal and After

Eleanor Health clinicians regularly help people safely reduce and stop kratom use in an outpatient setting. Many people can safely reduce or stop kratom without inpatient detox using evidence-based medical care, medication when appropriate, therapy, and ongoing support. If a higher level of care is needed, our clinicians can help determine that and coordinate the next steps. 

If you’re outside our service area or need immediate help finding treatment, the SAMHSA National Helpline (1-800-662-HELP [4357]) provides free, confidential, 24/7 treatment referrals and information in English and Spanish.13 Eleanor Health offers ongoing outpatient care for substance use disorders, including therapy and care coordination.

Frequently Asked Questions

Is kratom withdrawal dangerous?

Most people experience uncomfortable but manageable withdrawal symptoms. However, severe symptoms, dehydration, hallucinations, seizures, or significant medical concerns should be evaluated by a healthcare professional. Eleanor clinicians can assess your symptoms and help determine the safest treatment approach.

Does kratom withdrawal cause Post-Acute Withdrawal Syndrome (PAWS)?

Post-acute withdrawal syndrome (PAWS) has not been systematically studied or well-characterized specifically for kratom. At least one published case report described prolonged withdrawal symptoms using this terminology, but this is not the same as an established diagnostic syndrome.15 Kratom withdrawal can include symptoms such as anxiety and mood changes, and the experience can vary from person to person.4 Research is still limited on how long kratom withdrawal symptoms may last and whether some people experience persistent symptoms after the acute withdrawal period.

What helps with kratom withdrawal?

Treatment depends on symptom severity. Medical care may include supportive care, therapy, and medications such as buprenorphine (Suboxone) to help manage withdrawal symptoms. Eleanor clinicians can assess your symptoms and determine the most appropriate treatment plan.

Can you die from kratom withdrawal?

Death from kratom withdrawal itself appears to be uncommon. However, withdrawal can become medically complicated for some people, particularly when other substances or underlying health conditions are involved. If you’re experiencing severe symptoms or you’re unsure what level of care you need, seek medical evaluation promptly.

Sources

  1. National Institute on Drug Abuse. Kratom. National Institute on Drug Abuse. Updated March 11, 2026. Accessed August 4, 2026. https://nida.nih.gov/research-topics/kratom
  2. US Food and Drug Administration. FDA and kratom. US Food and Drug Administration. Accessed August 4, 2026. https://www.fda.gov/news-events/public-health-focus/fda-and-kratom
  3. American Society of Addiction Medicine. Definition of addiction. American Society of Addiction Medicine. Adopted September 15, 2019. Accessed August 4, 2026. https://www.asam.org/quality-care/definition-of-addiction
  4. Stanciu CN, Gnanasegaram SA, Ahmed S, Penders T. Kratom withdrawal: a systematic review with case series. J Psychoactive Drugs. 2019;51(1):12-18. doi:10.1080/02791072.2018.1562133
  5. Diep J, Chin DT, Gupta S, Syed F, Xiong M, Cheng J. Kratom, an emerging drug of abuse: a case report of overdose and management of withdrawal. A A Pract. 2018;10(8):192-194. doi:10.1213/XAA.0000000000000658
  6. Olsen EO, O’Donnell J, Mattson CL, Schier JG, Wilson N. Notes from the field: unintentional drug overdose deaths with kratom detected – 27 states, July 2016-December 2017. MMWR Morb Mortal Wkly Rep. 2019;68(14):326-327. doi:10.15585/mmwr.mm6814a2
  7. US Drug Enforcement Administration. Schedules of Controlled Substances: Temporary Placement of Mitragynine Pseudoindoxyl, MGM-15, and MGM-16 in Schedule I. US Drug Enforcement Administration. Fed Regist. 2026;91:54948-54956. Docket No. DEA-1644. Published August 26, 2026. Doc. No. 2026-17429. https://www.federalregister.gov/d/2026-17429
  8. US Drug Enforcement Administration. Schedules of Controlled Substances: Temporary Placement of 7-Hydroxymitragynine Above a Specified Threshold in Schedule I; Notice of Intent. US Drug Enforcement Administration. Fed Regist. 2026;91:40917. Docket No. DEA-1570. Published July 6, 2026. Doc. No. 2026-13580. https://www.federalregister.gov/documents/2026/07/06/2026-13580/schedules-of-controlled-substance-temporary-placement-of-7-hydroxymitragynine-above-a-specified
  9. US Department of Health and Human Services, Office of the Assistant Secretary for Health. Temporary Placement of 7-Hydroxymitragynine Above a Specified Threshold in Schedule I; Extension of Comment Period. Fed Regist. 2026;91:55104. Docket No. HHS-OASH-2026-0232. Published August 26, 2026. Doc. No. 2026-17409. Comment period extended through September 10, 2026. https://www.federalregister.gov/documents/2026/08/26/2026-17409/hydroxymitragynine-above-a-specified-threshold-in-schedule-i-extension-of-comment-period
  10. Broyan VR, Brar JK, Allgaier T, Allgaier JT. Long-term buprenorphine treatment for kratom use disorder: a case series. Subst Abus. 2022;43(1):763-766. doi:10.1080/08897077.2021.2010250
  11. Buresh M. Treatment of kratom dependence with buprenorphine-naloxone maintenance. J Addict Med. 2018;12(6):481-483. doi:10.1097/ADM.0000000000000428
  12. Weiss S, Douglas H. Treatment of kratom withdrawal and dependence with buprenorphine/naloxone: a case series and systematic literature review. J Addict Med. 2021;15(2):167-172. doi:10.1097/ADM.0000000000000721
  13. Broyan VR, Brar JK, Allgaier T, Allgaier JT. Long-term buprenorphine treatment for kratom use disorder: a case series. Subst Abus. 2022;43(1):763-766. doi:10.1080/08897077.2021.2010250
  14. Substance Abuse and Mental Health Services Administration. SAMHSA national helpline. Substance Abuse and Mental Health Services Administration. Accessed August 4, 2026. https://www.samhsa.gov/find-help/helplines/national-helpline
  15. El-Shammaa N, Street K, Pinninti N. Release the Kratom: Post-Acute Withdrawal Syndrome in a 70 Year Old Male. Rowan-Virtua Research Day. 2023. DOI: 10.31986/issn.2689-0690_rdw.stratford_research_day.110_2023.