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

What Is Post-Acute Withdrawal (PAWS)?

For some people, milder symptoms such as anxiety, low mood, or sleep trouble can continue in waves after the acute phase resolves. This is sometimes referred to as post-acute withdrawal syndrome (PAWS). It doesn’t happen to everyone, and when it does, how long it lasts varies by person.

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

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?

In some cases, a clinician may consider medications such as buprenorphine to help manage kratom withdrawal, particularly when symptoms overlap with opioid withdrawal.7,8,9 Although this isn’t a standard protocol, evidence here comes from a small number of case reports and case series, not controlled trials. Typically, a clinician would weigh this on an individual basis.

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.10 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 PAWS?

For some people, lingering symptoms such as anxiety, sleep difficulties, or low mood may continue after the acute withdrawal phase. This is sometimes referred to as post-acute withdrawal syndrome (PAWS), although it doesn’t happen to everyone.

What helps with kratom withdrawal?

Treatment depends on symptom severity. Many people benefit from medical evaluation, supportive care, therapy, and, in some cases, medications that help manage withdrawal symptoms. Eleanor clinicians can help 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. Buresh M. Treatment of kratom dependence with buprenorphine-naloxone maintenance. J Addict Med. 2018;12(6):481-483. doi:10.1097/ADM.0000000000000428
  8. 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
  9. 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
  10. 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