Using Kratom With a History of Substance Use Disorder: What You Need to Know

Key Takeaways: Kratom (Mytragina speciosa) is a plant from Southeast Asia that has opioid-like properties and has become readily available in the U.S. Kratom is currently unregulated in the vast majority of states and it’s widespread accessibility has lead many people to view it as a common health remedy, unaware of its psychoactive potential. Kratom is particularly potent for users of opioids because it targets the same receptors in the brain and can easily turn into a new addiction for the user or lead someone in recovery from opioids to relapse with their original drug of choice.

The Risks of Using Kratom With a History of Substance Abuse

In recent years kratom (Mytragina speciosa) has become more and more popular in the United States. Touted for its pain relief and mood enhancing properties, this psychoactive plant from Southeast Asia has gained a reputation as an effective replacement drug for those recovering from opioid addiction, as well as as a remedy for chronic pain, anxiety, and depression. However, despite the amount of people who use Kratom regularly to help with opioid withdrawal, there are major risks to using Kratom for this purpose, including the possibility of cross addiction or relapse.

What is Cross Addiction?

Cross addiction, also known as addiction transfer or addiction interaction, is when someone replaces their addiction with another substance. It can refer to someone in recovery who then gets addicted to a different drug that affects their brain in similar ways, or someone who is abusing multiple substances at the same time. 

Addiction is a physiological phenomenon. Prolonged use of chemical substances overstimulates the brain’s reward center by flooding it with dopamine, the “feel good” chemical, negatively affecting the brain’s “emotional nervous system” located in the limbic system. The limbic system governs basic instincts and feelings such as pain, pleasure, hunger, and reproduction and reinforces habits that are deemed necessary for survival. Over time, the brain begins to equate pleasure and even survival with the use of specific drugs that flood it with dopamine and motivates you to keep seeking it out for that good feeling it produces. Continued use leads to decreased sensitivity to the substance as the receptors in your brain adapt to its effects and build up tolerance. The brain then needs to consume the drug in higher quantities to get that good feeling again, resulting in a chemical dependence. 

Because addiction physically alters the brain by desensitizing its dopamine receptors, someone who already has an addiction is more likely to get addicted to other substances, especially if they target the same parts of the brain like opioids and kratom do. Some people may be genetically predisposed to addiction, but even if someone becomes addicted through force of habit, once they are addicted, their brain has been altered and their chances of cross addiction increase. Those who are in active recovery from one substance but become addicted to another substance (cross addiction) are also at a higher risk of relapse with their original substance of addiction.

Kratom vs Opioids

The two main psychoactive alkaloids in kratom are Mitragynine and 7-Hydroxymitragynine. They are considered “atypical opioids” because although they are structurally distinct from the classical opioids of the poppy plant (Papaveraceae), they bond with opioid receptors in the brain and body like classical opioids do. 

This means they have similar effects on the body. Both substances have antinociceptive properties, meaning they block pain signals to the brain, and flood the body with pleasure. And in smaller doses they act as stimulants while in larger doses as sedatives. 

Reports about the effectiveness of kratom vary widely. Some studies and anecdotes suggest relief from pain and eased withdrawal symptoms with a low risk of substance abuse while there are also reports of addictions and even deaths linked to kratom abuse. Part of what contributes to the varied experiences with Kratom is its status as a federally unregulated drug in the United States. 

Kratom’s Complex Status as an Unregulated Drug

Kratom is currently unregulated by the F.D.A. (Food and Drug Association) and classified as a botanic dietary supplement. It has been banned by six states and is largely unregulated in all but four states which have passed the KCPA (Kratom Consumer Protection Act). The KCPA maintains kratom’s legality while allowing for certain regulations. Kratom has been outright banned in many countries including those in its region of origin (Thailand, Vietnam, Malaysia).

Kratom’s status as an unregulated drug has complex implications. Many mistake kratom’s legality for safety. They assume that because the substance is legal it must be safe to use. This is not necessarily true. The drug has found its place in a growing market of herbal drinks and is often readily sold in gas stations, delis, and smoke shops throughout the country. This has helped bolster its perception as a natural, healthy remedy for all sorts of ailments, including the easing of opioid withdrawals.

This reputation and easy accessibility can be dangerous because it attracts a broad swath of people looking simply for a “pick me up.” Already there have been many reports of recovering opioid users unknowingly trying a seemingly innocuous kratom product and quickly developing a dependency or relapsing with their original drug of choice. 

The situation is made more complex by the fact that since Kratom is unregulated, as a product it is inconsistent and does not carry the same chemical makeup every time. The quantity of psychoactive alkaloids varies from one Kratom leaf to another and therefore varies from one dose to another, leading to unpredictability in potency. Lack of regulation also opens the door to potential contamination and combination with other illicit substances. This is especially dangerous for someone trying to recover from addiction because they are at a greater risk of encountering an illicit drug that could reignite their addiction.

Kratom Public Discourse 

On public forums like Reddit, users of Kratom discuss and compare their individual experiences with the drug and recovery. There’s been some debate as to whether the withdrawal symptoms from kratom are comparable to that of harder opioids and benzodiazepines. Some who experienced the throes of addiction and recovery with those harder substances suggest that kratom and its withdrawals pale in comparison to opioids and benzos while others deemed it just as intense and difficult to detach from. If you are trying to quit kratom, regardless of if your experience with the drug involves a history of illicit substances, the difficulties of your withdrawal are valid and merit proper attention. The potential mildness of kratom compared to opioids or benzodiazepines also does not constitute a valid reason to start using.

If you or a loved one is struggling with a kratom addiction and looking to get help, feel free to explore our support groups and resources at https://www.kratomanonymous.com/get-help.