Kratom dependence is real, withdrawal is hard, and you don't have to quit alone. Icon Medicine offers buprenorphine-based MAT for Kratom Use Disorder — same-day telehealth starts, no judgment, board-certified care.
Kratom (Mitragyna speciosa) is a tropical tree native to Southeast Asia — Thailand, Malaysia, Indonesia — where its leaves have been used for centuries as a stimulant by manual laborers and as a traditional remedy. In the United States, kratom is sold in gas stations, smoke shops, and online as powder, capsules, extracts, or "kratom tea." It's marketed as an herbal supplement for pain, energy, anxiety, or opioid withdrawal relief.
What makes kratom pharmacologically unique — and dangerous — is its dual mechanism: at low doses (1–5g), it acts like a stimulant, producing increased alertness and energy. At higher doses (5–15g+), the primary alkaloid mitragynine and its metabolite 7-hydroxymitragynine bind to mu-opioid receptors in the brain, producing pain relief, sedation, and euphoria nearly identical to opioid drugs. This opioid-receptor activity is the direct cause of physical dependence.
Common forms: powder mixed into drinks, capsules and tablets, liquid extracts, "kratom shots," and steeped tea. All forms carry the same dependence risk — the dose and frequency determine how quickly dependence develops.
Kratom Use Disorder (KUD) is a clinically recognized substance use disorder. It follows the same DSM-5 diagnostic framework as other substance use disorders — and it is treatable.
FDA Position: The FDA has reviewed 44 deaths associated with kratom and has stated that kratom has opioid properties and poses the same serious risks as opioids. The DEA has listed kratom as a Drug of Concern. While not yet federally scheduled, kratom is banned in several states — Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin — and numerous municipalities.
Prevalence: Studies estimate 5–15 million Americans use kratom regularly. Among regular users, rates of dependence are high — one survey found 91% met criteria for at least one DSM-5 substance use disorder criterion after extended use.
KUD presents across physical, behavioral, and psychological dimensions. Recognizing these signs is the first step toward recovery.
Understanding what happens during withdrawal helps you prepare — and underscores why medical support makes a critical difference in outcomes.
Anxiety, irritability, yawning, watery eyes, runny nose, and mild muscle aches emerge. Similar to the early stages of opioid withdrawal, symptoms are uncomfortable but manageable. Many patients mistake these for the flu.
Symptoms intensify significantly. Sweating, chills, goosebumps, insomnia, and restlessness become prominent. Cravings peak strongly during this window — this is when the majority of unsupported quit attempts fail.
The most challenging window. Muscle aches and cramps, nausea and vomiting, diarrhea, severe insomnia, restless leg syndrome, anxiety, and irritability are at their worst. Intensity is generally milder than heroin or fentanyl withdrawal, but comparable to prescription opioid withdrawal. Medical management is highly effective at this stage.
Physical symptoms begin to subside. However, psychological symptoms persist — depression, anxiety, fatigue, and anhedonia (inability to feel pleasure) remain significant. Relapse risk remains very high without support during this transition.
Physical symptoms are largely resolved. Mental health symptoms continue — insomnia, depression, low motivation, and cognitive fog (sometimes called "kratom brain") are common. Mood support and medical monitoring remain important during this phase.
Intermittent cravings, mood instability, and sleep disturbances can persist for weeks to months. This is Post-Acute Withdrawal Syndrome (PAWS). Professional support and ongoing medication significantly reduce the duration and severity of PAWS and protect long-term recovery.
Our six-step protocol is built around published clinical evidence for buprenorphine-based treatment of KUD — personalized, compassionate, and delivered entirely via telehealth.
Your first appointment is a confidential telehealth visit. Our provider conducts a comprehensive substance use assessment — how long you've been using kratom, how much, your previous quit attempts, and any co-occurring conditions such as anxiety, depression, or chronic pain. This usually takes 45–60 minutes and can happen the same day you reach out.
Based on your assessment, we build a treatment plan. For most KUD patients, this includes buprenorphine/naloxone (Suboxone) to manage withdrawal and reduce cravings. Your starting dose is determined by your kratom use history — published evidence guides dosing: lower use patterns require lower induction doses, heavier use patterns require higher doses.
Buprenorphine works by partially activating the same opioid receptors that kratom's alkaloids bind to — relieving withdrawal symptoms without producing significant euphoria. Unlike full opioid agonists, it has a "ceiling effect" that reduces overdose risk. Induction typically begins when you're in mild-to-moderate withdrawal, usually 12–24 hours after your last kratom dose.
We monitor your response closely during the stabilization phase. Most patients reach a stable point within 2–3 weeks. We adjust your dose as needed to eliminate cravings and prevent withdrawal between doses. All follow-up visits occur via telehealth — no travel, no waiting rooms, full privacy.
Once stable, we work with you on a tapering schedule — gradually reducing your buprenorphine dose over weeks or months until you're medication-free. Or we continue maintenance dosing if that is the safest approach for your situation. Both paths are medically valid and supported by evidence. We never force a timeline on your recovery.
MAT works best alongside behavioral support. We connect you with counseling resources and provide ongoing monitoring for co-occurring conditions — anxiety, depression, and chronic pain — that often drive kratom use in the first place. Treating the whole person is the foundation of lasting recovery.
Going it alone carries significant risks. Here is why medically supervised care dramatically improves your chance of lasting recovery.
Going cold turkey from kratom carries serious risks: severe withdrawal symptoms, dehydration from vomiting and diarrhea, psychiatric crises including severe anxiety and suicidal ideation, and extremely high relapse rates. Medically supervised withdrawal management with buprenorphine dramatically reduces these risks and improves long-term outcomes.
Most people who develop KUD were using kratom to self-medicate something: chronic pain, anxiety, depression, PTSD, or prior opioid use disorder. Treatment that doesn't address these underlying conditions leaves patients vulnerable to relapse or substitution with another substance. We screen and treat the whole picture.
Heavy, prolonged kratom use has been associated with hepatotoxicity (liver injury), seizures at high doses, and cardiovascular effects. Abnormal liver function tests are found in a subset of heavy users. A medical provider can screen for and actively manage these complications while you are in treatment — protecting your overall health throughout recovery.
Our treatment protocols are grounded in published peer-reviewed evidence. If you need immediate support, free and confidential help is available 24/7.
National Institute on Drug Abuse overview of kratom pharmacology, risks, and current research.
nida.nih.gov/research-topics/kratomFree, confidential, 24/7 treatment referral and information service for individuals facing substance use disorders.
1-800-662-4357FDA Commissioner statement on scientific evidence of opioid compounds in kratom and associated risks.
FDA.gov Statement"Treatment of Kratom Withdrawal and Dependence with Buprenorphine/Naloxone: A Case Series and Systematic Review." Journal of Addiction Medicine, 15(2):167–172.
"Long-Term Buprenorphine Treatment for Kratom Use Disorder: A Case Series." The American Journal on Addictions. Demonstrates sustained remission with buprenorphine maintenance.
"Self-treatment of opioid withdrawal using kratom." American Journal of Addiction. Examines the intersection of OUD and kratom use — the dual-disorder population we frequently treat.
MAT for substance use disorders is covered under most insurance plans. Transparent self-pay pricing is always available with no hidden fees.
We accept most major commercial insurance plans. Coverage for MAT is required under the Mental Health Parity and Addiction Equity Act (MHPAEA). Call us to verify your specific benefits before your appointment.
Don't see your plan listed? Call (240) 966-4266 — we verify coverage for all major insurers.
You've been managing this alone long enough. Icon Medicine offers same-day, judgment-free KUD treatment via telehealth — from the privacy of your home, starting today.
This page is for informational purposes only and does not constitute medical advice. Kratom Use Disorder treatment should be supervised by a qualified healthcare provider. If you are experiencing a medical emergency, call 911 or go to your nearest emergency room. Icon Medicine is a telehealth practice licensed in Maryland, Virginia, and Florida.