Kratom

Kratom is a Southeast Asian plant that acts on opioid receptors at moderate doses. It is widely used for pain, opioid withdrawal management, and recreation. Dependence develops with daily use and withdrawal, while manageable, is real. Approach it with the same respect as any opioid-acting substance.

dosage reference

dose	effect
1–2g	Stimulant-like: energy, focus, sociability
3–5g	Moderate: analgesia, euphoria, relaxation
5–8g	Strong: sedation, heavy opioid-like effects
8g+	High risk: nausea, dizziness, excessive sedation

• Potency varies significantly between vendors and strains — start low with any new source
• Tolerance develops quickly — more is not always better
• Taking on an empty stomach intensifies effects
• The "sweet spot" for most users is 3-5g — higher doses often produce worse effects

harm reduction

• Avoid daily use if possible — tolerance and dependence develop within weeks of daily dosing
• If using daily, take regular breaks — even 2 days off per week slows tolerance development
• Stay hydrated — kratom is dehydrating and can cause constipation with regular use
• Rotate strains to slow tolerance, though evidence for this is mostly anecdotal
• Buy from reputable vendors who test for heavy metals and salmonella — kratom quality is unregulated
• Never combine with other CNS depressants (alcohol, benzodiazepines, opioids) — respiratory depression risk

dangerous combinations

• Opioids: additive respiratory depression — dangerous
• Benzodiazepines: CNS depression, overdose risk
• Alcohol: increases sedation and CNS depression
• MAOIs: potential serotonergic interaction — avoid
• Stimulants: cardiovascular strain from opposing effects

dependence & withdrawal

• Physical dependence develops with daily use — sometimes within 2-4 weeks
• Withdrawal symptoms: muscle aches, insomnia, anxiety, irritability, runny nose, nausea, hot/cold flashes
• Timeline: begins 12-24h after last dose, peaks 2-3 days, largely resolves in 1-2 weeks
• Not life-threatening unlike alcohol or benzo withdrawal — uncomfortable but survivable
• Tapering is the most effective approach — reduce dose by 10% every 1-2 weeks
• Comfort medications: ibuprofen for aches, loperamide for GI symptoms, clonidine (prescription) for anxiety
• Buprenorphine can be used for severe dependence — speak to a doctor

using kratom for opioid withdrawal

• Many people use kratom to manage opioid withdrawal — it can be effective but creates its own dependence
• Use for the shortest time possible — ideally less than 2 weeks
• Taper kratom doses rather than stopping abruptly
• Buprenorphine (Suboxone) is a more evidence-based option with medical support
• The goal is harm reduction, not replacing one dependency with another long-term

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