research · 2014-03-22
Landmark Malaysia Study: More Than Half of Regular Kratom Users Develop Severe Dependence, With Classic Opioid Withdrawal
Source: Academic Research
Why it matters
This is the first systematic study of kratom dependence, withdrawal, and craving in a real-world population of regular users — and it finds that the majority develop significant dependence, with a recognizable opioid withdrawal syndrome. The 2014 findings established the evidence base that has underpinned kratom regulatory debates ever since.
The big picture
This study's finding that over half of regular kratom users develop severe dependence is one of the most-cited pieces of evidence in kratom scheduling arguments. But crucially, the population studied used kratom in a Southeast Asian cultural context at high daily doses — raising questions about how findings translate to typical Western users consuming lower amounts.
Key findings
- • More than half (>50%) of regular kratom users (6+ months of use) developed severe kratom dependence; 45% showed moderate dependence
- • Physical withdrawal symptoms: muscle spasms and pain, sleeping difficulty, watery eyes/nose, hot flashes, fever, decreased appetite, diarrhea
- • Psychological withdrawal symptoms: restlessness, tension, anger, sadness, nervousness
- • Average mitragynine per dose: 79mg; average daily intake: approximately 276.5mg mitragynine
- • Consuming ≥3 glasses of kratom drink per day significantly raised odds of severe dependence, withdrawal, and inability to control cravings
What they say
Cross-sectional survey of 293 male regular kratom users in three northern Malaysian states (Penang, Perlis, Kedah); Leeds Dependence Questionnaire, Marijuana Withdrawal Checklist, and Craving Questionnaire used; Universiti Sains Malaysia and University of Erlangen-Nuremberg; Drug and Alcohol Dependence, 2014.
Bottom line
Regular kratom use in traditional high-dose contexts produces a clear opioid-type dependence syndrome — a finding that applies primarily to heavy daily users and may not generalize to the lower-dose, occasional-use patterns common among Western consumers.