First Brain Imaging Study Shows Kratom Dependence Alters Dopamine Transporter Levels in the Striatum

Why it matters

This is the first study to use brain imaging to directly measure how kratom dependence changes the dopamine system — providing neurobiological evidence that kratom addiction alters the same reward circuits affected by other opioids.

The big picture

The finding of reduced dopamine transporter levels in kratom-dependent subjects aligns kratom addiction biologically with other opioid use disorders, which could influence both clinical treatment approaches and regulatory arguments. However, the small sample size means these findings should be considered preliminary.

Key findings

• • Kratom-dependent subjects showed significantly lower dopamine transporter (DAT) uptake in the left caudate (0.938 vs. 1.251, p=0.014) and left striatum (1.055 vs. 1.29, p=0.036) compared to healthy controls
• • The asymmetry index in the caudate region was significantly higher in kratom users (33% vs. 14%, p=0.019), indicating uneven dopaminergic activity
• • Changes are similar in pattern to those seen in cocaine, heroin, and methamphetamine dependence — all of which show striatal DAT reductions
• • This is the first neuroimaging study to assess DAT activity specifically in kratom-dependent individuals
• • The brain regions affected (striatum, caudate) are central to reward processing, motivation, and the development of compulsive drug use

What they say

Pilot study using 99mTc-TRODAT-1 SPECT-CT brain imaging; 12 kratom-dependent subjects vs. 13 healthy male controls; Universiti Sains Malaysia; Cureus, August 2023.

Bottom line

The biological fingerprint of kratom addiction in the brain resembles that of classical opioid and stimulant dependencies — a finding that supports treating kratom use disorder with similar clinical rigor to other substance use disorders.