Methadone Proves Effective for Kratom Use Disorder in First Multi-Site Clinical Study

Why it matters

Clinicians treating kratom use disorder now have evidence supporting methadone as a viable alternative when buprenorphine is unsuitable, broadening treatment options for a growing patient population.

The big picture

As kratom use disorder has increased — particularly with the rise of concentrated 7-OH products — clinicians have faced limited evidence on how to treat it pharmacologically. Buprenorphine has been the most described treatment, but not all patients tolerate or respond to it. This multi-site retrospective study is the first to examine methadone specifically for this population across multiple opioid treatment programs.

Key findings

• Researchers identified 14 patients with kratom use disorder across multiple OTPs, treated between January 2024 and October 2025
• Mean age was 36.8 years; 71% were male; 64% used both kratom and 7-OH
• Mean starting methadone dose was 27.5 mg/day; mean maximum dose was 98.6 mg/day
• 13 of 14 patients (93%) remained in treatment at last follow-up — a high retention rate
• No adverse events were reported across the entire cohort

What they say

The authors wrote: "Methadone was well tolerated and effective in stabilizing patients with KUD, supporting its use as a viable alternative when buprenorphine is not suitable."

Bottom line

Methadone achieved a 93% treatment retention rate in kratom use disorder patients, establishing it as a credible pharmacotherapy option alongside buprenorphine.