Methadone Stabilizes 93% of Kratom Use Disorder Patients in First Multi-Site Clinical Study

Why it matters

As kratom use disorder becomes more recognized in clinical settings, clinicians need evidence-based treatment options. This study provides the first multi-site data showing methadone is both safe and effective for patients who cannot tolerate or access buprenorphine — expanding the treatment toolkit.

The big picture

Kratom use disorder (KUD) has gained increased recognition since Johns Hopkins published a clinical diagnostic algorithm in 2025. Buprenorphine has been described in case reports as a first-line treatment, but published experience with methadone has been extremely limited. With millions of U.S. kratom users and growing rates of dependence on potent 7-OH products, clinical guidance on treatment is urgently needed.

Key findings

• 14 patients across multiple Opioid Treatment Programs (OTPs) were treated with methadone for kratom use disorder between January 2024 and October 2025
• Mean patient age was 36.8 years; 71% were male
• 64% of patients reported using both natural kratom and synthetic 7-OH products
• The mean first-day methadone dose was 27.5 mg, with a mean maximum dose of 98.6 mg
• 13 of 14 patients (93%) remained in treatment at last follow-up, with no adverse events reported

What they say

According to lead author Dr. Robert Sherrick of Community Medical Services, methadone was well tolerated and effective in stabilizing patients with kratom use disorder, supporting its use as a viable alternative when buprenorphine is not suitable.

Bottom line

Methadone is an effective and safe treatment option for kratom use disorder, offering clinicians a second viable medication-assisted treatment when buprenorphine is not appropriate.