Kratom, 7‑Hydroxymitragynine, and Treatment Options for Dependence

Kratom, 7‑Hydroxymitragynine, and Treatment Options for Dependence

Kratom has become widely available in the U.S., often marketed as a “natural” remedy for pain, anxiety, or opioid withdrawal. But many patients develop dependence—especially on 7‑hydroxymitragynine (7‑OH), a potent opioid‑like metabolite found in kratom products.

How Kratom Affects the Brain

Kratom’s main alkaloids, mitragynine and 7‑OH, act on the mu‑opioid receptor. At higher or frequent doses, this can lead to:

• Tolerance

• Withdrawal symptoms

• Cravings

• Loss of control over use

Withdrawal often resembles opioid withdrawal and may include anxiety, restlessness, insomnia, sweating, GI upset, and strong cravings.

Why 7‑OH Matters

7‑OH is significantly more potent than mitragynine. Some commercial kratom products contain elevated levels, increasing the risk of dependence and more intense withdrawal.

How We Diagnose Kratom Use Disorder

Although kratom isn’t listed separately in DSM‑5, dependence fits under Other Substance Use Disorder. Evaluation includes:

• Pattern and amount of use

• Functional impairment

• Withdrawal symptoms

• Co‑occurring mental health conditions

Our approach is non‑judgmental and focused on restoring stability.

Evidence‑Based Treatment Options

Medication‑Assisted Treatment (MAT)

Because kratom acts on opioid receptors, medications used for opioid use disorder can be effective:

• Buprenorphine (Suboxone, Brixadi, Sublocade) – reduces withdrawal and cravings

• Clonidine or Lofexidine – non‑opioid options for withdrawal relief

Gradual Tapering

For milder dependence or patients who prefer a non‑MAT approach, a structured taper can reduce withdrawal intensity.

Addressing Co‑Occurring Conditions

Many patients use kratom to self‑treat anxiety, depression, trauma, or chronic pain. Treating these conditions reduces relapse risk.

Therapy and Recovery Support

CBT, Motivational Interviewing, relapse‑prevention planning, and trauma‑informed therapy help patients build long‑term stability.

When to Seek Help

If kratom use is causing withdrawal, cravings, or loss of control, treatment can help. Dependence on kratom or 7‑OH is treatable, and patients do recover with the right support.

Brilliant Behavioral Health can help with both addiction and mental health and the complex relationship between the two. If you have been struggling with Kratom or 7-OH give us a call at (856) 390-0696.