The only ranked list on the site
Every other page on this site treats quitting paths as equally legitimate. They are. This page answers a narrower question: if you’re picking from scratch with no constraints, what order would the community try things in?
The logic is harm reduction. Plans drift. Tapers run longer than planned, short stabilizations become long ones. The order favors paths where the worst-case drift lands you on the most benign compound. Kratom leaf is the least harmful thing on this list to stay on long-term. Long-acting MAT is the most committing.
If your situation doesn’t support starting at the bottom, start where you need to.
The ladder
1. Cold turkey
Stop. Ride out withdrawal with nothing on your mu receptors and no medication.
Fits: short use, lower doses, strong support around you, a clear stretch of nothing-to-do.
Doesn’t fit: longer-term extended use, high tolerance, daily responsibilities you can’t drop, prior unsuccessful cold-turkey attempts.
See Withdrawal Help for the timeline and symptom map.
2. Kratom leaf taper
Swap 7-OH for plain kratom leaf, then step the leaf down to zero over days or weeks. Leaf gives the receptors mitragynine at much lower potency while you wean.
Plain leaf is preferred over concentrated mitragynine products. Concentrates work but introduce a stronger compound than necessary; use them only if leaf isn’t available or isn’t enough. The concentrated-mitragynine path is documented separately on Quit 7-OH with Concentrated Mitragynine, including the product-contamination concerns specific to that route.
Fits: stable supply of leaf, ability to weigh doses, patience for a multi-week wean.
Doesn’t fit: severe withdrawal that breaks through a leaf swap, no access to clean leaf, no time for a slow taper.
See Quit 7-OH with Kratom Leaf.
3. Helper medications
Use non-opioid medications (clonidine, gabapentin, trazodone, baclofen, ondansetron) to take the edge off specific withdrawal symptoms. Nothing on the mu receptors; you’re managing the symptom side while your body resets.
Fits: moderate withdrawal, prescriber or telehealth access, willingness to take meds for a week or two.
Doesn’t fit: severe withdrawal where helpers don’t touch the floor.
See Helper Medications.
4. Helper meds plus a kratom leaf taper
Stack rungs 2 and 3. Leaf provides receptor coverage while helpers handle the residual symptoms leaf doesn’t reach (anxiety, sleep, GI).
Same leaf-over-concentrates preference as rung 2.
Fits: leaf alone wasn’t quite enough, helpers alone weren’t quite enough, or you want both safety nets at once.
5. Suboxone, with helpers if needed
Buprenorphine. A long-acting partial mu agonist. A correct induction removes most of withdrawal within hours and stabilizes you on a controlled medication. Helpers fill any residual gaps.
Fits: high-dose synthetics, long use, multiple failed lower-rung attempts, severe withdrawal that broke through everything else, situations where you cannot be out of commission for a week.
See Suboxone.
6. SR-17, with helpers if needed
SR-17018. A biased mu agonist with a long duration of action. Sidesteps the buprenorphine-displacement problem that makes Suboxone tricky for long-acting kratom synthetics like MGM-15. Off-prescription, less clinical literature than buprenorphine.
Fits: Suboxone isn’t accessible, prior bupe induction failed, dual-receptor compounds like MGM-15 in the picture, or you want the long-acting MAT option that doesn’t risk precipitated withdrawal during induction.
See SR-17018.
Rungs 5 and 6 are equivalent. Pick based on access, prior experience, and which prescriber relationship you have.
A note on direct dose-tapering of 7-OH itself. Some people don’t switch to anything; they step the concentrated 7-OH dose down on its own schedule, halving from high doses, plateauing at the lower end, then jumping off. That path sits adjacent to this ladder rather than on it (it doesn’t reduce to one rung), and it has its own characteristic shape and stall points. Tapering Off 7-OH covers what it looks like in practice and how it usually ends.
Moving between rungs
You can move between rungs in either direction. Some people start cold turkey, hit the wall on day three, and induct on Suboxone. Others stabilize on Suboxone and wind down to a leaf taper later.
- Helpers work alongside any other rung. Adding clonidine to a Suboxone induction is routine.
- Kratom leaf alongside Suboxone has a place. Bupe covers the mu-opioid side, but 7-OH dependence also involves the minor alkaloids, whose adrenergic and serotonergic activity bupe doesn’t touch. A small amount of leaf is a common community fix when that side of withdrawal breaks through.
- Never combine naltrexone (LDN, ULDN, Vivitrol) with active opioid use. Naltrexone is for after the acute phase. Taking it with opioids on board will precipitate withdrawal.
Out of scope
- Dosing for any of the medications above. Each path has its own page.
- Suboxone induction timing or COWS/SOWS gating. See Suboxone induction.
- Post-acute recovery. See Post-Acute once you’re through the first weeks.