Kratom Use and Toxicities in the United States

  title={Kratom Use and Toxicities in the United States},
  author={William Eggleston and Robert Stoppacher and Kyle Suen and Jeanna M Marraffa and Lewis S. Nelson},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
Kratom is an herbal supplement containing alkaloids with opioid properties. This review was conducted to determine toxicities associated with kratom use in the United States in order to provide insight into its safety as a dietary supplement. 
Kratom exposures among older adults reported to U.S. poison centers, 2014–2019
Healthcare providers and older adult patients should be aware of the potential risks of kratom use, including medication interactions and falls, when reviewing medication lists and query this population for all medications and substances being used.
Kratom—Pharmacology, Clinical Implications, and Outlook: A Comprehensive Review
This manuscript will discuss the most current epidemiology, pharmacology, toxicity, and management related to kratom, while seeking to provide a contemporary perspective on the issue and its role in the greater context of the opioid epidemic.
Kratom (Mitragyna speciosa)-Induced Hepatitis
A case report is provided detailing the clinicopathologic findings of drug-induced liver injury caused by kratom, and Liver biopsy demonstrated a prominent canalicular cholestatic pattern, mixed portal inflammation, and newly described perivenular necrosis.
Kratom: The safe legal high?
Kratom Use Within the Context of the Evolving Opioid Crisis and the COVID-19 Pandemic in the United States
This report highlights how converging factors have led to a surge in interest in kratom as a potential harm reduction agent in the treatment of pain and opioid use disorder.
Clinical Pharmacology of the Dietary Supplement Kratom (Mitragyna speciosa)
Until studies are conducted that define kratom's role in treating opioid withdrawal and/or other central nervous system conditions, kratom will likely remain available as a dietary supplement for the foreseeable future.
Pharmacologic and clinical assessment of kratom: An update.
  • C. White
  • Medicine
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2019
Kratom has a unique pharmacologic profile that might offer advantages over other opioids, but its high abuse liability, potential for drug interactions and adverse events, and inadequate research into the balance of benefits to harm are concerning.
Kratom is a herbal product that is most commonly obtained as a powder and consumed as a beverage that reduces pain, cause dose-dependent stimulant and sedative effects, and have an adverse effect profile consistent with opioids.
Case Report: Treatment of Kratom Use Disorder With a Classical Tricyclic Antidepressant
The case of a patient who developed anxiety and dysphoric mood and insomnia while using kratom, with these symptoms persisting after withdrawal, is described.


The pharmacology and toxicology of kratom: from traditional herb to drug of abuse
There are currently no standard analytical screening techniques for mitragynine and its metabolites following ingestion limiting its detection to more sophisticated techniques like liquid chromatography-mass spectrometry to determine kratom use.
Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth).
The predominant alkaloid of kratom, mitragynine, binds mu- and kappa-opioid receptors, but has additional receptor affinities that might augment its effectiveness at mitigating opioid withdrawal.
Pharmacokinetics of mitragynine in man
The first pharmacokinetic study in humans, which demonstrated linearity and was consistent with the oral two-compartment model with a terminal half-life of about 1 day, suggests there is a possibility for it to be developed medically as a pain killer or better opioid substitute in the future.
Suspected Adulteration of Commercial Kratom Products with 7-Hydroxymitragynine
A unique form of product adulteration is described, which stresses the importance of increased dietary supplement oversight of Kratom-containing supplements.
Discriminative stimulus properties of mitragynine (kratom) in rats
It is demonstrated that the discriminative stimulus effect of MG possesses both opioid- and psychostimulant-like subjective effects.
Patterns of Kratom use and health impact in the US-Results from an online survey.
Dietary supplements: how they are used and regulated.
Overall use of nutrient and botanical dietary supplements (DS) has increased for years across all major categories, but the wording of S/F claims has become a difficult issue in the proposed DS labeling regulations.
HHS recommended that the DEA ban kratom, documents show