Kratom Use and Toxicities in the United States

@article{Eggleston2019KratomUA,
  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},
  year={2019},
  volume={39}
}
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. 
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References

SHOWING 1-9 OF 9 REFERENCES
The pharmacology and toxicology of kratom: from traditional herb to drug of abuse
TLDR
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).
TLDR
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
TLDR
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
TLDR
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
TLDR
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.
TLDR
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