Pharmacology of Kratom: An Emerging Botanical Agent With Stimulant, Analgesic and Opioid-Like Effects

@article{Prozialeck2012PharmacologyOK,
  title={Pharmacology of Kratom: An Emerging Botanical Agent With Stimulant, Analgesic and Opioid-Like Effects},
  author={Walter C. Prozialeck and Jateen K Jivan and Shridhar V. Andurkar},
  journal={Journal of Osteopathic Medicine Journal of Osteopathic Medicine},
  year={2012},
  volume={112},
  pages={792 - 799}
}
Abstract Kratom (Mitragyna speciosa) is a plant indigenous to Thailand and Southeast Asia. Kratom leaves produce complex stimulant and opioid-like analgesic effects. In Asia, kratom has been used to stave off fatigue and to manage pain, diarrhea, cough, and opioid withdrawal. Recently, kratom has become widely available in the United States and Europe by means of smoke shops and the Internet. Analyses of the medical literature and select Internet sites indicate that individuals in the United… 

Figures from this paper

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.
Kratom: The Herbal Opioid
TLDR
In the medical examiner setting, kratom found in postmortem toxicology is rising and associated deaths are no longer esoteric, and increasing evidence of toxicity likely warrants some measure of regulation.
Update on the Pharmacology and Legal Status of Kratom
  • W. Prozialeck
  • Environmental Science
    The Journal of the American Osteopathic Association
  • 2016
TLDR
This report highlights the current scientific and legal controversies regarding kratom and its mitragynine constituents, which prompted a massive response from kratom advocates.
Kratom: The safe legal high?
The Potential for Kratom as an Antidepressant and Antipsychotic
TLDR
The dire need for further research to be conducted on kratom, its mechanism of action and the constituents that elicit these antidepressant, anxiolytic, and antipsychotic properties is highlighted.
Kratom: Implications for Health Care Providers.
TLDR
Health care providers need to be familiar with the pharmacology, adverse effects, and problems associated with kratom ingestion when caring for individuals.
Kratom policy: The challenge of balancing therapeutic potential with public safety
A Case of Kratom-induced Seizures
TLDR
A case of kratom-induced tonic-clonic seizures in a 27-year-old Caucasian male with a psychiatric history of anxiety, attention-deficit/hyperactivity disorder, benzodiazepine use disorder, and opioid use disorder is reported, highlighting the life-threatening complications of Kratom that is easily available online.
Kratom: A growing substance of abuse in the United States.
TLDR
Kratom is an emerging drug of abuse in the United States and its use is increasing in individuals who may seek to experience an opioidlike "high" as well as to help reduce withdrawal effects from other opioids.
Kratom and Future Treatment for the Opioid Addiction and Chronic Pain: Periculo Beneficium?
TLDR
The aim of this review is to highlight on the potential use of kratom, unique 'herbs" as a substitution therapy for chronic pain and opioid addiction, based on the neurobiological perspective of pain and the underlying mechanism of actions of drug addiction.
...
...

References

SHOWING 1-10 OF 53 REFERENCES
A Case Report of Inpatient Detoxification after Kratom (Mitragyna speciosa) Dependence
TLDR
These observations support the idea that kratom dependence syndrome is due to short-acting opioid receptor agonist activity, and suggest that dihydrocodeine and lofexidine are effective in supporting detoxification.
Opioid receptors and legal highs: Salvia divinorum and Kratom
TLDR
Both Kratom alkaloids are reported to activate supraspinal mu- and delta- opioid receptors, explaining their use by chronic narcotics users to ameliorate opioid withdrawal symptoms.
Here Today, Gone Tomorrow…and Back Again? A Review of Herbal Marijuana Alternatives (K2, Spice), Synthetic Cathinones (Bath Salts), Kratom, Salvia divinorum, Methoxetamine, and Piperazines
TLDR
The background, pharmacology, clinical effects, detection, and management of synthetic cannabinoid, synthetic cathinone, methoxetamine, and piperazine exposures are discussed.
A study of kratom eaters in Thailand.
TLDR
Thirty male and female cases of kratom addiction were selected from the Nondhaburi province and from the suburbs of Bangkok for the purpose of an intensive study, and the interview method was used with a questionnaire consisting of 30 items.
Chemistry and pharmacology of analgesic indole alkaloids from the rubiaceous plant, Mitragyna speciosa.
  • H. Takayama
  • Chemistry, Biology
    Chemical & pharmaceutical bulletin
  • 2004
TLDR
The potent opioid agonistic activities of mitragynine, the major constituent of this plant, and its analogues were found in in vitro and in vivo experiments and the mechanisms underlying the analgesic activity were clarified, and 7-hydroxymitragynines, a minor constituent of M. speciosa, was found to exhibit potent antinociceptive activity in mice.
Indole alkaloids of a Thai medicinal herb, Mitragyna speciosa, that has opioid agonistic effect in guinea-pig ileum.
TLDR
The results suggest that the opioid effect of M. speciosa is mostly based on the activity of 7-hydroxymitragynine, which shows the most potent opioid effect on the electrically-stimulated contraction.
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.
The evaluation of antinociceptive activity of alkaloid, methanolic, and aqueous extracts of Malaysian Mitragyna speciosa Korth leaves in rats
TLDR
Results suggest the presence of antinociceptive effect in various extracts of Malaysian M. speciosa leaves and vary depending on the type of solvents used for extraction.
Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton.
TLDR
It is believed that the addition of the potent mu-receptor agonist O-desmethyltramadol to powdered leaves from Kratom contributed to the unintentional death of the nine cases presented and intake of Krypton is not as harmless as it often is described on internet websites.
...
...