Abstract
Kratom (Mitragyna speciosa Korth., Rubiaceae) is a plant native to Southeast Asia, where it has been used for centuries as a mild stimulant and as medicine for various ailments. More recently, as kratom has gained popularity in the West, United States federal agencies have raised concerns over its safety leading to criminalization in some states and cities. Some of these safety concerns have echoed across media and broad-based health websites and, in the absence of clinical trials to test kratom’s efficacy and safety, considerable confusion has arisen among healthcare providers. There is, however, a growing literature of peer-reviewed science that can inform healthcare providers so that they are better equipped to discuss kratom use with consumers and people considering kratom use within the context of their overall health and safety, while recognizing that neither kratom nor any of its constituent substances or metabolites have been approved as safe and effective for any disease. An especially important gap in safety-related science is the use of kratom in combination with physiologically active substances and medicines. With these caveats in mind we provide a comprehensive overview of the available science on kratom that has the potential to i clarity for healthcare providers and patients. We conclude by making recommendations for best practices in working with people who use kratom.
Highlights
Kratom (Mitragyna speciosa Korth., Rubiaceae; known as ketum) is made from the leaves of a tropical tree in the coffee family indigenous to Southeast (SE) Asia, where it has been used for centuries as medicine for various ailments, including hypertension, diarrhea, cough, and fever (Tanguay, 2011; Cinosi et al, 2015; Singh et al, 2016)
Only 2% of 6,135 kratom-users in the Pain News Network (2017) online survey responded “yes” to the question “Can you get high from kratom?” In addition to survey data, thousands of public comments to Drug Enforcement Administration (DEA) and Food and Drug Administration (FDA) attested to the successful substitution of kratom for opioids (Prozialeck et al, 2019)
Despite centuries of kratom use in SE Asia, there have been few reports of serious adverse events associated with its use, and kratom overdose has not been identified as a direct cause of death in fatalities coincident with kratom use (PinneyAssociates, 2016)
Summary
Kratom (Mitragyna speciosa Korth., Rubiaceae; known as ketum) is made from the leaves of a tropical tree in the coffee family indigenous to Southeast (SE) Asia, where it has been used for centuries as medicine for various ailments, including hypertension, diarrhea, cough, and fever (Tanguay, 2011; Cinosi et al, 2015; Singh et al, 2016). As six United States have done at the time of this writing, has the potential to create a new illicit market for kratom products, increasing the likelihood of adulteration and the use of dangerous substances as kratom substitutes All of this results in harm to people who regularly use kratom to address pain, psychiatric problems, and SUD symptoms (Grundmann, 2017; Swogger and Walsh, 2018; Coe et al, 2019; Smith et al, 2021a; Smith et al, 2021b). Subsequent to increased kratom use in the United States, an eight-factor analysis (8 FA) normally required prior to scheduling decisions was performed by the FDA, and another by an independent agency (Pinney Associates) The former has been criticized by kratom researchers for omission of important scientific studies and pertinent data, as well as inappropriate use of a computer simulation model (PHASE) that provided data that the FDA used to deem kratom an “opioid” (Grundmann et al, 2018), linking it to more dangerous classical opioids without providing information on differences between kratom and these drugs. We conclude with recommendations to health practitioners for conceptualizing kratom use and working with patients who use kratom
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
