Contents

Search

Mitragyna speciosa; kratom

banned by the FDA in 2014. Recommended for classication as DEA class I. Uses: - used as a recreational drug - used to treat opioid addiction - used as a stimulant & an opioid substitute [2] Contraindications: - FDA warns: do NOT use [4,5] Epidemiology: - grows naturally in Thailand, Malaysia, Indonesia, & Papua New Guinea [4] - may be contaminated with Salmonella March 2018 [6] - Triangle Pharmanaturals refused to cooperate with FDA despite repeated attempts to encourage voluntary recall [6] - calls to U.S. poison control centers regarding exposure to kratom increased over 50-fold from 2011 to 2017 [10] Dosage: - 1-5 grams with stimulant effect - larger doses with opioid-like or sedative effects [11] Adverse effects: - most common - tachycardia - agitation/irritability - drowsiness - nausea - hypertension [2] - rhinitis [3] - nervousness - seizures [4] - respiratory depression (perphaps not) [3] - vomiting - may not cause constipation [3] - opiate withdrawal symptoms [4] (perhaps not) [3] - aggression - hostility - myalgia - bone pain - muscle twitches - abdominal pain, diarrhea, dysphoria [3] - appears to have properties that expose users to the risks of - addiction, substance abuse, & dependence [4] - neonatal abstinence syndrome from maternal kratom use Mechanism of action: - opioid receptor agonist Notes: - nickel & lead found in some Kratom products [9]

Interactions

drug adverse effects of opiates

General

pharmaceutical herb; medicinal herb; herbal supplement; botanical opioid receptor agonist (narcotic)

References

  1. FDA News Release. January 6, 2016 US Marshals seize dietary supplements containing kratom http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm480344.htm
  2. Anwar M, Law R, Schier J. Notes from the Field. Kratom (Mitragyna speciosa) Exposures Reported to Poison Centers - United States, 2010-2015. MMWR Morb Mortal Wkly Rep 2016;65:748-749 http://www.cdc.gov/mmwr/volumes/65/wr/mm6529a4.htm
  3. Clopton J. Medscape. Sep 28, 2016. What Is Kratom? Why Does the DEA Want to Ban It? http://www.medscape.com/viewarticle/869404
  4. FDA News & Events. Nov 14, 2017 FDA and Kratom. https://www.fda.gov/NewsEvents/PublicHealthFocus/ucm584952.htm - FDA Statement. Nov 14, 2017 Statement from FDA Commissioner Scott Gottlieb, M.D. on FDA advisory about deadly risks associated with kratom. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm584970.htm
  5. Brooks M Kratom Now an Opioid, FDA Says. Medscape - Feb 06, 2018. https://www.medscape.com/viewarticle/892375 - FDA Statement. Feb 6, 2018 Statement from FDA Commissioner Scott Gottlieb, M.D., on the agency's scientific evidence on the presence of opioid compounds in kratom, underscoring its potential for abuse. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm595622.htm
  6. Centers for Disease Control & Prevention (CDC) Multistate Outbreak of Salmonella I 4,[5],12:b:- Infections Linked to Kratom. https://www.cdc.gov/salmonella/kratom-02-18/index.html - Ault A Kratom-Related Salmonella Outbreak Spreads to 35 States. Medscape - Mar 16, 2018. https://www.medscape.com/viewarticle/894040 - FDA News Release. April 3, 2018 FDA orders mandatory recall for kratom products due to risk of salmonella. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm603517.htm
  7. Eldridge WB, Foster C, Wyble L Neonatal Abstinence Syndrome Due to Maternal Kratom Use. Pediatrics. November 2018 PMID: 30404789 http://pediatrics.aappublications.org/content/early/2018/11/05/peds.2018-1839
  8. Swetlitz I HHS recommended that the DEA make kratom a Schedule I drug, like LSD or heroin. STAT. Nov 9 2018 https://mail.google.com/mail/u/0/
  9. FDA Statement. Nov, 27, 2018 Statement by FDA Commissioner Scott Gottlieb, M.D., on risk of heavy metals, including nickel and lead, found in some kratom products. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm626738.htm
  10. Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011-2017 Clin Toxicol (Phila). 2019 Feb 20:1-8 PMID: 30786220 https://www.tandfonline.com/doi/full/10.1080/15563650.2019.1569236
  11. Collar AL, Barrett ED. Kratom: An Emerging Issue for Research and Physician Education. Ann Intern Med. 2024 Aug 13. PMID: 39133928