Eight-Factor Analysis of Kratom: 2022 School of Pharmacy, Concordia University Wisconsin

Eight-Factor Analysis of Kratom: 2022 School of Pharmacy, Concordia University Wisconsin

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science, Eight-Factor Analysis

Based on our review of the available literature, we conclude that regulation of M. speciosa in Wisconsin as a schedule-I substance is not justified at this time. We base this conclusion, in part, on the scientific evidence demonstrating that M. speciosa and its chemical constituents have lower potential for overdose and abuse relative to other agents that are not scheduled in this way. We believe that controlling M. speciosa and its chemical constituents under schedule-I harms public health and stifles much-needed research into its therapeutic and toxic properties.

Respiratory effects of oral mitragynine and oxycodone in a rodent model

Respiratory effects of oral mitragynine and oxycodone in a rodent model

Admin
science, substance use disorder

Abstract

Rationale Kratom derives from Mitragyna speciosa (Korth.), a tropical tree in the genus Mitragyna (Rubiaceae) that also includes the coffee tree. Kratom leaf powders, tea-like decoctions, and commercial extracts are taken orally, primarily for health and well-being by millions of people globally. Others take kratom to eliminate opioid use for analgesia and manage opioid withdrawal and use disorder. There is debate over the possible respiratory depressant overdose risk of the primary active alkaloid, mitragynine, a partial μ-opioid receptor agonist, that does not signal through ß-arrestin, the primary opioid respiratory depressant pathway.

Kratom Science Update: Evidence-Based Facts

Kratom Science Update: Evidence-Based Facts

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science, kratom research

Preface

Kratom science has been increasing almost exponentially over the past decade with more than 100 new published studies addressing kratom safety, benefits, and abuse potential since early 2018. The science provides evidence to guide consumer safety leading to kratom regulations now passed into law in seven states, with many more states considering such laws. As discussed below, these new scientific findings also led the United States Department of Health and Human Services (US DHHS) to reverse its position on Controlled Substances Act (CSA) scheduling and, in August 2018, to rescind its earlier scheduling recommendation to the Drug Enforcement Administration (DEA). More recently, and with still more evidence, in 2021, the World Health Organization Expert Committee on Drug Dependence (WHO ECDD), reviewed the evidence for international scheduling and concluded that there was not sufficient evidence to recommend scheduling, meaning the available data did not show public health risks of kratom warranting international restrictions.

What is clearly needed is balanced regulation to ensure that kratom products purchased by consumers are pure and unadulterated, in other words meeting the same types of standards that apply to other food products, and even bottled water. Steps toward such standards were taken in states that passed their own versions of kratom consumer protection act laws. Ultimately, the Food and Drug Administration (FDA) needs to develop national performance standards for kratom as it does for other products. Such standards will help ensure access to kratom products that are appropriately marketed and are without contaminants and adulterants that might pose safety risks.

Kratom use as more than a “self-treatment”

Kratom use as more than a “self-treatment”

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science

Conclusions: Kratom use motivations are diversifying, with multiple factors driving use. As sales continue to increase, the public-health, clinical, and policy responses to kratom should be grounded in rigorous bench-to-bedside scientific research. Comprehensive study of kratom is currently lacking.

Kratom use as more than a “self-treatment”

Kratom use as more than a “self-treatment”

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science, survey

Background: Mitragyna speciosa (kratom) is increasingly used in the United States for its pharmacological effects. Kratom's relative novelty makes for a dynamic situation, such that use motivations are not firmly established and may be changing. Investigators and clinicians require frequent updates on kratom trends.

Assessment of the possible health risks associated with the consumption of botanical preparations of Mitragyna speciosa (kratom)

Assessment of the possible health risks associated with the consumption of botanical preparations of Mitragyna speciosa (kratom)

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science, Harm Reduction

The current report summarises the work performed in the context of the European Food Risk Assessment Fellowship Programme (EU-FORA), which included the evaluation of health risks associated with the consumption of botanical preparations of Mitragyna speciosa (kratom). Mitragyna speciosa is a tree native to Southeast Asia, where its leaves and preparations of the leaves have been used for centuries, among others, as a stimulant or as a traditional herbal medicine.

Understanding Kratom Use: A Guide for Healthcare Providers

Understanding Kratom Use: A Guide for Healthcare Providers

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science, Healthcare Providers

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

Can a Controversial Tree Help End the Opioid Crisis?

Can a Controversial Tree Help End the Opioid Crisis?

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science, Plants

Kratom (botanical name Mitragyna speciosa Korth) is a tree in the coffee family (Rubiaceae) indigenous to Southeast Asia. Its leaves are the source of a Thai traditional drug, kratom, that possesses unique pharmacologic actions—e.g., stimulant actions like those of the coca plant plus depressant ones like those of opium. Traditionally, in its countries of origin, kratom extract has been used as an opium substitute; in Thailand, it has been used as a treatment for addiction.

Recently, human case reports have increased in the literature from its use in the United States, and the U.S. Drug Enforcement Administration has listed kratom as a Drug and Chemical of Concern. However, little was known scientifically about this tree and drug. Studies in animal models and published case reports on patients from the past few years have focused on the potential of kratom and its major alkaloid (mitragynine) in the context of opioid withdrawal.

Dr. McCurdy will discuss the traditional medicinal use of kratom, the chemistry of the current pharmacologic studies, and the results of his team’s behavioral studies in rodent models. Kratom’s differing uses, availability, and preparation around the world will also be explored. More knowledge about the science may help patients’ and health care providers’ thinking about this botanical.

WHO ECDD PRE-REVIEW OF KRATOM

WHO ECDD PRE-REVIEW OF KRATOM

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science, WHO ECDD

WHO review history Kratom has been under ECDD surveillance since 2020 due to a country level report indicating the potential for abuse, dependence, and harm to public health from mitragynine and 7-hydroxymitragynine, and a report from an international organization regarding documented fatalities associated with kratom use. A pre-review on kratom, mitragynine, and 7-hydroxymitragynine was initiated following consideration of these reports.

Natural Herb Kratom May Have Therapeutic Effects And Relatively Low Potential For Abuse Or Harm, According To A User Survey

Natural Herb Kratom May Have Therapeutic Effects And Relatively Low Potential For Abuse Or Harm, According To A User Survey

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science, survey, Harm Reduction

Researchers say findings underscore need for research and regulation, but not an outright ban on sales

Credit: Johns Hopkins Medicine

Using results of a survey of more than 2,700 self-reported users of the herbal supplement kratom, sold online and in smoke shops around the U.S., Johns Hopkins Medicine researchers conclude that the psychoactive compound somewhat similar to opioids likely has a lower rate of harm than prescription opioids for treating pain, anxiety, depression and addiction.

In a report on the findings, published in the Feb. 3 issue of Drug and Alcohol Dependence, the researchers caution that while self-reporting surveys aren’t always entirely reliable, they confirmed that kratom is not regulated or approved by the U.S. Food and Drug Administration (FDA), and that scientific studies have not been done to formally establish safety and benefits. They say that U.S. drug agencies should seek to study and regulate rather than ban kratom sales outright because of its seemingly safe therapeutic potential, and as a possible alternative to opioid use.

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