Kratom safety and toxicology in the public health context: research needs to better inform regulation

Frontiers in Pharmacology, Journal Year: 2024, Volume and Issue: 15

Published: June 3, 2024

Although kratom use has been part of life for centuries in Southeast Asia, the availability and United States (US) increased substantially since early 2000s when there was little information on pharmacology, patterns, effects, all critical to guiding regulation policy. Here we provide a synthesis research with several hundred English-language papers published past 5 years drawing from basic research, epidemiological surveillance data, recent clinical research. This review available literature aims an integrated update regarding our current understanding kratom’s benefits, risks, epidemiology, which may inform States-based regulation. Recent indicates are likely million past-year consumers, though estimates vary widely. Even without precise prevalence is no longer niche, millions adults using it myriad reasons. Despite its botanical origins coffee tree family polypharmacy, popularly characterized as opioid presumed opioid-system-based risks addiction or overdose. Neuropharmacology, toxicology, epidemiology studies show that more accurately substance diverse complex pharmacology. Taken together work reviewed here provides foundation future scientific studies, well guide ongoing efforts regulate kratom. also informs much-needed federal oversight, including by Food Drug Administration. We conclude recommendations priorities needed address policy knowledge gaps around this increasingly used product.

Language: Английский

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Growing pains with kratom: experiences discussed in subreddits contrast with satisfaction expressed in surveys

Frontiers in Pharmacology, Journal Year: 2024, Volume and Issue: 15

Published: June 14, 2024

Background “Kratom” refers to an array of bioactive products derived from Mitragyna speciosa , a tree indigenous Southeast Asia. Most kratom consumers report analgesic and stimulatory effects, common reasons for use are address mental physical health needs, manage pain, reduce other substances. Natural-history studies survey suggest that many perceive benefits those uses, but such unlikely capture the full range kratom-use experiences. Methods We collected text data Reddit posts 2020-2022 qualitatively examine conceptualizations, motivations, consequences associated with among people posting social media. mentioning were studied using template thematic analysis, which included collecting descriptions product types practices. Network analyses coded themes was performed independent relationships themes, between types. Results Codes applied 329 370 comprised final sample; 134 contained descriptions. As accounts functionally anonymous, demographic estimates untenable. Themes dependence (tolerance, withdrawal, or avoid withdrawal), perceived addiction (net detrimental effects on functioning), quitting. Extract positively reports addiction, dependence, experiences quitting kratom. Many used energy self-treatment fatigue, problems opioid alcohol; they these uses as effective. Consumers expressed frustrations about inconsistencies lack information. Conclusion in previous studies, deemed helpful some hindrance others, we also found evidence notable negative have not been well documented surveys. Daily may produce mild-moderate greater severity being possibly more concentrated extracts; however, there currently no human laboratory extracts. Such detailed information, needed help inform consumer decision-making.

Language: Английский

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Mitragynine and Morphine Stabilize Different Conformations of the Μ-Opioid Receptor as Revealed by Molecular Dynamics Simulation Studies

Published: Jan. 1, 2025

µ-Opioid receptors are pivotal in mediating the analgesic and addictive properties of opioid drugs. (−)-Mitragynine, a natural alkaloid, is known for its effects functions as G protein-biased ligand at µ-opioid receptor. However, molecular-level understanding receptor-mitragynine interactions remains unclear. This study examined structural alterations receptor upon binding with (−)-mitragynine, (+)-mitragynine, 7-OH-mitragynine, morphine using molecular docking 1 µs classical all-atom dynamics simulations lipid membranes. Our results showed that (−)-mitragynine (-7.2 Kcal/mol) 7-OH-mitragynine (-7.8 have higher affinities than (-6.78 Kcal/mol). The remained relatively stable during dynamics, though residues 260-280 exhibited notable fluctuations. (−)-Mitragynine formed hydrogen bonds more consistently other ligands throughout simulation period. Asp-147 played critical role formation salt bridge positively charged amino group all ligands, which key interaction orthosteric typical receptors. All four preferentially interacted Trp-293 helix-6, highlighting activation. A plot free energy versus helix-6 tilt angle distance between tertiary nitrogen revealed distinct conformational population compared to mitragynine, may explain their different downstream signaling bias. unique patterns mitragynine derivatives receptor, providing foundation designing novel potentially developing new analgesics.

Language: Английский

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Home Care and the Patient Taking Kratom

Home Healthcare Now, Journal Year: 2025, Volume and Issue: 43(2), P. 122 - 124

Published: Feb. 28, 2025

The author declares no conflicts of interest. Address for correspondence: Heidi Sykora, DNP, RN, GNP-BC (retired), 2321 Ridgewood Rd., Grafton, WI 53024.

Language: Английский

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Prevalence and Use Patterns of Kratom ( Mitragyna speciosa Korth.) in a US Nationally Representative Sample

Journal of Psychoactive Drugs, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 9

Published: March 1, 2025

With increasing diversity of kratom (Mitragyna speciosa Korth.) products containing higher amounts alkaloids including mitragynine and 7-hydroxymitragynine, safety becomes a public concern. The study aimed to estimate the prevalence use examine potential benefits adverse effects based on product formulations. A cross-sectional survey utilized non-probabilistic nationally representative sampling with total 11,545 respondents which 1,049 reported current use, indicating 9.1% prevalence. most common used in past 30 days were pills, gummies powder Pain relief (n = 603, 57.5%) was condition for using kratom, followed by relaxation/stress 562, 53.6%) boost energy 520, 49.6%). increased from tea bags improved sleep leaf or extract powders. significant positive correlation found between frequency consuming shots/extract pain (p .009 0.015, respectively. incidence as amount per dose gummies/capsules/tablets/pills. lack standardization consistency results unpredictable effects, emphasizing need research establish reliable guidelines dosage recommendations.

Language: Английский

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Commentary: Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological report

Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 15

Published: May 23, 2024

Language: Английский

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Kratom as a potential substance use disorder harm reduction agent

Frontiers in Public Health, Journal Year: 2024, Volume and Issue: 12

Published: May 30, 2024

Substance use disorders contribute to considerable U.S. morbidity and mortality. While effective pharmacotherapy options are available treat opioid alcohol disorders, for a variety of reasons, many patients lack access treatment or may be reluctant seek care due concerns such as perceived stigma current desire completely curtail their substance use. Furthermore, limited with stimulant polysubstance disorders. Thus, there is need expand the disorder harm reduction armamentarium. Kratom ( Mitragyna speciosa Korth.) an herbal that can produce both stimulant-like effects, its in US growing. Though regarding adverse dependence risk, regulation manufacturing sale, pharmacology kratom early preclinical studies suggest potential role agent various it has historically been used Southeast Asia purposes. The goal this review describe kratom’s history use, pharmacology, pre-clinical observational research therapeutic disorder, well alcohol, stimulant, while also highlighting around existing gaps literature, directions future research.

Language: Английский

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Beneficial and Adverse Health Effects of Kratom (Mitragyna speciosa): A Critical Review of the Literature

Food and Chemical Toxicology, Journal Year: 2024, Volume and Issue: 192, P. 114913 - 114913

Published: Aug. 10, 2024

Language: Английский

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Dynamic Topic Modeling of Kratom Use and Experiences: Insights on 13 years of Reddit Discussions

Published: Aug. 19, 2024

Traditionally used in Southeast Asia for common ailments, kratom (Mitragyna speciosa) is increasingly being adopted other regions the self-treatment of pain, mental health issues such as anxiety, depression, and dependence or managing withdrawal symptoms linked to stimulants/sedatives substances absence clinical supervision. To gain better insight into experiences motivations underlying use, previous studies have analyzed material shared among users on social media. However, these investigations often employed manual labeling categorizations, which are time-consuming do not allow investigation large samples. The present work utilized a natural language processing approach (BERTopic) extract prominent topics discussion from kratom-related Reddit posts made between 2010 2023 (n = 188,139 posts). Dynamic Topic Modeling was also implemented analyze how discussions about evolved over time. From results, discussed including usage substance use disorder recovery (e.g., suboxone), drug testing, consumption methods, logistic bringing flights, receiving via mail), tapering off kratom, providing support others who process quitting kratom. current study supports need trials well new ecological insights users, while supporting implementation policies regulate its usage.

Language: Английский

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Time course of kratom effects via ecological momentary assessment, by product type, dose amount, and assayed alkaloid content

Drug and Alcohol Dependence, Journal Year: 2024, Volume and Issue: 264, P. 112460 - 112460

Published: Oct. 10, 2024

Using ecological momentary assessment (EMA), we undertook a natural experiment wherein kratom-product variability was tool to assess kratom dose-response relationships based on product form and alkaloid level.

Language: Английский

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