An update on the clinical pharmacology of kratom: uses, abuse potential, and future considerations

Expert Review of Clinical Pharmacology, Год журнала: 2024, Номер 17(2), С. 131 - 142

Опубликована: Янв. 13, 2024

Introduction Kratom (Mitragyna speciosa) has generated substantial clinical and scientific interest as a complex natural product. Its predominant alkaloid mitragynine several stereoisomers have been studied for activity in opioid, adrenergic, serotonin receptors. While awaiting trial results, the pre-clinical evidence suggests range of potential therapeutic applications kratom with careful consideration adverse effects.

Язык: Английский

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Ecological Momentary Assessment of Self-Reported Kratom Use, Effects, and Motivations Among US Adults

JAMA Network Open, Год журнала: 2024, Номер 7(1), С. e2353401 - e2353401

Опубликована: Янв. 26, 2024

Importance Kratom products, which are sold legally in most of the US, contain alkaloids with opioidergic, adrenergic, and serotonergic activity. Millions people use kratom to relieve pain, improve mood, or self-manage substance disorders (SUDs). has primarily been examined via surveys, recall biases among satisfied users may lead minimization transient negative outcomes. Further prospective study use, such as ecological momentary assessment (EMA), is needed. Objective To characterize proximal motivators, effects, patterns assess whether frequency associated motivations, past-year criteria for SUD (KUD), other use. Design, Setting, Participants For this cross-sectional study, an intensive longitudinal smartphone-based EMA participants’ current behaviors experiences were repeatedly sampled real time was conducted between July 1 October 31, 2022. comprised a convenience sample US adults who used at least 3 days per week 4 weeks online screening. Criteria KUD based on Diagnostic Statistical Manual Mental Disorders, Fifth Edition . Data analysis performed November 2022 2023. Exposure The exposure 13 401 kratom-use events across 15 days. Main Outcomes Measures A baseline survey covering demographics, health, attitudes behaviors, administered before EMA. following entries then collected: event-contingent (product, dose, motivations), follow-up (short-term effects consequences events), random-prompt (mood), beginning-of-day (effects sleep), end-of-day (daily subjective descriptions effects). Bayesian regression estimate means credible intervals. Results total 357 participants completed Their mean (SD) age 38.0 (11.1) years; more than half men (198 [55.5%]). reported overall motivators that involved managing psychiatric problems, but evaluated during situation-specific needs increasing energy productivity decreasing pain. Acute considered congruent daily obligations. Use patterns, despite having some distinguishing features, generally similar their effects; predominantly daytime seemed find frequencies suited needs. Higher symptoms physical dependence (eg, withdrawal tolerance). Co-used substances included caffeine, nicotine, vitamins, cannabis. Conclusions Relevance Most using seemingly nonproblematic way. When appeared problematic, key element usually avoidance became motivator. Longitudinal studies examining changes over

Язык: Английский

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Responses to a “Typical” Morning Dose of Kratom in People Who Use Kratom Regularly: A Direct-Observation Study

Journal of Addiction Medicine, Год журнала: 2024, Номер 18(2), С. 144 - 152

Опубликована: Янв. 3, 2024

Introduction Use of kratom has outpaced systematic study its effects, with most studies reliant on retrospective self-report. Methods We aimed to assess acute effects following use in adults who regularly, and quantify alkaloids the products, urine, plasma. Between July November 2022, 10 came our clinic orally self-administered their typical dose; blinding procedures were not used. Physiological measures included blood pressure, respiratory rate, heart pulse oximetry, temperature, pupil diameter. Subjective outcomes Opioid Withdrawal Scale, Addiction Research Center Inventory, Drug Effects Questionnaire. Psychomotor performance was also assessed. Results Participants 6 men 4 women, mean age 41.2 years. Nine non-Hispanic White; 1 biracial. They had used for 6.6 years (SD, 3.8 years) average (2.0–14.1). Sessions 190.89 minutes 15.10 minutes). Mean session dose 5.16 g (median, 4.38 g; range, 1.1–10.9 g) leaf powder. Relative baseline, physiological changes minor. However, diameter decreased (right, b = −0.70, P < 0.01; left, −0.73, 0.01) 40–80 postdose remained below baseline >160 minutes. Scale pre-dosing mild (5.5 ± 3.3) (b [−4.0, −2.9], 0.01). Questionnaire “feeling effects” increased 40/100 30.5) within 40 above 80 120 19.0, 0.04), peaking at 72.7/100; participants rated euphoria as Inventory Morphine-Benzedrine-scale. did reliably improve or deteriorate postdosing. Conclusions Among regular consumers, we found few clinically significant differences pre- post-kratom dosing. Alkaloidal contents products expected ranges.

Язык: Английский

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

Frontiers in Pharmacology, Год журнала: 2024, Номер 15

Опубликована: Июнь 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.

Язык: Английский

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Kratom addiction per DSM-5 SUD criteria, and kratom physical dependence: Insights from dosing amount versus frequency

Drug and Alcohol Dependence, Год журнала: 2024, Номер 260, С. 111329 - 111329

Опубликована: Май 20, 2024

Язык: Английский

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Prevalence of Kratom Use Disorder Among Kratom Consumers

Journal of Addiction Medicine, Год журнала: 2024, Номер 18(3), С. 306 - 312

Опубликована: Март 5, 2024

Kratom leaf products are increasingly consumed in the United States, with many consumers reporting they experience beneficial effects from kratom use. However, there is a growing concern for kratom's potential to result dependence when used regularly. As such, we sought assess, using Diagnostic and Statistical Manual of Mental Disorders , (DSM-5) diagnostic criteria substance use disorder, prevalence "kratom disorder" (KUD) among consumers.

Язык: Английский

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

Frontiers in Pharmacology, Год журнала: 2024, Номер 15

Опубликована: Июнь 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.

Язык: Английский

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Effects of kratom on driving: Results from a cross-sectional survey, ecological momentary assessment, and pilot simulated driving Study

Traffic Injury Prevention, Год журнала: 2024, Номер 25(4), С. 594 - 603

Опубликована: Март 18, 2024

Objectives Despite widespread kratom use, there is a lack of knowledge regarding its effects on driving. We evaluated the self-reported driving behaviors consumers and assessed their simulated-driving performance after self-administering products.

Язык: Английский

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At least four groups of kratom consumers in the United States: latent-class analysis of motivations for kratom use

The American Journal of Drug and Alcohol Abuse, Год журнала: 2025, Номер unknown, С. 1 - 13

Опубликована: Янв. 30, 2025

Background: Kratom is a plant with alkaloids acting at opioid, serotonergic, adrenergic, and other receptors. Consumers report numerous use motivations.

Язык: Английский

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

Frontiers in Psychiatry, Год журнала: 2024, Номер 15

Опубликована: Май 23, 2024

Язык: Английский

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