Kratom
Common name
N/A
ID
HD0044
Scientific name of the plant
Mitragyna speciosa, Nauclea speciosa
Anatomical part for use
leaf
Human use
Mental stress & mood disorders
Summary
Mitragyna speciosa (commonly known as kratom) is a tropical evergreen tree in the coffee family native to Southeast Asia. It is indigenous to Thailand, Indonesia, Malaysia, Myanmar, and Papua New Guinea, where it has been used in herbal medicine since at least the nineteenth century. Kratom has opioid properties and some stimulant-like effects.As of 2018, the efficacy and safety of kratom are unclear, and the drug was unapproved as a therapeutic agent due to the poor quality of the research. In 2019, the United States Food and Drug Administration (FDA) stated that there is no evidence that kratom is safe or effective for treating any condition. Some people take it for managing chronic pain, for treating opioid withdrawal symptoms, or for recreational purposes. The onset of effects typically begins within five to ten minutes and lasts for two to five hours.Anecdotal reports describe increased alertness, physical energy, talkativeness, sociability, sedation, changes in mood, and pain relief following kratom use at various doses. Common side effects include appetite loss, erectile dysfunction, hair loss and constipation. More severe side effects may include respiratory depression (decreased breathing), seizure, addiction, and psychosis. Other side effects may include high heart rate and blood pressure, trouble sleeping, and, rarely, liver toxicity. When use is stopped, withdrawal symptoms may occur. Deaths have occurred with kratom both by itself and mixed with other substances. Serious toxicity is relatively rare and generally appears at high doses or when kratom is used with other substances.Kratom is a controlled substance in 16 countries and, in 2014, the FDA banned importing and manufacturing of kratom as a dietary supplement. As of 2018, there is growing international concern about a possible threat to public health from kratom use. In some jurisdictions, its sale and importation have been restricted, and several public health authorities have raised alerts. (Source: Wiki)
Evidence Level
Level 4 (Individual reports repeated observed over 5 years among different countries)
Hepatotoxicity reports in literature
Hepatotoxicity Description
Chronic use of kratom recreationally has been associated with rare instances of acute liver injury. The onset of injury is usually within 1 to 8 weeks of starting regular use of kratom powder or tablets, with symptoms of fatigue, nausea, pruritus and dark urine followed by jaundice. The pattern of liver injury is typically cholestatic or mixed, and it can be severe with serum bilirubin levels rising above 20 mg/dL. The severe cholestasis can be accompanied by acute renal failure and bone marrow toxicity. Fever is common, but not rash or eosinophilia and autoantibodies are usually absent. The cholestasis can be prolonged, but usually resolves spontaneously. Corticosteroids as well as N-acetylcysteine have been used in cases of suspected kratom hepatotoxicity, but their efficacy is unproven. Kratom is a banned substance in many areas of the country and considered an agent of abuse rather than a dietary supplement. At least two dozen cases of clinically apparent liver injury with jaundice have been reported in the literature and a similar number reported to the Food and Drug Administration adverse event database. (Source: LiverTox)
Uses
As of 2013, kratom has been studied in cells and in animals, but no clinical trials have been conducted in the United States. The United States Drug Enforcement Administration (DEA) stated in 2013: "There is no legitimate medical use for kratom". In April 2019, the United States Food and Drug Administration (FDA) stated that there is no evidence that kratom is safe or effective for treating any condition, and there are no approved clinical uses for kratom.Kratom leaves are commonly used by chewing, as a tea, powdered in capsules or pills, or extracted for use in liquids. Kratom is rarely smoked. Because some anecdotal reports claim that red vein varieties of kratom native to Bali tend to produce different effects than green and white vein varieties native to Malaysia, it has been speculated that different varieties of kratom contain different relative proportions of alkaloids. (Source: Wiki)
Traditional use
In cultures where the plant grows, kratom has been used in traditional medicine. The leaves are chewed to relieve musculoskeletal pain and increase energy, appetite, and sexual desire in ways similar to khat and coca. The leaves or extracts from them are used to heal wounds and as a local anesthetic. Extracts and leaves have been used to treat coughs, diarrhea, and intestinal infections. They are also used as intestinal deworming agents in Thailand.Kratom is often used by workers in laborious or monotonous professions to stave off exhaustion as well as a mood enhancer and painkiller. In Thailand, kratom was "used as a snack to receive guests and was part of the ritual worship of ancestors and gods". The herb is bitter and is generally combined with a sweetener. (Source: Wiki)
Opioid withdrawal
As of 2018, there have been no formal trials to study the efficacy or safety of kratom to treat opioid addiction. Kratom is not approved for this or any other medical use. However, because the withdrawal effects of kratom are often reported to be less severe than those associated with traditional opioids, some people use kratom in the attempt to manage opioid use disorder. While some literature reviews claim that kratom has less potential for dependence or overdose than traditional opioids, other reviews note that kratom withdrawal itself can still be quite severe.Data on how often it is used worldwide are lacking, as it is not detected by typical drug-screening tests. Rates of kratom use appear to be increasing among those who have been self-managing chronic pain with opioids purchased without a prescription and are cycling (but not quitting) their use.In 1836, kratom was reported to have been used as an opium substitute in Malaysia. Kratom was also used as an opium substitute in Thailand in the nineteenth century. (Source: Wiki)
Common name
N/A
ID
HD0044
Scientific name of the plant
Mitragyna speciosa, Nauclea speciosa
Anatomical part for use
leaf
Human use
Mental stress & mood disorders
Summary
Mitragyna speciosa (commonly known as kratom) is a tropical evergreen tree in the coffee family native to Southeast Asia. It is indigenous to Thailand, Indonesia, Malaysia, Myanmar, and Papua New Guinea, where it has been used in herbal medicine since at least the nineteenth century. Kratom has opioid properties and some stimulant-like effects.As of 2018, the efficacy and safety of kratom are unclear, and the drug was unapproved as a therapeutic agent due to the poor quality of the research. In 2019, the United States Food and Drug Administration (FDA) stated that there is no evidence that kratom is safe or effective for treating any condition. Some people take it for managing chronic pain, for treating opioid withdrawal symptoms, or for recreational purposes. The onset of effects typically begins within five to ten minutes and lasts for two to five hours.Anecdotal reports describe increased alertness, physical energy, talkativeness, sociability, sedation, changes in mood, and pain relief following kratom use at various doses. Common side effects include appetite loss, erectile dysfunction, hair loss and constipation. More severe side effects may include respiratory depression (decreased breathing), seizure, addiction, and psychosis. Other side effects may include high heart rate and blood pressure, trouble sleeping, and, rarely, liver toxicity. When use is stopped, withdrawal symptoms may occur. Deaths have occurred with kratom both by itself and mixed with other substances. Serious toxicity is relatively rare and generally appears at high doses or when kratom is used with other substances.Kratom is a controlled substance in 16 countries and, in 2014, the FDA banned importing and manufacturing of kratom as a dietary supplement. As of 2018, there is growing international concern about a possible threat to public health from kratom use. In some jurisdictions, its sale and importation have been restricted, and several public health authorities have raised alerts. (Source: Wiki)
Evidence Level
Level 4 (Individual reports repeated observed over 5 years among different countries)
Hepatotoxicity reports in literature
Hepatotoxicity Description
Chronic use of kratom recreationally has been associated with rare instances of acute liver injury. The onset of injury is usually within 1 to 8 weeks of starting regular use of kratom powder or tablets, with symptoms of fatigue, nausea, pruritus and dark urine followed by jaundice. The pattern of liver injury is typically cholestatic or mixed, and it can be severe with serum bilirubin levels rising above 20 mg/dL. The severe cholestasis can be accompanied by acute renal failure and bone marrow toxicity. Fever is common, but not rash or eosinophilia and autoantibodies are usually absent. The cholestasis can be prolonged, but usually resolves spontaneously. Corticosteroids as well as N-acetylcysteine have been used in cases of suspected kratom hepatotoxicity, but their efficacy is unproven. Kratom is a banned substance in many areas of the country and considered an agent of abuse rather than a dietary supplement. At least two dozen cases of clinically apparent liver injury with jaundice have been reported in the literature and a similar number reported to the Food and Drug Administration adverse event database. (Source: LiverTox)
Uses
As of 2013, kratom has been studied in cells and in animals, but no clinical trials have been conducted in the United States. The United States Drug Enforcement Administration (DEA) stated in 2013: "There is no legitimate medical use for kratom". In April 2019, the United States Food and Drug Administration (FDA) stated that there is no evidence that kratom is safe or effective for treating any condition, and there are no approved clinical uses for kratom.Kratom leaves are commonly used by chewing, as a tea, powdered in capsules or pills, or extracted for use in liquids. Kratom is rarely smoked. Because some anecdotal reports claim that red vein varieties of kratom native to Bali tend to produce different effects than green and white vein varieties native to Malaysia, it has been speculated that different varieties of kratom contain different relative proportions of alkaloids. (Source: Wiki)
Traditional use
In cultures where the plant grows, kratom has been used in traditional medicine. The leaves are chewed to relieve musculoskeletal pain and increase energy, appetite, and sexual desire in ways similar to khat and coca. The leaves or extracts from them are used to heal wounds and as a local anesthetic. Extracts and leaves have been used to treat coughs, diarrhea, and intestinal infections. They are also used as intestinal deworming agents in Thailand.Kratom is often used by workers in laborious or monotonous professions to stave off exhaustion as well as a mood enhancer and painkiller. In Thailand, kratom was "used as a snack to receive guests and was part of the ritual worship of ancestors and gods". The herb is bitter and is generally combined with a sweetener. (Source: Wiki)
Opioid withdrawal
As of 2018, there have been no formal trials to study the efficacy or safety of kratom to treat opioid addiction. Kratom is not approved for this or any other medical use. However, because the withdrawal effects of kratom are often reported to be less severe than those associated with traditional opioids, some people use kratom in the attempt to manage opioid use disorder. While some literature reviews claim that kratom has less potential for dependence or overdose than traditional opioids, other reviews note that kratom withdrawal itself can still be quite severe.Data on how often it is used worldwide are lacking, as it is not detected by typical drug-screening tests. Rates of kratom use appear to be increasing among those who have been self-managing chronic pain with opioids purchased without a prescription and are cycling (but not quitting) their use.In 1836, kratom was reported to have been used as an opium substitute in Malaysia. Kratom was also used as an opium substitute in Thailand in the nineteenth century. (Source: Wiki)