is a herbal product that is most commonly obtained as a powder and consumed as a beverage (1)
Kratom (Mitragyna speciosa, Rubiaceae family) is an indigenous tropical tree from Southern East Asia (e.g., Malaysia, Thailand, Laos, Cambodia), which also grows in East‐West Africa and Papua New Guinea (2)
also known locally with other names, such as Biak‐Biak, Ketum, Kakuam, Ithang, Thom, and Mambog (2)
Kratom leaves are generally smoked, chewed, or brewed as an herbal decoction
contains the indole alkaloid compounds mitragynine and 7-hydroxymitragynine, which are opioid receptors agonists.
reduces pain, causes dose-dependent stimulant and sedative effects, and has an adverse effect profile consistent with opioid activity
use is associated with stimulant effects at low doses (1–5 g), and sedative effects at higher doses (5–15 g) (1,2)
adverse effects most commonly include gastrointestinal symptoms and agitation, and are reported to be dose dependent
is not detected on conventional urine drug-screening tests
doses in excess of 15 g may mimic an opioid toxidrome (1)
naloxone should be given for drowsiness and respiratory depression (1)
Reference:
Sanderson M, Rowe A. Kratom. CMAJ. 2019 Oct 7;191(40):E1105.
Prevete E, Kuypers KPC, Theunissen EL, Corazza O, Bersani G, Ramaekers JG. A systematic review of (pre)clinical studies on the therapeutic potential and safety profile of kratom in humans. Hum Psychopharmacol. 2022 Jan;37(1):e2805.
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