Kratom

Kratom

• 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:

1. Sanderson M, Rowe A. Kratom. CMAJ. 2019 Oct 7;191(40):E1105.
2. 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.