Kratom: a unique leaf with stimulant and opiate-like effects

March 23, 2012, 12:58 am


MSNBC reported Tuesday on the “legal high” kratom, which is being associated with increasing numbers of emergency department visits in certain areas of the country. Unfortunately, scientific literature about the effects and toxicity of kratom is sparse.

Kratom is a psychoactive leaf from the southeast asian tree Mitragyna speciosa (picture).  This tree is related to the plants that produce coffee. Because there are a number of different alkaloids in kratom and because some of its actions are dose related, ingesting the leaf has been associated with a variety of effects, including sedation, analgesia, increased energy, a sense of well being, and improved mood.  Of the major alkaloids, mitragynine is a stimulant and 7-hydroxymitragyine a sedative and analgesic, acting primarily as an agonist at the μ-opioid receptor. Kratom is often consumed as a tea. Low doses are reported to have primarily stimulant effects; higher doses have opiate-like depressant and sedative actions. Seizures have been reported in association with use of kratom; it does not seem clear whether this is a primary effect of alkaloids contained in the leaf, an effect secondary to hypoxia from respiratory depression, or possibly direct effects of unknown contaminants.

Last year, physicians from Sweden reported nine fatal cases associated with use of kratom. Post-mortem analysis revealed the presence of mitragynine, as well as O-Desmethyltramadol, the active metabolite of tramadol. This second ingredient had apparently been added to powdered kratom leaves, possibly to increase opiate-like effects.

Although the DEA considers kratom a “drug of concern”, at this point it is legal and unregulated in the United States.

Related posts:

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Hepatotoxicity associated with abuse of kratom: first reported case

 

 

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