Kratom, also known as herbal speed, is the powdered leaves of the Asian kratom tree (Mitragyna speciosa Korth.). The consumption of kratom powder or kratom tea for diarrhea, inflammation, fever, and pain, but also for anxiety and depression is based on traditional experiences from East Asian herbal medicine. Pharmacologically, kratom is an intoxicant or narcotic. In low doses, the leaves have a stimulating effect, in high doses, they are depressant and psychoactive like opioids. There is a steadily increasing popularity of the herbal drug kratom and its psychoactive compounds mitragynine and 7-hydroxymitragynine around the world. To date, no randomized controlled human intervention study has evaluated the safety and efficacy of kratom ingestion. In addition, there are increasing reports of kratom-associated adverse effects including herb-induced liver toxicity and nephrotoxicity, cardiovascular and neurological symptoms, and withdrawal syndrome. The still unsatisfactory lack of regulatory control and easy availability via internet providers will continue to increase kratom use in many countries. Clinicians should be aware that kratom use can be addictive and have potentially serious side effects. It is important to determine the consumption of dietary and herbal supplements when taking the patient's medical history.
Hanapi NA, Chear NJ, Azizi J, Yusof SR. Kratom Alkaloids: Interactions With Enzymes, Receptors, and Cellular Barriers. Front Pharmacol. 2021;12:751656. doi: 3389/fphar.2021.751656
Papadi G, Bakhiya N, Ildico Hirsch-Ernst K. Assessment of the possible health risks associated with the consumption of botanical preparations of Mitragyna speciosa (kratom). EFSA J. 2022;20(Suppl 1):e200415. doi:10.2903/j.efsa.2022.e200415
Swogger MT, Smith KE, Garcia-Romeu A, Grundmann O, Veltri CA, Henningfield JE, et al. Understanding Kratom Use: A Guide for Healthcare Providers. Front Pharmacol. 2022;13:801855. doi:10.3389/fphar.2022.801855
Warner ML, Kaufman NC, Grundmann O. The pharmacology and toxicology of kratom: from traditional herb to drug of abuse. Int J Legal Med. 2016;130(1):127-38. doi:10.1007/s00414-015-1279-y
Hartley C 2nd, Bulloch M, Penzak SR. Clinical Pharmacology of the Dietary Supplement Kratom (Mitragyna speciosa). J Clin Pharmacol. 2022;62(5):577-93. doi:10.1002/jcph.2001
Shah K, Tankersley W, Mekala H. Kratom: An Emerging Issue and Need for Regulations in the United States. Prim Care Companion CNS Disord. 2021;23(1):20r02770. doi:10.4088/pcc.20r02770
Henningfield JE, Wang DW, Huestis MA. Kratom Abuse Potential 2021: An Updated Eight Factor Analysis. Front Pharmacol. 2022;12:775073. doi:10.3389/fphar.2021.775073
Sharma V, Cottler LB, Bares CB, Lopez-Quintero C. Kratom Use Among U.S. Adolescents: Analyses of the 2019 National Survey on Drug Use and Health. J Adolesc Health. 2022;70(4):677-81. doi:10.1016/j.jadohealth.2021.10.009
Tanna RS, Tian DD, Cech NB, Oberlies NH, Rettie AE, Thummel KE, et al. Refined Prediction of Pharmacokinetic Kratom-Drug Interactions: Time-Dependent Inhibition Considerations. J Pharmacol Exp Ther. 2021;376(1):64-73. doi:10.1124/jpet.120.000270
Aldyab M, Ells PF, Bui R, Chapman TD, Lee H. Kratom-Induced Cholestatic Liver Injury Mimicking Anti-Mitochondrial Antibody-Negative Primary Biliary Cholangitis: A Case Report and Review of Literature. Gastroenterology Res. 2019;12(4):211-15. doi:10.14740/gr1204
Fernandes CT, Iqbal U, Tighe SP, Ahmed A. Kratom-Induced Cholestatic Liver Injury and Its Conservative Management. J Investig Med High Impact Case Rep. 2019;7:2324709619836138. doi:10.1177/2324709619836138
Ahmad J, Odin JA, Hayashi PH, Fontana RJ, Conjeevaram H, Avula B, et al. Liver injury associated with kratom, a popular opioid-like product: Experience from the U.S. drug induced liver injury network and a review of the literature. Drug Alcohol Depend. 2021;218:108426. doi:10.1016/j.drugalcdep.2020.108426
Botejue M, Walia G, Shahin O, Sharma J, Zackria R. Kratom-Induced Liver Injury: A Case Series and Clinical Implications. Cureus. 2021;13(4):e14679. doi:10.7759/cureus.14679
Antony A, Lee TP. Herb-Induced Liver Injury With Cholestasis and Renal Injury Secondary to Short-Term Use of Kratom (Mitragyna speciosa). Am J Ther. 2019;26(4):e546-47. doi:10.1097/mjt.0000000000000802
Khan MZ, Saleh MA, Alkhayyat M, Roberts DE, Lindenmeyer CC. Multiorgan Dysfunction Related to Kratom Ingestion. ACG Case Rep J. 2021;8(8):e00647. doi:10.14309/crj.0000000000000647
Sangani V, Sunnoqrot N, Gargis K, Ranabhotu A, Mubasher A, Pokal M. Unusual Presentation of Kratom Overdose With Rhabdomyolysis, Transient Hearing Loss, and Heart Failure. J Investig Med High Impact Case Rep. 2021;9:23247096211005069. doi:10.1177/23247096211005069
Jasim RK, Hassan Z, Singh D, Boyer E, Gam LH. Characterization of urinary protein profile in regular kratom (Mitragyna speciosa korth.) users in Malaysia. J Addict Dis. 2022;40(2):235-46. doi:10.1080/10550887.2021.1981122
Tobarran N, Wolf C, Cumpston KL, Wills BK. Pressure Necrosis Requiring Fasciotomy After Kratom Overdose. J Addict Med. 2022;16(2):252-53. doi:10.1097/adm.0000000000000873
Maria-Rios JC, Darrabie M, Martin A. Severe Rhabdomyolysis Complicated with Compartment Syndrome Likely Associated to Recent Kratom Use. Am J Respir Crit Care Med 2022;205:A1578. doi:10.1164/ajrccm-conference.2022.205.1_MeetingAbstracts.A1578
Torres-Ortiz A, Al Zein S, Alqudsi M. A Case of Hyperkalemia Induced by Kratom (Mitragyna speciosa). Cureus. 2022;14(4):e24036. doi:10.7759/cureus.24036
Eggleston W, Stoppacher R, Suen K, Marraffa JM, Nelson LS. Kratom Use and Toxicities in the United States. Pharmacotherapy. 2019;39(7):775-77. doi:10.1002/phar.2280
Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-54. doi:10.1080/15563650.2019.1569236
Davidson C, Cao D, King T, Weiss ST, Wongvisavakorn S, Ratprasert N, et al. A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017. Am J Drug Alcohol Abuse. 2021;47(1):74-83. doi:10.1080/00952990.2020.1836185
Leong Bin Abdullah MFI, Singh D. The Adverse Cardiovascular Effects and Cardiotoxicity of Kratom (Mitragyna speciosa Korth.): A Comprehensive Review. Front Pharmacol. 2021;12:726003. doi:10.3389/fphar.2021.726003
Abdullah HMA, Haq I, Lamfers R. Cardiac arrest in a young healthy male patient secondary to kratom ingestion: is this 'legal high' substance more dangerous than initially thought? BMJ Case Rep. 2019;12(7):e229778. doi:10.1136/bcr-2019-229778
Wolfer H, Gerona R, Blumenberg A. Evidence of a potential mechanism for Kratom-related cardiac arrest. Clin Toxicol (Phila). 2020;58(8):851-52. doi:10.1080/15563650.2019.1687907
Sheikh M, Ahmed N, Gandhi H, Chen O. Report of ventricular fibrillation in a 44-year-old man using kratom. BMJ Case Rep. 2021;14(3):e237837. doi:10.1136/bcr-2020-237837
Demick DS, Lee TT, Summers AT, El-Mallakh RS. Kratom: A growing substance of abuse in the United States. Ann Clin Psychiatry. 2020;32(4):275-80. doi:10.12788/acp.0012
Burke DJ, Mahonski SG, Van Cott AC. Breakthrough Seizure Associated With Kratom Use in Patients With Epilepsy. Neurol Clin Pract. 2021;11(1):78-84. doi:10.1212/cpj.0000000000000846
Halim SA, Low JH, Chee YC, Alias MR. Seizures among young adults consuming kratom beverages in Malaysia: A case series. Epilepsy Behav. 2021;121(Pt A):108057. doi:10.1016/j.yebeh.2021.108057
Zuberi M, Guru PK, Bansal V, Diaz-Gomez J, Grieninger B, Alejos D. Undifferentiated Shock and Extreme Elevation of Procalcitonin Related to Kratom Use. Indian J Crit Care Med. 2019;23(5):239-41. doi:10.5005/jp-journals-10071-23170
Singh V, Mulla N, Wilson JL, Umansky A, Lee J, Stead T, et al. Intractable nausea and vomiting in naïve ingestion of kratom for analgesia. Int J Emerg Med. 2020;13(1):42. doi:10.1186/s12245-020-00301-0
Stanciu CN, Gnanasegaram SA, Ahmed S, Penders T. Kratom Withdrawal: A Systematic Review with Case Series. J Psychoactive Drugs. 2019;51(1):12-8. doi:10.1080/02791072.2018.1562133
Wright ME, Ginsberg C, Parkison AM, Dubose M, Sherbondy M, Shores E. Outcomes of mothers and newborns to prenatal exposure to kratom: a systematic review. J Perinatol. 2021;41(6):1236-43. doi:10.1038/s41372-021-00952-8
Smith KE, Dunn KE, Rogers JM, Garcia-Romeu A, Strickland JC, Epstein DH. Assessment of Kratom Use Disorder and Withdrawal Among an Online Convenience Sample of US Adults. J Addict Med. 2022 Feb 25. Epub ahead of print. doi:10.1097/adm.0000000000000986
Jittasopa W, Srisont S. The Causes of Death and Pathological Findings of Kratom Users: A 5-Year Retrospective Analysis. Am J Forensic Med Pathol. 2021;42(4):335-40. doi:10.1097/paf.0000000000000691
Nsubuga J, Baugher J, Dahl E, Schwensohn C, Blessington T, Aguillon R, et al. Multistate Outbreak Investigation of Salmonella Infections Linked to Kratom: A Focus on Traceback, Laboratory, and Regulatory Activities. J Food Prot. 2022;85(5):747-54. doi:10.4315/jfp-21-319
Prozialeck WC, Edwards JR, Lamar PC, Plotkin BJ, Sigar IM, Grundmann O, et al. Evaluation of the Mitragynine Content, Levels of Toxic Metals and the Presence of Microbes in Kratom Products Purchased in the Western Suburbs of Chicago. Int J Environ Res Public Health. 2020;17(15):5512. doi:10.3390/ijerph17155512
Prozialeck W, Fowler A, Edwards J. Public Health Implications and Possible Sources of Lead (Pb) as a Contaminant of Poorly Regulated Kratom Products in the United States. Toxics. 2022;10(7):398. doi:10.3390/toxics10070398
Sekar A, Velani S, Katzman S, O'Donnell M, Conway KS. Suspected Fanconi syndrome from cadmium toxicity exacerbated by heavy kratom use. A rare occurrence. Clin Toxicol (Phila). 2022;60(7):888-89. doi:10.1080/15563650.2022.2046774
Fleming, JH Jr, Poklis J; Peace MR, Alves EA. The Analysis of Commercially Available Kratom Products in Richmond, Virginia. Graduate Research Posters 2022. Poster 142. Available at: https://scholarscompass.vcu.edu/gradposters/142/
S. Food and Drug Administration (FDA). FDA announces seizure of adulterated dietary supplements containing kratom. May 21, 2021. Available at: https://www.fda.gov/news-events/press-announcements/fda-announces-seizure-adulterated-dietary-supplements-containing-kratom
Commission on Narcotic Drugs. Summary of assessments, findings, and recommendations of the 44th World Health Organization’s (WHO) Expert Committee on Drug Dependence (ECDD), 11–15 October 2021. E/CN.7/2021/CRP.12. December 2021. Available at: https://www.unodc.org/documents/commissions/CND/CND_Sessions/CND_64Reconvened/ECN72021_CRP12_V2108992.pdf
Lautenschlager F, Weiss M, Feuerer S, Wodarz N. Kratom – eine kurze Űersicht für die Schmerzmedizin [Kratom - a short review for pain medicine]. Schmerz. 2022;36(2):128-34. German. doi:10.1007/s00482-021-00588-9
Hofmeister, M. (2022). Kratom Consumption can be Addictive and have Adverse Health Effects. Novelty in Clinical Medicine, 1(4), 168-172. doi: 10.22034/ncm.2022.350622.1050
MLA
Martin Hofmeister. "Kratom Consumption can be Addictive and have Adverse Health Effects". Novelty in Clinical Medicine, 1, 4, 2022, 168-172. doi: 10.22034/ncm.2022.350622.1050
HARVARD
Hofmeister, M. (2022). 'Kratom Consumption can be Addictive and have Adverse Health Effects', Novelty in Clinical Medicine, 1(4), pp. 168-172. doi: 10.22034/ncm.2022.350622.1050
VANCOUVER
Hofmeister, M. Kratom Consumption can be Addictive and have Adverse Health Effects. Novelty in Clinical Medicine, 2022; 1(4): 168-172. doi: 10.22034/ncm.2022.350622.1050