The Worldwide Spread of ‘Herbal Highs’
Ornella Corazza, Andres Roman-Urrestarazu in Handbook of Novel Psychoactive Substances, 2018
Over the last few decades, the evolution of the international drug market has increased the availability of a range of natural drugs, nowadays known as plant-derived or natural NPSs. Consequently, the tropical tree Mitragyna speciosa Korth. (kratom) has now planted its ‘roots’ of use worldwide. Kratom is still easily available in native countries and is also just ‘a click’ away and potentially available to a wide range of new users, including vulnerable individuals who may want to experience the effects of kratom because of its reported non-harmful effects. To date, the exact dispersion of kratom use is unknown, and the Internet appears to be an important source to facilitate its commercialization, while it also serves as a repository of information for selected groups who can share experiences and suggest new products or novel modalities of intake via online fora, chat rooms, blogs, and videos (Bersani et al., 2014; Corazza et al., 2013; Corazza, Bersani et al., 2014; Corazza, Valeriani et al., 2014; Corazza, Simonato, Corkery, Trincas, & Schifano, 2014; Santacroce et al., 2015; Schifano et al., 2010; Valeriani et al., 2015). The use of kratom has been so far only minimally studied and has attracted growing interest among the scientific community, general public, online communities, enforcement agencies, and policy makers.
Regulation of Nutraceuticals and Functional Foods
Robert E.C. Wildman, Richard S. Bruno in Handbook of Nutraceuticals and Functional Foods, 2019
The FDA has various options to protect consumers from unsafe supplements. The Secretary of the Department of Health and Human Services (which falls under the FDA's oversight) has the power to declare a dangerous supplement to be an “imminent hazard” to public health or safety and immediately suspend sales of the product. The FDA also has the authority to protect consumers from dietary supplements that do not present an imminent hazard to the public but do present certain risks of illness or injury to consumers. The law prohibits introducing adulterated products into interstate commerce. A supplement shall be deemed adulterated if it presents “a significant or unreasonable risk of illness or injury.” The standard does not require proof that consumers have actually been harmed or even that a product will harm anyone. It was under this provision that the FDA concluded that dietary supplements containing ephedra, androstenedione, and 1-3, Dimethylamylamine (DMAA) presented an unreasonable risk. Most recently, the FDA imposed an importation ban on the botanical Mitragyna speciosa, better known as Kratom. In 2016, the FDA issued Import Alert #54-15, which allows for detention without physical examination of dietary supplements and bulk dietary ingredients that are, or contain, Kratom. Criminal penalties are present for a conviction of introducing adulterated supplement products into interstate commerce. While the harms associated with dietary supplements may pale in comparison to those linked to prescription drugs, recent pronouncements from the U.S. Department of Justice confirm that the supplement industry is being watched vigilantly to protect the health and safety of the American public.
Cannabis and addiction
Betty Wedman-St. Louis in Cannabis, 2018
Mitragyna speciosa has been used medically throughout Asia, Africa, and Oceania in formulations of topical balms or tinctures [64]. The tree and leaves are currently illegal in four countries, but it is legal and widely available in the United States [65]. Vardi et al. [66] showed that kratom-based drugs had analgesic effects but fewer side effects, slower development of tolerance, and lower potential for dependence than morphine in a mouse model. The therapeutic benefits of kratom can be noted in several United States patents issued from 1964 to 2009 [67–69].
Characterization of urinary protein profile in regular kratom (Mitragyna speciosa korth.) users in Malaysia
Published in Journal of Addictive Diseases, 2022
Rana Khudhair Jasim, Zurina Hassan, Darshan Singh, Edward Boyer, Lay-Harn Gam
Mitragyna speciosa (Korth.) also known as “kratom” or “ketum” has been perennially used for its medicinal value in Southeast Asia.1 In traditional context, kratom leaves are usually used as a remedy to treat common ailments such as fever, cough, diarrhea and pain.2 It is also ingested in the form of a brewed solution to increase work productivity.1 Individuals who are seeking to refrain from opioid and methamphetamine use, generally use kratom as a substitute to self-treat their substance use disorder (SUD).3–5 Given its purported pain-relieving and mood-altering effects, although the Food and Drug Administration (FDA) have not approved its utility, kratom is now typically used in the United States (U.S) to treat chronic pain, opioid use disorder (OUD) and withdrawal, as well as mental health symptoms like anxiety and depression.6–8,10 In the wake of the intensifying opioid misuse crisis in U.S, kratom advocates believe kratom has the potential to be utilized as a harm reduction component among substance users who want to quit opioids.9
The Use of Benzodiazepines among Kratom (Mitragyna Speciosa Korth.) Users
Published in Journal of Psychoactive Drugs, 2020
Darshan Singh, Suresh Narayanan, Oliver Grundmann, Edward W. Boyer, Balasingam Vicknasingam
Mitragyna speciosa (Korth.) is a medicinal plant, found abundantly in Malaysia and Thailand (Singh, Narayanan, and Vicknasingam 2016). For centuries, people living in rural communities in Southeast Asia have used kratom leaves for its curative properties, and as a mild narcotic for improving work efficiency under the blistering sun (Saingam et al. 2012; Singh, Narayanan, and Vicknasingam 2016). Due to its addictive potential, kratom is banned in Malaysia and Thailand (Singh, Narayanan, and Vicknasingam 2016). Though kratom remains unregulated at the federal level in the US, the Food and Drug Administration (FDA) has classified two kratom compounds, mitragynine, and 7-hydroxymitragynine, as opioids therefore compelling the Drug Enforcement Administration to place kratom under Schedule 1 of the Controlled Substances Act (CSA). There is still insufficient scientific information supporting claims of kratom’s pain relieving efficacy or as an opioid substitute (Henningfield, Fant, and Wang 2018). In the West, kratom is widely marketed on the internet and promoted for its mood-enhancing and pain-relieving benefits (Boyer et al. 2008; Grundmann 2017). While its principal alkaloid, mitragynine, and minor constituent, 7-hydroxymitragynine, are reported to produce opioid-like effects, their mechanism of action appears to be distinctly different from classical opioids such as morphine or heroin (Kruegel et al. 2016).
Severity of Pain and Sleep Problems during Kratom (Mitragyna speciosa Korth.) Cessation among Regular Kratom Users
Published in Journal of Psychoactive Drugs, 2018
Darshan Singh, Suresh Narayanan, Balasingam K. Vicknasingam, Walter C. Prozialeck, Surash Ramanathan, Hadzliana Zainal, Sabariah Noor Harun
Mitragyna speciosa (M. speciosa) Korth. from the Rubiaceae (coffee) family is a native tropical tree from Southeast Asia (Saingam et al. 2012; Singh, Narayanan, and Vicknasingam 2016; Singh et al. 2017). In Malaysia, M. speciosa leaves are known as ketum, and in Thailand as kratom. Since kratom is the term more widely used in the literature, we follow this convention. Kratom extracts are reported to have complex dose-dependent stimulant and opioid-like effects (Hassan et al. 2013; Warner, Kaufman, and Grundmann 2015). Nearly 40 alkaloids have been isolated from M. speciosa leaves (Adkins, Boyer, and McCurdy 2011). Mitragynine as the principal alkaloid and 7-hydroxymitargynine as the minor constituent are shown to have potent analgesic properties akin to opiates (Kruegel and Grundmann 2017).
Related Knowledge Centers
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- Herbal Medicine
- Opioid
- Prescription Drug
- Opioid Withdrawal
- Recreational Drug Use