Kratom and Its Effects

"Kratom is a plant-derived from a species of plant native to Southeast Asia called Mitragyna speciosa [1]. It is generally prepared through boiling leaves derived from Mitragyna speciosa to produce kratom tea. Additionally, kratom can be crushed in order to produce a powder that is then able to be ingested [2]. Kratom comprises numerous alkaloids, which are organic compounds that contain nitrogen. Two of these alkaloids are mitragynine and 7-hydroxy mitragynine. Both are believed to be crucial in kratom's physiological effect on humans [3]. Though the mechanism of action of these compounds is still not fully understood, it is believed they work primarily via acting as agonists at certain subtypes of opioid receptors expressed on neurons, with mitragynine acting at the μ and δ receptors while 7-hydroxy mitragynine acts at the μ and κ receptors. These receptor-ligand interactions may then stimulate signal transduction mechanisms involving the activation of G proteins. In addition, these metabolites are also believed to act on various monoaminergic and opioid receptors [4,5].

"Kratom has been shown to cause both a stimulant-like effect and a sedative effect in humans. The physiological effects vary based on the dose that is taken as well as the particular strain of kratom that is consumed [3]. For example, the red vein strain of Mitragyna speciosa tends to induce a sedated state when ingested, whereas the green vein strain tends to cause a stimulating effect [6]. The use of kratom has historically been by people living in Southeast Asia [7]. However, in recent years, the use of kratom has increased significantly among people living in the United States [8]. In the United States, kratom can now be bought online or at certain drug shops [9]. As kratom has only recently gained popularity in the United States, much is still unknown regarding the potential adverse effects of the drug. However, some negative side effects that have been documented include nausea, vomiting, hypertension, tachycardia, and elevated levels of creatine phosphokinase [10].

"Additionally, there have been several instances where kratom intake caused severe liver damage that was eliminated once patients stopped consuming kratom [11]. Further compounding issues with kratom are evidence showing that individuals taking kratom develop a physiological dependence, especially when taking other drugs of abuse, which can result in withdrawal symptoms. These withdrawal symptoms include extreme pain, muscle spasms, and difficulty sleeping [12,13]."