Healthcare Provider’s Guide to Kratom: Succinct Introduction to the Basics and the Questions

Abstract

Background: The leaves of Mitragyna speciosa (kratom), a tropical tree that is indigenous to Southeast Asia, have been used traditionally to increase stamina, as a digestive aid, and as an analgesic. Kratom use is now increasingly popular in the rest of the world because of easy availability through the Internet and real, or perceived, views of efficacy and safety. Methods: PubMed and MedLine searches were conducted of published articles available in English. Results: Mitragynine and 7-hydroxymitragynine are the primary psychoactive compounds of the over 25 alkaloids in kratom. Subjective effects are dose dependent: a mild stimulation at lower doses, sedative effects at intermediate doses, and mild opioid-like effects at higher doses. Toxicity is rare and may be due instead to polypharmacy. Abrupt discontinuation after extensive use can produce withdrawal symptoms, but use does not imply overt dysfunction or decreased quality of life. In fact, Kratom has been used by opioid substance abusers as a