Prevalence and motivations for kratom use in a sample of substance users enrolled in a residential treatment program

Smith, Kirsten E.; Lawson, Thomas R.

doi:10.1016/j.drugalcdep.2017.08.034

Cited by 108 publications

(85 citation statements)

References 91 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The currently inflated interest in kratom in the United States coincides with changes in opioid prescribing guidelines by the Center for Disease Control and Prevention in 2016 (Renthal, 2016) and the rise in heroin adulterated with fentanyl-like opioids, leading to a spike in fatal and non-fatal overdoses (Dowell, Noonan, & Houry, 2017;Gostin, Hodge, & Noe, 2017). Kratom contains more than 40 alkaloids with varying affinity and activity at opioid receptors (Adkins, Boyer, & McCurdy, 2011;Brown, Lund, & Murch, 2017;Hassan et al, 2013;Kruegel et al, 2016;Takayama, 2004) and is commonly used for the self-medication of opioid dependence and withdrawal, the management of chronic pain and mood disorders or as substitute for heroin or prescription opioids (Grundmann, 2017;Singh et al, 2016;Smith & Lawson, 2017). Despite these perceived benefits, increasing rates of kratom use have led to concomitant increases in reports of adverse effects following consumption, although to date, no fatal overdoses have been attributed to kratom use alone (Cinosi et al, 2015;Kruegel & Grundmann, 2017).…”

Section: Introductionmentioning

confidence: 99%

G protein‐biased kratom‐alkaloids and synthetic carfentanil‐amide opioids as potential treatments for alcohol use disorder

Gutridge

Robins

Cassell

et al. 2020

British J Pharmacology

View full text Add to dashboard Cite

Background and Purpose Mitragyna speciosa, more commonly known as kratom, is a plant that contains opioidergic alkaloids but is unregulated in most countries. Kratom is used in the self‐medication of chronic pain and to reduce illicit and prescription opioid dependence. Kratom may be less dangerous than typical opioids because of the stronger preference of kratom alkaloids to induce receptor interaction with G proteins over β‐arrestin proteins. We hypothesized that kratom (alkaloids) can also reduce alcohol intake. Experimental Approach We pharmacologically characterized kratom extracts, kratom alkaloids (mitragynine, 7‐hydroxymitragynine, paynantheine, and speciogynine) and synthetic carfentanil‐amide opioids for their ability to interact with G proteins and β‐arrestin at μ, δ, and κ opioid receptors in vitro. We used C57BL/6 mice to assess to which degree these opioids could reduce alcohol intake and whether they had rewarding properties. Key Results Kratom alkaloids were strongly G protein‐biased at all three opioid receptors and reduced alcohol intake, but kratom and 7‐hydroxymitragynine were rewarding. Several results indicated a key role for δ opioid receptors, including that the synthetic carfentanil‐amide opioid MP102—a G protein‐biased agonist with modest selectivity for δ opioid receptors—reduced alcohol intake, whereas the G protein‐biased μ opioid agonist TRV130 did not. Conclusion and Implications Our results suggest that kratom extracts can decrease alcohol intake but still carry significant risk upon prolonged use. Development of more δ opioid‐selective synthetic opioids may provide a safer option than kratom to treat alcohol use disorder with fewer side effects.

show abstract

Section: Introductionmentioning

confidence: 99%

G protein‐biased kratom‐alkaloids and synthetic carfentanil‐amide opioids as potential treatments for alcohol use disorder

Gutridge

Robins

Cassell

et al. 2020

British J Pharmacology

View full text Add to dashboard Cite

show abstract

“…It is increasingly used to self-treat opioid dependence and is not detected by commercial drug screens. 4,5 In this report, we describe a case of NAS due to maternal Kratom use.…”

mentioning

confidence: 94%

“…The search for nonopioid alternatives for the treatment of opioid dependence has intensified, as has the marketing and supply of herbal products advertised to treat opioid withdrawal. 4,5 Pediatricians need to be aware of these products to better care for infants born to mothers with a history of opioid dependence. Kratom is a legal, widely available herbal alkaloid that acts agonistically at opioid receptors.…”

mentioning

confidence: 99%

Neonatal Abstinence Syndrome Due to Maternal Kratom Use

2018

View full text Add to dashboard Cite

Neonatal abstinence syndrome (NAS) is a clinical diagnosis based on the observation of symptoms attributed to postpartum substance withdrawal in a newborn with chronic in utero exposure. It is most frequently attributed to prescription and nonprescription maternal opioid use during pregnancy. 1 Both NAS and maternal opioid use during pregnancy are increasing in incidence. 2,3 Pediatricians can identify infants at risk for NAS on the basis of maternal history and drug screens.

show abstract

“…In the United States, kratom has been predominantly used for self‐treating pain or mood disorders . Recently, kratom has gained acceptance among patients with opioid use disorder (OUD) as a practical alternative to evidence‐based medication‐assisted treatment, such as buprenorphine or methadone . Anecdotal reports have posited that kratom is a safe treatment alternative to relieve opioid withdrawal, but clinical evidence to support this claim is lacking.…”

mentioning

confidence: 99%

“…2 Recently, kratom has gained acceptance among patients with opioid use disorder (OUD) as a practical alternative to evidence-based medication-assisted treatment, such as buprenorphine or methadone. 3,4 Anecdotal reports have posited that kratom is a safe treatment alternative to relieve opioid withdrawal, but clinical evidence to support this claim is lacking. Although a clear dose-response relationship has not been established, preliminary data suggest that lower doses of kratom produce stimulantlike effects and higher doses produce sedative effects.…”

mentioning

confidence: 99%

Kratom Use and Toxicities in the United States

et al. 2019

View full text Add to dashboard Cite

Background Kratom is an herbal supplement containing alkaloids with opioid properties. This review was conducted to determine toxicities associated with kratom use in the United States in order to provide insight into its safety as a dietary supplement. Methods We conducted a retrospective review of kratom exposures reported to the National Poison Data System to determine the toxicities associated with kratom use. We also reviewed records from a county medical examiner's office in New York State to identify kratom‐associated fatalities. Results A total of 2312 kratom exposures were reported, with 935 cases involving kratom as the only substance. Kratom most commonly caused agitation (18.6%), tachycardia (16.9%), drowsiness (13.6%), vomiting (11.2%), and confusion (8.1%). Serious effects of seizure (6.1%), withdrawal (6.1%), hallucinations (4.8%), respiratory depression (2.8%), coma (2.3%), and cardiac or respiratory arrest (0.6%) were also reported. Kratom was listed as a cause or contributing factor in the death of four decedents identified by the county medical examiner's office. Conclusions Kratom use is increasing and is associated with significant toxicities. Our findings suggest kratom is not reasonably expected to be safe and poses a public health threat due to its availability as an herbal supplement.

show abstract

Prevalence and motivations for kratom use in a sample of substance users enrolled in a residential treatment program

Cited by 108 publications

References 91 publications

G protein‐biased kratom‐alkaloids and synthetic carfentanil‐amide opioids as potential treatments for alcohol use disorder

G protein‐biased kratom‐alkaloids and synthetic carfentanil‐amide opioids as potential treatments for alcohol use disorder

Neonatal Abstinence Syndrome Due to Maternal Kratom Use

Kratom Use and Toxicities in the United States

Contact Info

Product

Resources

About