Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jan-Jun;17(2):131-142.
doi: 10.1080/17512433.2024.2305798. Epub 2024 Jan 29.

An update on the clinical pharmacology of kratom: uses, abuse potential, and future considerations

Christopher R McCurdy  1   2 , Abhisheak Sharma  1 , Kirsten E Smith  3 , Charles A Veltri  4 , Stephanie T Weiss  5 , Charles M White  6 , Oliver Grundmann  2   4
Affiliations
Review

An update on the clinical pharmacology of kratom: uses, abuse potential, and future considerations

Christopher R McCurdy et al. Expert Rev Clin Pharmacol. 2024 Jan-Jun.

Abstract

Introduction: Kratom (Mitragyna speciosa) has generated substantial clinical and scientific interest as a complex natural product. Its predominant alkaloid mitragynine and several stereoisomers have been studied for activity in opioid, adrenergic, and serotonin receptors. While awaiting clinical trial results, the pre-clinical evidence suggests a range of potential therapeutic applications for kratom with careful consideration of potential adverse effects.

Areas covered: The focus of this review is on the pharmacology, pharmacokinetics, and potential drug-drug interactions of kratom and its individual alkaloids. A discussion on the clinical pharmacology and toxicology of kratom is followed by a summary of user surveys and the evolving concepts of tolerance, dependence, and withdrawal associated with kratom use disorder.

Expert opinion: With the increasing use of kratom in clinical practice, clinicians should be aware of the potential benefits and adverse effects associated with kratom. While many patients may benefit from kratom use with few or no reported adverse effects, escalating dose and increased use frequency raise the risk for toxic events in the setting of polysubstance use or development of a use disorder.

Keywords: Kratom; Mitragyna speciosa; mitragynine; pharmacology; toxicology; use disorder.

PubMed Disclaimer

Conflict of interest statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

References

    1. Brown PN, Lund JA, Murch SJ. A botanical, phytochemical and ethnomedicinal review of the genus Mitragyna korth: Implications for products sold as kratom. J Ethnopharmacol [Internet]. 2017/03/24. 2017;202:302–325. Available from: 10.1016/j.jep.2017.03.020. - DOI - PubMed
    1. Veltri C, Grundmann O. Current perspectives on the impact of Kratom use. Subst Abuse Rehabil [Internet]. 2019;10:23–31. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31308789. - PMC - PubMed
    1. Singh D, Azuan MA, Narayanan S. Kratom (Mitragyna speciosa) use in a sample of drug-dependent adolescents in rehabilitation for drug use in Malaysia. J Ethn Subst Abuse. 2023;1–16. - PubMed
    1. Grundmann O, Hill K, Al Barzanji E, et al. Correlations of kratom (Mitragyna speciosa Korth.) tea bag preparations and reported pharmacological effects. J Ethnopharmacol. 2023;317:116779. - PubMed
    1. Palamar JJ. Past-Year Kratom Use in the U.S.: Estimates From a Nationally Representative Sample. Am J Prev Med [Internet]. 2021; Available from: https://www.ncbi.nlm.nih.gov/pubmed/34027890. - PMC - PubMed

LinkOut - more resources