In Malaysia, Dutch botanist Pieter Korthals in 1831 first discovered Kratom or Mitragyna speciosia. Kratom is derived from the Nitragyna speciose korth, a tropical forest tree found in Malaysia, Thailand and Myanmar. The trees’ leaves contain contain psychoactive opioid compounds, consumed for thousands of years. Kratom contains alkaloids that bind to opioid receptors, with an opioid drug structure. Kratom induces euphoria, and in lower doses acts similar to a stimulant by increasing energy, alertness, while in higher doses it induces sedation. Kratom is purportedly used for anxiety, depression, inflammation, libido. Importantly, given opioid activity, it suppresses opioid withdrawal. With regular use, Kratom is associated with dependence and addiction.

Kratom is gaining increasingly popularity especially among the young in the US population and is causing rising numbers of ER visits, calls to poison control centers and even deaths related to multiple causes.

There are currently very limited clinical studies available that demonstrate safety and efficacy in humans. Kratom The FDA has not approved Kratom for medical use, and publishes warnings regarding its toxicity. Available information is mostly based on reports from users or animal models. Case reports involving the use of Kratom are concerning and alarming.

Kratom is classified as an herbal supplement and therefore easily available to the user as it is sold in convenience stores, online or gas stations. At this point, it is a dangerous drug with opioid activity, freely available without controls for safety.

This article is a systematic review of literature on the current available data on Kratom guided for physician and clinician education and to raise awareness about Kratom as a substance.

Utilized sources were Pubmed, Ovid, Medline, PsychInfo, and EMBASE.