Article published in MedPage Today on December 22, 2018 by John Gever
“In April, we reported on an FDA order to remove some kratom products from the market because of Salmonella contamination. That turned out to be the opening shot in a war that the federal government has declared on the herbal product — or, at least, that’s how kratom’s advocates see it. In this story, we review what has happened since with the opioid mimic and the government’s efforts to discourage its use.
Kratom comes from an Asian plant, Mitragyna speciosa, that has long been a mild recreational drug and part of folk remedies. In recent years, it has gained a following in North America with claims that it can relieve pain that conventional drugs can’t touch, and that it can also relieve symptoms of opioid withdrawal. It’s sold in smoke shops, “alternative medicine” storefronts, and, of course, online from countless vendors.
Its mechanism of action isn’t entirely clear. That’s partly because it’s an herbal product with dozens of possible active compounds. However, attention has focused on two alkaloids that bind to mu-opioid receptors, which are also the target for conventional opioids. But its activity is also different from opium derivatives, earning it the moniker “atypical opioid.””