ORN Summer 2024 - Kratom Consumers in the United States: What clinicians need to know-Recording - ORN Summer 2024 - Kratom Consumers in the United States

Video Transcription

Video Summary

In the AOIM webinar titled "Kratom Consumers in the United States: What Clinicians Need to Know," Dr. Kirsten Smith, an assistant professor in the Department of Psychiatry and Behavioral Sciences at Johns Hopkins University, shared comprehensive insights into kratom. Kratom, derived from a complex botanical indigenous to Malaysia, Thailand, and Indonesia, markets various forms, including juices and concentrated extracts in the U.S. Important to note, kratom's main chemical component, mitragynine, acts as a partial agonist at mu-opioid receptors and also affects alpha-adrenergic and serotonergic systems. Another significant compound, 7-hydroxymitragynine, is 14-22 times more potent than morphine in lab tests, albeit not naturally abundant in kratom leaves.<br /><br />Dr. Smith emphasized kratom's legal status in the U.S., lacking FDA regulation and DEA scheduling, leading to varied state-level controls. Her research involved an extensive survey and momentary assessment involving over 13,000 kratom use events, uncovering that most users consume kratom during the first half of the day for pain relief, energy, mood enhancement, or to self-manage opioid dependency. Issues such as kratom withdrawal and dependence appear prominent, yet severe substance use disorders are less common.<br /><br />Key takeaways include kratom's habit-forming potential and mild withdrawal symptoms, though research has not conclusively linked its use to significant clinical impairments or respiratory depression. Dr. Smith also discussed the safety of kratom, where initial studies show few severe adverse events but highlight the necessity for further research to demystify kratom's long-term and psychoactive impacts. Continued investigations at Hopkins aim to decode kratom's withdrawal and pharmacodynamics comprehensively. Dr. Smith urged clinicians to share kratom-related cases for broader understanding and coverage.

Keywords

Kratom

Mitragynine

7-hydroxymitragynine

Opioid receptors

FDA regulation

DEA scheduling

Withdrawal symptoms

Pain relief

Mood enhancement

Johns Hopkins University