Kratom (Mitragyna speciosa) Use, Addiction Potential, and Legal Status

This chapter focuses on the resurgence of Kratom (Mitragyna speciosa, mitragynine, 7-hydroxymitragynine) use in Thailand and its emergence on the global market. Currently neither Kratom, mitragynine, nor other alkaloids from the M. speciosa plant are listed under the Schedules of the United Nations Drug Conventions; therefore, its legal status is independently established by each country, state, or region. However, M. speciosa, mitragynine, and 7-hydroxymitragynine are illegal or controlled in several European countries, many South East Asian countries, and some parts of the United States. The availability and trade of Kratom in Europe, Australia, and the United States emerged at the turn of the twenty-first century primarily through proliferation of information on the Internet about the drug coupled with Internet sales and global marketing of the drug. The use of Kratom in its more natural form as a plant preparation in its countries of origin is associated with lower addiction and health problems. However, the extraction of more potent and purified alkaloids has increased its addiction and abuse potential. Kratom is a unique drug in that at low doses it produces a stimulant effect; whereas at higher doses it has opiate-like effects.