As of 2018[update], the efficacy and safety of kratom are unclear.[9] In 2019, the United States Food and Drug Administration (FDA) stated that there is no evidence that kratom is safe or effective for treating any condition.[10] Some people take it for managing chronic pain, for treating opioid withdrawal symptoms, or for recreational purposes.[4][11] The onset of effects typically begins within five to ten minutes and lasts for two to five hours.[4]
Anecdotal reports describe increased alertness, physical energy, talkativeness, sociability, sedation, changes in mood, and pain relief following kratom use at various doses.[11] Common side-effects include appetite loss, erectile dysfunction, nausea and constipation.[12] More severe side-effects may include respiratory depression (decreased breathing), seizure, psychosis,[4][7][13][14] elevated heart rate and blood pressure, trouble sleeping, and, rarely, liver toxicity.[4][15][16][17] Addiction is a possible risk with regular use: when use is stopped, withdrawal symptoms may occur.[11][8] A number of deaths have been attributed to the use of kratom, both by itself and mixed with other substances.[7] Serious toxicity is relatively rare and generally appears at high doses or when kratom is used with other substances.[4][11]
As of 2018, kratom is a controlled substance in 16 countries.[7]
There is growing international concern about a possible threat to public health from kratom use.[7][11][18] In some jurisdictions its sale and importation have been restricted, and several public health authorities have raised alerts.[11][18]
^Hassan Z, Muzaimi M, Navaratnam V, Yusoff N, Suhaimi FW, Vadivelu R, Vicknasingam BK, Amato D, von Hörsten S, Ismail N, Jayabalan N, Hazim AI, Mansor SM, Müller CP (2013). "From Kratom to mitragynine and its derivatives: Physiological and behavioural effects related to use, abuse, and addiction". Neurosci Biobehav Rev. 37 (2): 138–151. doi:10.1016/j.neubiorev.2012.11.012. ISSN0149-7634. PMID23206666. S2CID8463133.
^Advokat CD, Comaty JE, Julien RM (2019). Julien's Primer of Drug Action: a comprehensive guide to the actions, uses, and side effects of psychoactive drugs (14th ed.). New York: Worth Publishers. p. 570. ISBN978-1-319-20054-1.
^White CM (2018). "Pharmacologic and clinical assessment of kratom". Am J Health Syst Pharm (Review). 75 (5): 261–267. doi:10.2146/ajhp161035. PMID29255059.
^Cite error: The named reference fda4-3-19 was invoked but never defined (see the help page).
^ abcdefWarner ML, Kaufman NC, Grundmann O (2016). "The pharmacology and toxicology of kratom: from traditional herb to drug of abuse". Int. J. Legal Med. (Review). 130 (1): 127–38. doi:10.1007/s00414-015-1279-y. PMID26511390. S2CID2009878.
^Cite error: The named reference corkery was invoked but never defined (see the help page).
^Marx, John, Walls, Ron, Hockberger, Robert (2014). "Chapter 156: Hallucinogens". Rosen's emergency medicine : concepts and clinical practice (Eighth ed.). London: Elsevier Health Sciences. pp. 2015–23. ISBN978-1-4557-4987-4.
^Cite error: The named reference liverreview was invoked but never defined (see the help page).
^"Kratom". LiverTox, National Library of Medicine, US National Institutes of Health. 9 March 2017. PMID31643176. Retrieved 29 March 2017.