Although mitragynine can act on the mu (μ)- and kappa (κ)-opioid receptors, it is structurally different from morphine and other opioid narcotic pain-killers.

2016 aedating ch product-522016 aedating ch product-14

1998), and kappa opioid receptors (Boyer et al., 2008; Dale et al., 2012).

The raw botanical and products containing this ingredient are often marketed as “legal highs” because they have not been scheduled by the Drug Enforcement Agency. The leaf and extracts are usually imported with a product code 54 as they are almost always intended as dietary supplements for ingestion.

It has potential medical use as an alternative for chronic pain and opioid withdrawal self-therapy due to the opioid agonist activity of the major alkaloids in kratom [68,69].

It is commonly used by workers during physical labour to increase stamina and endurance and as a substitute for opium in Thailand and Malaysia [70].

Kratom is sold in various forms including fresh and dried leaves, powder or a resinous extract which is the main form of NPS (Fig 14.7A common route of administration is by chewing the fresh leaves at a dosage of normally 10 to 30 leaves per day.

Kratom can be ingested as crushed dried leaves by taking powder, drinking as a tea or by smoking the leaves or the extract [71]. 14.8) is the major alkaloid (up to 66% in the extract) in kratom, and is the principle compound responsible for analgesic activity due to its potent opioid agonist property [70,72].

They are labeled as dietary supplements within the letter of the law.

As finished products, they contain statements of identity as dietary supplements in accordance with Section 403(s)(2)(B) and within the meaning of Title 21 of the Code of Federal Regulations (CFR) Section 101.3(g).

Consumption of kratom can lead to respiratory depression, nervousness, agitation, aggression, sleeplessness, hallucinations, delusions, tremors, loss of libido, constipation, skin hyperpigmentation, nausea, vomiting, addiction, and severe withdrawal signs and symptoms after refraining from use. In general, FDA would not be inclined to support the detention of bulk new dietary ingredients unless it could identify concrete safety concerns, as with kratom.