Striley Catherine W, Hoeflich Carolin C, Viegas Andrew T, Berkowitz Lindsey A, Matthews Emily G, Akin Leyla P, Iheanyi-Okeahialam Chidinma, Mansoor Urmeen, McCurdy Christopher R
Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
College of Pharmacy, University of Florida, Gainesville, FL, USA.
Subst Abuse. 2022 May 20;16:11782218221095873. doi: 10.1177/11782218221095873. eCollection 2022.
Kratom () consumption and associated health effects have raised debates in the United States. Although most people using this herb do not experience adverse health effects associated with kratom use, medical providers should be knowledgeable of emerging substances and concurrent, sequential, or simultaneous use of other drugs which may impact healthcare recommendations and prescribing practices.
The objective of this narrative review was to elucidate selected health effects associated with using kratom-either alone or with other substances. Since scientifically controlled human subjects research on kratom use is still limited, relevant case reports were also described.
Cardiovascular, gastrointestinal, neurological, and psychiatric effects associated with kratom use were especially notable, and in-utero exposure accompanied concern regarding a neonate's risk for developing neonatal abstinence syndrome. Our ability to identify and understand the role of this herb in kratom-associated fatalities is complicated since kratom is not routinely screened for in standard forensic toxicology. If a screening is performed, it is usually for the major alkaloid, mitragynine, as a surrogate for kratom use. In addition to lacking a standard practice of screening decedents for kratom alkaloids, the association between mortality and kratom use may be confounded by polysubstance use, adulteration of kratom products, and drug-herb interactions.
Increasing medical awareness of this herb is vital to ensuring prompt administration of best-practice medical advice or treatment for people seeking information related to kratom use or for patients experiencing an adverse health effect that may be associated with using or withdrawing from kratom. Knowledge gained from continued surveillance and study of kratom and its associated health effects may assist in guiding clinical decision-making and preventing development of adverse health effects among people using kratom.
在美国，服用 kratom 及其相关健康影响引发了诸多争议。尽管大多数使用这种草药的人并未出现与服用 kratom 相关的不良健康影响，但医疗服务提供者应了解这些新兴物质以及可能影响医疗建议和处方做法的其他药物的同时、先后或并发使用情况。
本叙述性综述的目的是阐明与单独使用或与其他物质联合使用 kratom 相关的特定健康影响。由于关于 kratom 使用的科学对照人体研究仍然有限，因此也描述了相关病例报告。
与服用 kratom 相关的心血管、胃肠道、神经和精神方面的影响尤为显著，而子宫内接触 kratom 引发了对新生儿发生新生儿戒断综合征风险的担忧。由于在标准法医毒理学中通常不会对 kratom 进行常规筛查，所以我们识别和理解这种草药在与 kratom 相关的死亡事件中所起作用的能力受到了影响。如果进行筛查，通常是检测主要生物碱——帽柱木碱，以此作为服用 kratom 的替代指标。除了缺乏对死者进行 kratom 生物碱筛查的标准做法外，死亡率与服用 kratom 之间的关联可能会因多物质使用、kratom 产品掺假以及药物 - 草药相互作用而变得复杂。
提高对这种草药的医学认知对于确保为寻求与服用 kratom 相关信息的人或因服用或停用 kratom 而出现不良健康影响的患者及时提供最佳医疗建议或治疗至关重要。通过对 kratom 及其相关健康影响的持续监测和研究获得的知识，可能有助于指导临床决策，并预防使用 kratom 的人群出现不良健康影响。
