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Research library index
209 published studies, case reports, surveillance reports and agency documents on 7-OH and kratom, from 1975 to 2026. Each card gives the key finding in one line and links to the original.
By topic
By evidence type
- Case reports40
- Reviews & commentary35
- Lab (in vitro)33
- Human studies26
- Animal studies22
- Surveillance20
- Agency & legal documents19
- Product testing14
How to read this: one-line findings are taken from each study’s published abstract (or a short description for agency documents) and have not been checked against the full text. Evidence types are approximate. Case reports and lab studies cannot show how common a harm is. Court filings are allegations, not scientific evidence. See the research library for our own summaries.
Showing 209 of 209
Deaths & poisonings28
- Human studies2026
Kratom-Associated Pulmonary Toxicity: A Systematic Review of Case Reports and Forensic Series with a Proposed Clinical Phenotype Classification
J Med Toxicol · Kanchustambham V, Saladi S
Key finding: Reported kratom-associated pulmonary presentations cluster into five provisional, hypothesis-generating categories spanning primary lung injury and secondary systemic effects.
- Case reports2026
Severe Early-Onset Withdrawal Following Intentional Use of Mitragynine Pseudoindoxyl: A Case Report and Emerging Clinical Considerations
Cureus · Stanciu CN
Key finding: Clinicians should recognize its severe withdrawal profile, the limitations of standard toxicology, and the potential role of naltrexone in relapse prevention once an opioid-free interval is established.
- Case reports2026
7-Hydroxymitragynine: Not Your Garden Variety Kratom
Am J Forensic Med Pathol · Papsun DM, Schroeder W, Brower J, Krotulski A, Ellefsen K
No summary available; see the original.
- Surveillance2026
Increases in Kratom-Related Reports to Poison Centers - National Poison Data System, United States, 2015-2025
MMWR Morb Mortal Wkly Rep · Towers EB, Thomas YT, Holstege CP, Farah R
Key finding: NPDS data indicate that kratom-related reports to poison centers are increasing and expanding among demographic groups, underscoring the value of ongoing surveillance to identify high-risk patterns of kratom use and guide strategies to…
- Surveillance2026
Increase in Poison Center Reports Linked to Kratom-Containing Kava Products - National Poison Data System, United States, 2000-2025
MMWR Morb Mortal Wkly Rep · Towers EB, Williams IL, Holstege CP, Farah R
Key finding: The findings in this report suggest the need for enhanced surveillance for, clinical awareness of, and public education regarding commercial products containing kava.
- Surveillance2026
Kratom exposure cases reported to United States Poison Centers: 2016-July 2025
Am J Emerg Med · Leonard JB, Brown K, Colvin JM
Key finding: There has been a significant increase in kratom exposures reported to US Poison Centers, but the overall outcomes have remained similar.
- Surveillance2026
Characterizing Clinical Effects of 7-Hydroxymitragynine at a US Poison Control Center
Am J Ther · Wahrenbrock TN, Bompard M, Downs JW
No summary available; see the original.
- Surveillance2026
Americas Poison Centers 2026 7-OH Exposure Advisory
Agency / organization document · Americas
No summary available; see the original.
- Surveillance2026
CDC MMWR 2026 Increases in Kratom-Related Reports to Poison Centers
Agency / organization document · CDC
No summary available; see the original.
- Product testing2026
Mislabeling and Status of Semisynthetic Kratom-Derived Products in the US Market
Drug Test Anal · Gour A, Kanumuri SRR, Mukhopadhyay S, Pullman MK, León F, Cutler SJ et al.
Key finding: Collectively, this highlights the need for improved regulatory oversight and strengthened post-marketing surveillance, including real-time poison control center data, to ensure consumer safety.
- Agency & legal documents2026
Mills v Savla 2026 Complaint Exhibit A in Kinsale v Hydroxie Allegations
Agency / organization document · Mills
Key finding: Public court filing (legal allegations, not scientific evidence); included only as a record of a reported fatality involving 7-OH products.
- Human studies2025
Reported associations between kratom and seizures: a systematic review
Front Pharmacol · Turla T, Abele G, Hua M, Paustenbach D
Key finding: OR SIGNIFICANCE: Currently, the available literature primarily consists of a limited number of studies, including case reports and case series, which document self-reported kratom use and provide minimal quantitative toxicological data…
- Case reports2025
Postmortem distribution of mitragynine and 7-hydroxymitragynine in 51 cases
J Anal Toxicol · Osawa KA, Johnson RD
Key finding: Methanolic preparations of mitragynine and 7-hydroxymitragynine were stable following 3 months of storage at -20°C.
- Surveillance2025
Americas Poison Centers 2025 Kratom and 7-OH Alert
Agency / organization document · Americas
No summary available; see the original.
- Reviews & commentary2025
From kratom to 7-hydroxymitragynine: evolution of a natural remedy into a public-health threat
Pharm Biol · Alsbrook S, Pro G, Koturbash I
Key finding: Collectively, the evidence demonstrates that concentrated 7-OH products are pharmacologically and toxicologically distinct from kratom leaf and pose significant risks of morbidity and mortality under typical conditions of use.
- Agency & legal documents2025
FDA 2025 7-Hydroxymitragynine Assessment of the Scientific Data and Toxicological Concerns
Agency / organization document · FDA
Key finding: FDA 2025 scientific assessment: 7-OH is a potent mu-opioid agonist with abuse and toxicity concerns; supports recommending scheduling.
- Human studies2024
Human Mitragynine and 7-Hydroxymitragynine Pharmacokinetics after Single and Multiple Daily Doses of Oral Encapsulated Dried Kratom Leaf Powder
Molecules · Huestis MA, Brett MA, Bothmer J, Atallah R
Key finding: These mitragynine and 7-hydroxymitragynine data provide guidance for future clinical kratom dosing studies and an interpretation of clinical and forensic mitragynine and 7-hydroxymitragynine concentrations.
- Case reports2024
Acquired Type 1 Brugada Syndrome Induced by Chronic High-Dose Kratom Use
Cureus · Holton K, Sanchez Corredera C, Haidar J, Valentin RG, Perez D, Boccio E
Key finding: While the clinical management of kratom toxicity is mostly supportive, physicians should consider potentially fatal cardiac dysrhythmias including Brugada syndrome.
- Reviews & commentary2021
The Adverse Cardiovascular Effects and Cardiotoxicity of Kratom (Mitragyna speciosa Korth.): A Comprehensive Review
Front Pharmacol · Leong Bin Abdullah MFI, Singh D
Key finding: Conclusion: Although kratom use has been associated with death and cardiotoxicity, especially at higher doses and when associated with other psychoactive drugs, the dearth of data and methodological limitations reported in existing…
- Lab (in vitro)2020
Temperature and pH-Dependent Stability of Mitragyna Alkaloids
J Anal Toxicol · Basiliere S, Kerrigan S
Key finding: These findings are discussed within the context of the identification of Mitragyna alkaloids in toxicological specimens.
- Surveillance2019
Kratom exposures reported to United States poison control centers: 2011-2017
Clin Toxicol (Phila · Post S, Spiller HA, Chounthirath T, Smith GA
Key finding: Individuals who choose to use kratom should be educated about its potential risks, including the dangers of using it in combination with other substances.
- Surveillance2019
Notes from the Field: Unintentional Drug Overdose Deaths with Kratom Detected - 27 States, July 2016-December 2017
MMWR Morb Mortal Wkly Rep · Olsen EO, O'Donnell J, Mattson CL, Schier JG, Wilson N
No summary available; see the original.
- Surveillance2019
Kratom Use and Toxicities in the United States
Pharmacotherapy · Eggleston W, Stoppacher R, Suen K, Marraffa JM, Nelson LS
Key finding: Kratom use is increasing and is associated with significant toxicities.
- Reviews & commentary2019
Risk of death associated with kratom use compared to opioids
Prev Med · Henningfield JE, Grundmann O, Babin JK, Fant RV, Wang DW, Cone EJ
Key finding: More research on kratom safety and risks is needed, as is regulation of commercial kratom products to ensure that consumers are informed by FDA labeling and that kratom products are not contaminated or adulterated with other substances.
- Human studies2017
Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis
BMJ · Sun EC, Dixit A, Humphreys K, Darnall BD, Baker LC, Mackey S
Key finding: If this association is causal, elimination of concurrent benzodiazepine/opioid use could reduce the risk of emergency room visits related to opioid use and inpatient admissions for opioid overdose by an estimated 15% (95% confidence…
- Surveillance2016
Notes from the Field: Kratom (Mitragyna speciosa) Exposures Reported to Poison Centers - United States, 2010-2015
MMWR Morb Mortal Wkly Rep · Anwar M, Law R, Schier J
Key finding: NPDS case records are the result of call reports made by the public and health care providers.
- Case reports2014
An accidental poisoning with mitragynine
Forensic Sci Int · Karinen R, Fosen JT, Rogde S, Vindenes V
Key finding: We recommend that both mitragynine and 7-hydroxymitragynine are analyzed for in cases with suspected Kratom intoxication.
- Case reports2011
Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend Krypton
J Anal Toxicol · Kronstrand R, Roman M, Thelander G, Eriksson A
Key finding: We believe that the addition of the potent mu-receptor agonist O-desmethyltramadol to powdered leaves from Kratom contributed to the unintentional death of the nine cases presented and conclude that intake of Krypton is not as harmless…
Dependence, withdrawal & treatment34
- Case reports2026
A Case of 7-Hydroxymitragynine Use Requiring Inpatient Medically Managed Withdrawal
J Addict Med · Wightman RS, Hu D
Key finding: Given the widespread availability of kratom and kratom-related products it is important for health care providers to screen for use and development of use disorder and be prepared to provide counseling, support, and treatment for patients.
- Case reports2026
Cardio-pulmonary arrest in a patient revived with naloxone following reported use of 7-hydroxymitragynine
Clin Toxicol (Phila · Pullman MK, Kanumuri SRR, Leon JF, Cutler SJ, McCurdy CR, Sharma A
No summary available; see the original.
- Case reports2026
Treatment of Kratom Use Disorder With Methadone in an Opioid Treatment Program
J Addict Med · Sherrick RC
Key finding: Methadone was well tolerated and effective in stabilizing patients with KUD, supporting its use as a viable alternative when buprenorphine is not suitable.
- Case reports2026
Management of acute withdrawal from 7-hydroxymitragynine after high-dose chronic use: A case report
J Am Pharm Assoc (2003 · Lybik N, Cone B, Skelton S, Elfessi Z
Key finding: Concentrated 7-OH products differ from kratom leaf and can produce dependence and withdrawal; pharmacists should screen for these products, time buprenorphine initiation to moderate withdrawal, provide harm-reduction counseling, and…
- Case reports2026
A Case of 7-Hydroxymitragynine Use Disorder Treated With Buprenorphine
J Addict Med · Hendler R, Karavolis Z, Kim J, Gonzalez G
Key finding: 7-HMG is a widely available, largely unregulated, underrecognized substance with potency at the µ-opioid receptor that may increasingly concern clinicians and policymakers.
- Case reports2026
Buprenorphine for the Management of 7-Hydroxymitragynine (7-OH) Use: A Retrospective Case Series
J Addict Med · Fenske E, Williams B, Hallock-Koppelman L, Buchheit BM
Key finding: Buprenorphine initiation for problematic 7-OH use was feasible, well tolerated, and associated with symptom improvement, supporting development of pragmatic clinical approaches for this emerging substance use disorder.
- Case reports2026
7-Hydroxymitragynine Withdrawal Treated With Buprenorphine-Naloxone
Prim Care Companion CNS Disord · Held JT, Varicat FP
No summary available; see the original.
- Case reports2026
Managing 7-Hydroxymitragynine Use Disorder with Buprenorphine-Naloxone
Hawaii J Health Soc Welf · Kiyokawa M, Chun A, Hsia C
Key finding: Therefore, clinicians are recommended to routinely inquire about patients' use of botanical supplements in addition to illicit substances.
- Case reports2025
Substance Use Disorder Following Consumption of a Novel Synthetic 7-Hydroxymitragynine Product
J Addict Med · Reif B, Adkins A, Boyer EW, Kanumuri SRR, Sharma A, Smith KE
Key finding: The potency of 7-OH places unwitting consumers who may believe they are using kratom, not a partial MOR agonist, at risk.
- Case reports2025
7-Hydroxymitragynine and Nicotine Pouch Withdrawal Syndrome: A Case Report
Cureus · Sharma A, Nair BS, Pemminati S
Key finding: This case report highlights the diagnostic and therapeutic complexities of managing withdrawal from novel psychoactive substances, the need for multidisciplinary and flexible approaches, and the importance of systematic assessment and…
- Reviews & commentary2025
The Impact of Diverse Kratom Products on Use Patterns, Dependence, and Toxicity
Curr Psychiatry Rep · Vadiei N, Evoy KE, Grundmann O
Key finding: And based on misleading advertising, consumers may be unaware of the differences and increased risks associated with these products compared with traditional whole leaf kratom.
- Human studies2024
Kratom addiction per DSM-5 SUD criteria, and kratom physical dependence: Insights from dosing amount versus frequency
Drug Alcohol Depend · Rogers JM, Weiss ST, Epstein DH, Grundmann O, Hill K, Smith KE
Key finding: Greater dose amount and frequency were systematically related to the number of withdrawal symptoms upon cessation and to KUD symptoms; the relationship was stronger for dose frequency than amount.
- Reviews & commentary2024
An update on the clinical pharmacology of kratom: uses, abuse potential, and future considerations
Expert Rev Clin Pharmacol · McCurdy CR, Sharma A, Smith KE, Veltri CA, Weiss ST, White CM et al.
Key finding: While many patients may benefit from kratom use with few or no reported adverse effects, escalating dose and increased use frequency raise the risk for toxic events in the setting of polysubstance use or development of a use disorder.
- Case reports2022
Long-term buprenorphine treatment for kratom use disorder: A case series
Subst Abus · Broyan VR, Brar JK, Allgaier Student T, Allgaier JT
Key finding: Our findings suggest buprenorphine/naloxone can be used as an effective treatment option for KUD.
- Human studies2021
Outcomes of mothers and newborns to prenatal exposure to kratom: a systematic review
J Perinatol · Wright ME, Ginsberg C, Parkison AM, Dubose M, Sherbondy M, Shores E
Key finding: Maternal and infant withdrawal from kratom exposure was described in each case, resulting in pharmacologic treatment for both mothers and infants.
- Human studies2021
Past-Year Kratom Use in the U.S.: Estimates From a Nationally Representative Sample
Am J Prev Med · Palamar JJ
Key finding: Kratom use is particularly prevalent among those with prescription opioid use disorder, but it is also prevalent among people who use other drugs.
- Case reports2021
Treatment of Kratom Withdrawal and Dependence With Buprenorphine/Naloxone: A Case Series and Systematic Literature Review
J Addict Med · Weiss ST, Douglas HE
Key finding: Based on our analysis, patients using <20 g of kratom/d could be initiated on opioid agonist therapy with 4/1 mg-8/2 mg buprenorphine-naloxone/d, while patients using kratom doses >40 g/d could be initiated with 12/3 mg-16/4 mg of…
- Animal studies2021
Kratom Alkaloids, Natural and Semi-Synthetic, Show Less Physical Dependence and Ameliorate Opioid Withdrawal
Cell Mol Neurobiol · Wilson LL, Chakraborty S, Eans SO, Cirino TJ, Stacy HM, Simons CA et al.
Key finding: In conclusion, while retaining some liabilities, kratom, mitragynine, and mitragynine pseudoindoxyl produced significantly less physical dependence and ameliorated precipitated withdrawal in morphine-dependent animals, suggesting some…
- Animal studies2021
Methadone, Buprenorphine, and Clonidine Attenuate Mitragynine Withdrawal in Rats
Front Pharmacol · Hassan R, Sreenivasan S, Müller CP, Hassan Z
Key finding: This may suggest them as treatment options also for problematic mitragynine/kratom use in humans.
- Human studies2020
Kratom (Mitragyna speciosa): User demographics, use patterns, and implications for the opioid epidemic
Drug Alcohol Depend · Garcia-Romeu A, Cox DJ, Smith KE, Dunn KE, Griffiths RR
Key finding: Kratom is used among White, middle-aged Americans for symptoms of pain, anxiety, depression, and opioid withdrawal.
- Lab (in vitro)2020
G protein-biased kratom-alkaloids and synthetic carfentanil-amide opioids as potential treatments for alcohol use disorder
Br J Pharmacol · Gutridge AM, Robins MT, Cassell RJ, Uprety R, Mores KL, Ko MJ et al.
Key finding: Our results suggest that kratom extracts can decrease alcohol intake but still carry significant risk upon prolonged use.
- Lab (in vitro)2020
Investigation of the Adrenergic and Opioid Binding Affinities, Metabolic Stability, Plasma Protein Binding Properties, and Functional Effects of Selected Indole-Based Kratom Alkaloids
J Med Chem · Obeng S, Kamble SH, Reeves ME, Restrepo LF, Patel A, Behnke M et al.
Key finding: The observed polypharmacology of kratom alkaloids may support its utilization to treat opioid use disorder and withdrawal.
- Reviews & commentary2020
The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update
J Addict Med · (2020). J Addict Med. PMID 32511106 | DOI 10.1097/ADM.0000000000000633
No summary available; see the original.
- Reviews & commentary2020
Kratom Dependence and Treatment Options: A Comprehensive Review of the Literature
Curr Drug Targets · Bin Abdullah MFIL
Key finding: We conclude by adding a note on the research gap concerning kratom dependence, which future studies should focus on.
- Case reports2019
Kratom Withdrawal: A Systematic Review with Case Series
J Psychoactive Drugs · Stanciu CN, Gnanasegaram SA, Ahmed S, Penders T
Key finding: Clinicians need to be aware of the withdrawal symptomatology and implement a similar approach as for opioid withdrawal with long-term maintenance to prevent relapse.
- Animal studies2019
Abuse liability and therapeutic potential of the Mitragyna speciosa (kratom) alkaloids mitragynine and 7-hydroxymitragynine
Addict Biol · Hemby SE, McIntosh S, Leon F, Cutler SJ, McCurdy CR
Key finding: The present findings indicate that MG does not have abuse potential and reduces morphine intake, desired characteristics of candidate pharmacotherapies for opiate addiction and withdrawal, whereas 7-HMG should be considered a kratom…
- Case reports2018
Neonatal Abstinence Syndrome Due to Maternal Kratom Use
Pediatrics · Eldridge WB, Foster C, Wyble L
Key finding: Pediatricians and parents should be aware of the risk of NAS due to Kratom use during pregnancy.
- Human studies2017
Patterns of Kratom use and health impact in the US-Results from an online survey
Drug Alcohol Depend · Grundmann O
Key finding: Kratom shows a dose-dependent opioid-like effect providing self-reported perceived beneficial effects in alleviating pain and relieving mood disorders.
- Lab (in vitro)2016
Mitragynine/Corynantheidine Pseudoindoxyls As Opioid Analgesics with Mu Agonism and Delta Antagonism, Which Do Not Recruit β-Arrestin-2
J Med Chem · Váradi A, Marrone GF, Palmer TC, Narayan A, Szabó MR, Le Rouzic V et al.
Key finding: Additionally, 3 developed analgesic tolerance more slowly than morphine, showed limited physical dependence, respiratory depression, constipation, and displayed no reward or aversion in CPP/CPA assays, suggesting that analogs might…
- Reviews & commentary2016
Traditional and non-traditional uses of Mitragynine (Kratom): A survey of the literature
Brain Res Bull · Singh D, Narayanan S, Vicknasingam B
Key finding: Despite its addictive properties, reported side-effects and its tendency to be used a recreational drug, more scientific clinical human studies are necessary to determine its potential therapeutic value.
- Human studies2014
Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users
Drug Alcohol Depend · Singh D, Müller CP, Vicknasingam BK
Key finding: The findings from this study show that regular Kratom use is associated with drug dependency, development of withdrawal symptoms, and craving.
- Case reports2008
Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth)
Addiction · Boyer EW, Babu KM, Adkins JE, McCurdy CR, Halpern JH
Key finding: We report the self-treatment of chronic pain and opioid withdrawal with kratom.
- Product testing2007
Self-administration of drugs in animals and humans as a model and an investigative tool
Addiction · Panlilio LV, Goldberg SR
Key finding: The identification of drug use as behavior that is reinforced by drugs has contributed greatly to the understanding and treatment of addiction.
- Animal studies2005
Antinociception, tolerance and withdrawal symptoms induced by 7-hydroxymitragynine, an alkaloid from the Thai medicinal herb Mitragyna speciosa
Life Sci · Matsumoto K, Horie S, Takayama H, Ishikawa H, Aimi N, Ponglux D et al.
Key finding: These interesting characters of 7-hydroxymitragynine promote further investigation of it as a novel lead compound for opioid studies.
Liver & organ effects13
- Human studies2026
Liver Injury Associated With Kratom ( Mitragyna speciosa ): A Systematic Review
J Addict Med · Calicdan XA, Kopczynski A, Medina E, Singh S, Sotelo D, Wu AC et al.
Key finding: Further research is needed to better characterize kratom's mechanisms of liver injury and to inform clinical decision-making and public health policy.
- Case reports2026
Rhabdomyolysis, renal failure and chronic neurologic deficits after prolonged immobilization from use of a 7-hydroxymitragynine product
Clin Toxicol (Phila · Dorey A, Gerona R, Bell J, Ellison R, Moss M
No summary available; see the original.
- Case reports2025
Kratom Cardiotoxicity: Reversible Brugada Pattern and QTc Prolongation
JACC Case Rep · Miller AHF, Krotulski AJ, Walton SE, Dulaney AR, Frolichstein AP, Dusek HL et al.
Key finding: We present a patient who developed a reversible Brugada pattern and QT prolongation after self-treating his attention-deficit/hyperactivity disorder with kratom.
- Case reports2021
Liver injury associated with kratom, a popular opioid-like product: Experience from the U.S. drug induced liver injury network and a review of the literature
Drug Alcohol Depend · Ahmad J, Odin JA, Hayashi PH, Fontana RJ, Conjeevaram H, Avula B et al.
Key finding: Kratom can cause severe liver injury with jaundice.
- Case reports2021
Breakthrough Seizure Associated With Kratom Use in Patients With Epilepsy
Neurol Clin Pract · Burke DJ, Mahonski SG, Van Cott AC
Key finding: Neurologists need to be aware of its association with seizure and other neurologic side effects.
- Case reports2021
Seizures among young adults consuming kratom beverages in Malaysia: A case series
Epilepsy Behav · Halim SA, Low JH, Chee YC, Alias MR
Key finding: This study provided indirect evidence that chronic kratom use with or without concomitant drug abuse can cause recurrent seizures in susceptible individuals, which may progress to epilepsy or require antiepileptic medication.
- Animal studies2021
Oral Pharmacokinetics in Beagle Dogs of the Mitragynine Metabolite, 7-Hydroxymitragynine
Eur J Drug Metab Pharmacokinet · Maxwell EA, King TI, Kamble SH, Raju KSR, Berthold EC, León F et al.
Key finding: These results provide the first pharmacokinetic and safety data for 7-HMG in the dog and therefore contribute to the understanding of the putative pharmacologic role of 7-HMG resulting from an oral delivery of mitragynine from kratom.
- Case reports2020
Kratom (Mitragyna Speciosa) Liver Injury: A Comprehensive Review
Drugs · Schimmel J, Dart RC
Key finding: It remains unclear which subgroups of users are at heightened risk.
- Case reports2020
A Case of Kratom-induced Seizures
Cureus · Afzal H, Esang M, Rahman S
Key finding: This case highlights the life-threatening complications of Kratom that is easily available online.
- Human studies2019
Metabolite profiling and identification of enzymes responsible for the metabolism of mitragynine, the major alkaloid of Mitragyna speciosa (kratom)
Xenobiotica · Kamble SH, Sharma A, King TI, León F, McCurdy CR, Avery BA
Key finding: The CYP3A4 enzyme plays a predominant role in the metabolic clearance of mitragynine and also in the formation of 7-hydroxymitragynine (Met2), a known active minor alkaloid identified in the leaf material.
- Case reports2018
Recurrent seizures from chronic kratom use, an atypical herbal opioid
Epilepsy Behav Case Rep · Tatum WO, Hasan TF, Coonan EE, Smelick CP
Key finding: Our case suggests Kratom abuse may be associated with structural brain lesions on MRI and symptomatic focal epilepsy.
- Lab (in vitro)2016
Mitragynine and its potential blocking effects on specific cardiac potassium channels
Toxicol Appl Pharmacol · Tay YL, Teah YF, Chong YM, Jamil MFA, Kollert S, Adenan MI et al.
Key finding: Blocking of both hERG and GIRK channels may cause additive cardiotoxicity risks.
- Case reports2010
Seizure and coma following Kratom (Mitragynina speciosa Korth) exposure
J Med Toxicol · Nelsen JL, Lapoint J, Hodgman MJ, Aldous KM
Key finding: The proposed mechanism for this reaction is unclear but suggested mechanisms include adenosine binding or stimulation of adrenergic and/or serotonergic receptors similar to tramadol.
Regulation & policy26
- Lab (in vitro)2026
Quantitative analysis of 7-hydroxymitragynine in commercial kratom products and its stability under chemical and physiological conditions
Phytochemistry · Avula B, Ali SK, Tatapudi KK, Pandey P, Cheepilla L, Husain I et al.
Key finding: These findings underscore significant safety concerns over oral 7-OH products and necessitate validated analytical monitoring to guide regulatory oversight and consumer protection.
- Lab (in vitro)2026
Effects of 7-hydroxymitragynine on serotonin, amino acid profiles, and ion homeostasis in SH-SY5Y cells
Mol Biol Rep · Chujan S, Vajeethaveesin N, Rittapai N, Pholphana N, Nookabkaew S, Satayavivad J
Key finding: Together, these findings show that 7-HMG induced significant metabolic and ionic disturbances in neuronal cells, providing new mechanistic insight into its neurobiological activity and potential neurotoxicity.
- Reviews & commentary2026
ACMT Position Statement: Public Health Risks of 7-Hydroxymitragynine and Other Kratom-Associated Compounds
J Med Toxicol · Moss MJ, Altholz J, Babu K, Perrone J, Stolbach A
No summary available; see the original.
- Reviews & commentary2026
ACMT 2026 Position Statement Public Health Concerns 7-OH and Other Kratom Compounds
Agency / organization document · ACMT
No summary available; see the original.
- Agency & legal documents2026
DEA 2026 Notice of Intent Temporary Placement of 7-OH Above a Threshold FR 2026-13580
Agency / organization document · DEA
Key finding: DEA notice of intent to temporarily place 7-OH above a threshold in Schedule I (docket DEA-1570).
- Agency & legal documents2026
DEA 2026 Temporary Placement of MGPI MGM-15 and MGM-16 in Schedule I FR 2026-17429
Agency / organization document · DEA
Key finding: DEA temporary Schedule I placement of MGPI, MGM-15 and MGM-16.
- Agency & legal documents2026
DEA 2026 Notice of Intent Temporary Placement of 7-OH and MGPI Above a Threshold FR 2026-20943
Agency / organization document · DEA
Key finding: DEA notice of intent: temporary Schedule I placement of 7-OH and MGPI above a specified threshold.
- Agency & legal documents2026
FDA 2026 Hiding in Plain Sight 7-OH Products
Agency / organization document · FDA
No summary available; see the original.
- Agency & legal documents2026
FDA 2026 Import Alert 54-15 Kratom
Agency / organization document · FDA
No summary available; see the original.
- Agency & legal documents2026
DEA 2026 Press Release Temporarily Schedule 7-OH and Related Substances
Agency / organization document · DEA
No summary available; see the original.
- Agency & legal documents2026
HHS 2026 Press Release HHS and FDA Support DEA 7-OH Scheduling
Agency / organization document · HHS
No summary available; see the original.
- Agency & legal documents2026
CRS 2026 Legal Sidebar LSB11457 Temporary Control of 7-OH
Agency / organization document · CRS
No summary available; see the original.
- Agency & legal documents2026
Beyond kratom: Concentrated 7-hydroxymitragynine and mitragynine pseudoindoxyl products, an MME potency assessment
Regul Toxicol Pharmacol · Heywood J, Farnham H, Jackson E, Steimel K, Brown S, Riordan A
Key finding: Drug Enforcement Administration's July 2026 notice of scheduling intent, while traditional preparations retain non-negligible, mitragynine-ceiling-limited opioid activity.
- Human studies2025
Chemical Analysis and Alkaloid Intake for Kratom Products Available in the United States
Drug Test Anal · Sharma A, Smith KE, Kuntz MA, Berthold EC, Elashkar OI, Guadagnoli N et al.
Key finding: These findings on kratom products' chemical composition and daily kratom alkaloid consumption can also inform clinicians, policymakers, and consumers, particularly for whole-leaf material.
- Reviews & commentary2025
From Kratom to Semi-Synthetic Opioids: The Rise and Risks of MGM-15
Drug Test Anal · Gour A, Mukhopadhyay S, Henderson A, Awad A, Seabra MA, Pullman M et al.
Key finding: MGM-15 shows greater hMOR and hDOR binding affinities than 7-HMG, indicating the potential for higher opioid effects and risks, emphasizing the urgent need for more research to advise regulation and hopefully prevent misuse and harm.
- Agency & legal documents2025
LAPPA 2025 Kratom Summary of State Laws
Agency / organization document · LAPPA
No summary available; see the original.
- Agency & legal documents2025
FDA 2025 Consumer Update Products Containing 7-OH Can Cause Serious Harm
Agency / organization document · FDA
No summary available; see the original.
- Agency & legal documents2025
FDA 2025 Press Release Warning Letters to Firms Marketing 7-OH
Agency / organization document · FDA
No summary available; see the original.
- Agency & legal documents2025
FDA 2025 Press Release Steps to Restrict 7-OH Opioid Products
Agency / organization document · FDA
No summary available; see the original.
- Agency & legal documents2025
FDA 2025 Press Release FDA Seizes 7-OH Opioids
Agency / organization document · FDA
No summary available; see the original.
- Case reports2024
Ventricular fibrillation during football training as a consequence of kratom and caffeine use in an adolescent: case report
Eur Heart J Case Rep · Dodulík J, Plášek J, Handlos P, Gřegořová A, Václavík J
Key finding: We would like to stress the importance of reporting further case series for more scientific evidence and thus increasing the pressure for stricter availability and regulation of kratom in some countries, especially where it is…
- Reviews & commentary2021
Kratom Abuse Potential 2021: An Updated Eight Factor Analysis
Front Pharmacol · Henningfield JE, Wang DW, Huestis MA
Key finding: Regulation to minimize risks of contaminated, adulterated, and inappropriately marketed products is recommended.
- Lab (in vitro)2019
Mitragynine, an euphoric compound inhibits hERG1a/1b channel current and upregulates the complexation of hERG1a-Hsp90 in HEK293-hERG1a/1b cells
Sci Rep · Tay YL, Amanah A, Adenan MI, Wahab HA, Tan ML
Key finding: In conclusion, mitragynine inhibits hERG1a/1b current through direct channel blockade at lower concentration, but at higher concentration, it upregulates the complexation of hERG1a-Hsp90 which may be inhibitory towards channel trafficking.
- Reviews & commentary2018
The abuse potential of kratom according the 8 factors of the controlled substances act: implications for regulation and research
Psychopharmacology (Berl · Henningfield JE, Fant RV, Wang DW
Key finding: Although kratom appears to have pharmacological properties that support some level of scheduling, if it was an approved drug, placing it into Schedule I, thus banning it, risks creating public health problems that do not presently exist.
- Reviews & commentary2017
Changing trends in the use of kratom (Mitragyna speciosa) in Southeast Asia
Hum Psychopharmacol · Singh D, Narayanan S, Vicknasingam B, Corazza O, Santacroce R, Roman-Urrestarazu A
Key finding: Legal sanctions appear to have preceded serious scientific investigations into the claimed benefits of ketum.
- Agency & legal documents
DEA Drug Fact Sheet Kratom
Agency / organization document · DEA
No summary available; see the original.
Products & market32
- Human studies2026
Prevalence and Use Patterns of Kratom (Mitragyna speciosa Korth.) in a US Nationally Representative Sample
J Psychoactive Drugs · Grundmann O, Green M, Berthold E, Yoon SL, Ray D
Key finding: The lack of standardization and consistency in kratom products results in unpredictable effects, emphasizing the need for increased research to establish reliable safety guidelines for dosage recommendations.
- Human studies2026
A Pilot, Dose-Finding, Pharmacodynamic and Pharmacokinetic Study of Orally Administered Botanical Kratom
J Clin Psychopharmacol · Reissig CJ, Chen L, Nallani SC, Hawkins EG, Galati S, Bonson K et al.
Key finding: This study investigated the safety of single-sourced botanical kratom; the results may not be representative of other kratom-containing products.
- Case reports2026
Ventricular Tachycardia Following Kratom Ingestion Requiring Extracorporeal Membrane Oxygenation in a Young Woman: Case Report
Clin Pract Cases Emerg Med · McLin-Evans M, Tiscareno J, Beneke LL
Key finding: Concentrated kratom extracts can precipitate life-threatening ventricular arrhythmias in previously healthy individuals.
- Lab (in vitro)2026
Genotoxicity risk assessment of a 7-hydroxymitragynine-enriched Kratom preparation: An integrated in silico and in vitro approach
Toxicol Rep · Harnkit N, Sahad T, Noonate I, Primpai P, Radapong S, Pipatrattanaseree W et al.
Key finding: This study underscores the value of a combined computational and experimental workflow for the robust genotoxicity assessment of complex natural products.
- Reviews & commentary2026
7-OH and kratom vaping products: an emerging public health threat
Toxicol Sci · Schichlein KD, Kim HH, Porter NA, Jaspers I
No summary available; see the original.
- Reviews & commentary2026
A Call to Colleagues on Concentrated Synthetic 7-OH
Subst Abuse Rehabil · Gold MS, Avena NM, Badgaiyan RD, Thanos PK, Blum K
No summary available; see the original.
- Product testing2026
Elevated 7-Hydroxymitragynine Levels Found in Products Misbranded as Kratom
J AOAC Int · Brown PN, Chan M, Zhang X, Brendler T
Key finding: The products were verified to contain very high levels of 7-hydroxymitragynine, achievable only by synthetic means.
- Product testing2026
Avoiding False Identification of 7-Hydroxymitragynine in Kratom Products Using a Multicriteria LC-MS Confirmation
J Am Soc Mass Spectrom · Sheehan D, Li Y, Meckler E, Upton R, Zhang M
Key finding: These results highlight the importance of integrating chromatographic resolution with orthogonal MS/MS criteria for reliable identification of kratom alkaloids and provide an analytical framework for the characterization of complex…
- Product testing2026
Unlabeled kratom alkaloids detected in products marketed as kava
Clin Toxicol (Phila · Marshall S, Leisch L, Scott KS, Rivera J, Whiddon J, Bradford D et al.
Key finding: Unrecognized exposure to opioid-active kratom compounds may occur through products marketed as kava, highlighting the need for improved surveillance and increased awareness.
- Product testing2026
Effects of Botanical Variation, Plant Part, and Extraction Technique on Mitragynine and 7-Hydroxymitragynine in Kratom (Mitragyna speciosa) Extracts Quantified by a Validated HPLC-DAD Method
Molecules · Krongrawa W, Ponphaiboon J, Koedruen J, Samran C, Limmatvapirat S, Limmatvapirat C
Key finding: These findings highlight substantial phytochemical variability relevant to quality standardization of kratom-derived products.
- Agency & legal documents2026
HHS 2026 Press Release HHS Recommends Thresholds for Enhanced Kratom Products
Agency / organization document · HHS
No summary available; see the original.
- Case reports2025
Complicating Factors Surrounding Concurrent Use of Kratom and a Novel 7-hydroxymitragynine Product Among a Participant Enrolled in a Kratom Clinical Trial
J Addict Med · Smith KE, Rama Raju Kanumuri S, Sharma A, Rattenni R, LeComte R, McCurdy CR et al.
Key finding: As 7-OH products are misleadingly marketed as kratom, and as both long-time kratom consumers and kratom-naive individuals may experiment with these novel products, improved assessment methods are urgently needed in the absence of…
- Surveillance2025
De facto opioids: Characterization of novel 7-hydroxymitragynine and mitragynine pseudoindoxyl product marketing
Drug Alcohol Depend · Hill K, Boyer EW, Grundmann O, Smith KE
Key finding: Several products had names alluding to prescription opioids.
- Surveillance2025
A Descriptive Assessment of Products Containing the Opioid Receptor Stimulator Mitragynine Pseudoindoxyl
Subst Use Misuse · White CM, Belcourt J, Sedensky A
Key finding: Conclusions: There are many products that contain mitragynine pseudoindoxyl sold as dietary supplements and many have features that would appeal to children.
- Animal studies2025
Mitragynine and 7-hydroxymitragynine: Bidirectional effects on breathing in rats
J Pharmacol Exp Ther · Zuarth Gonzalez JD, Ragsdale AK, Mukhopadhyay S, McCurdy CR, McMahon LR, Obeng S et al.
Key finding: These findings highlight critical pharmacological differences between kratom-related alkaloids, emphasizing potential risks associated with products containing high concentrations of 7-HMG.
- Lab (in vitro)2025
Discovery of rhynchophylline and mitraphylline in two Thai Mitragyna species and the investigation of their biological activity via opioid gene expression analysis
Sci Rep · Sudmoon R, Tanee T, Wonok W, Ameamsri U, Liehr T, Daduang S et al.
Key finding: These Mitragyna species and the combination (formula details are patent registered), substances and their biological activities can be used for the innovative production of new medicines and further clinical investigation.
- Lab (in vitro)2025
Inhibitory effects of Kratom constituents, mitragynine and 7-hydroxymitragynine, on 4-methylumbelliferone glucuronidation by human UDP-glucuronosyltransferases
Toxicol Rep · Uchaipichat V
Key finding: The experimental Ki values found here are relatively high compared to the maximum plasma concentrations of mitragynine and 7-hydroxymitragynine reported in humans, suggesting an unlikely potential for herb-drug interactions via UGT…
- Reviews & commentary2025
The rise of novel, semi-synthetic 7-hydroxymitragnine products
Addiction · Smith KE, Boyer EW, Grundmann O, McCurdy CR, Sharma A
No summary available; see the original.
- Product testing2025
Phytochemical analysis of water and ethanol liquid extracts prepared using freshly harvested leaves of Mitragyna speciosa (Korth.)
Nat Prod Res · Karunakaran T, Vicknasingam B, Chawarski MC
Key finding: Further rigorous and comprehensive evaluations of the phytochemical composition of freshly harvested kratom leaves utilising advanced spectrometric methods are needed to establish the full spectrum of phytochemicals within the plant.
- Human studies2024
Time course of kratom effects via ecological momentary assessment, by product type, dose amount, and assayed alkaloid content
Drug Alcohol Depend · Smith KE, Panlilio LV, Sharma A, McCurdy CR, Feldman JD, Mukhopadhyay S et al.
Key finding: Alkaloid content was surprisingly consistent across kratom products, and participants were consistent in the amount they used across events.
- Reviews & commentary2024
Not all kratom is equal: The important distinction between native leaf and extract products
Addiction · Grundmann O, Garcia-Romeu A, McCurdy CR, Sharma A, Smith KE, Swogger MT et al.
No summary available; see the original.
- Human studies2023
Clinical Assessment of the Drug Interaction Potential of the Psychotropic Natural Product Kratom
Clin Pharmacol Ther · Tanna RS, Nguyen JT, Hadi DL, Layton ME, White JR, Cech NB et al.
Key finding: These data fill critical knowledge gaps about the safe use of this increasingly popular natural product, thereby addressing ongoing public health concerns.
- Product testing2023
Seasonal and Geographic Variation in Alkaloid Content of Kratom (Mitragyna speciosa (Korth.) Havil.) from Thailand
Plants (Basel · Sengnon N, Vonghirundecha P, Chaichan W, Juengwatanatrakul T, Onthong J, Kitprasong P et al.
Key finding: In conclusion, the present study suggested that the alkaloid content in kratom diverges based on seasonal and geographical origin.
- Human studies2022
Searching for a Signal: Self-Reported Kratom Dose-Effect Relationships Among a Sample of US Adults With Regular Kratom Use Histories
Front Pharmacol · Smith KE, Rogers JM, Dunn KE, Grundmann O, McCurdy CR, Schriefer D et al.
Key finding: These can help inform the development of controlled observational and experimental studies needed to advance the public health understanding of kratom product use.
- Human studies2022
Clinical Pharmacokinetic Assessment of Kratom (Mitragyna speciosa), a Botanical Product with Opioid-like Effects, in Healthy Adult Participants
Pharmaceutics · Tanna RS, Nguyen JT, Hadi DL, Manwill PK, Flores-Bocanegra L, Layton ME et al.
Key finding: This first comprehensive pharmacokinetic characterization of kratom alkaloids in humans provides the foundation for further research to establish safety and effectiveness of this emerging botanical product.
- Animal studies2021
Preclinical pharmacokinetic study of speciociliatine, a kratom alkaloid, in rats using an UPLC-MS/MS method
J Pharm Biomed Anal · Berthold EC, Kamble SH, Raju KS, King TI, Popa R, Sharma A et al.
Key finding: The speciociliatine pharmacokinetic parameters described here will help to better understand the overall effects reported with kratom product use.
- Animal studies2021
Pharmacokinetics of Eleven Kratom Alkaloids Following an Oral Dose of Either Traditional or Commercial Kratom Products in Rats
J Nat Prod · Kamble SH, Berthold EC, King TI, Raju Kanumuri SR, Popa R, Herting JR et al.
Key finding: This information will contribute to understanding the role of each alkaloid in the overall pharmacology of kratom and elucidating the pharmacokinetic differences between traditional and commercial kratom products.
- Lab (in vitro)2020
Metabolism of a Kratom Alkaloid Metabolite in Human Plasma Increases Its Opioid Potency and Efficacy
ACS Pharmacol Transl Sci · Kamble SH, León F, King TI, Berthold EC, Lopera-Londoño C, Siva Rama Raju K et al.
Key finding: This novel metabolite is formed in human plasma to a much greater extent than in the preclinical species tested (mouse, rat, dog, and cynomolgus monkey) and due to its μ-opioid potency may substantially contribute to the pharmacology of…
- Product testing2019
Simultaneous quantification of ten key Kratom alkaloids in Mitragyna speciosa leaf extracts and commercial products by ultra-performance liquid chromatography-tandem mass spectrometry
Drug Test Anal · Sharma A, Kamble SH, León F, Chear NJ, King TI, Berthold EC et al.
Key finding: Minor kratom alkaloids (corynantheidine, corynoxine, corynoxine B, 7-hydroxymitragynine, isocorynantheidine) were also quantified (0.01%-2.8% w/w) in the analyzed products; however mitraphylline was below the lower limit of…
- Product testing2016
Suspected Adulteration of Commercial Kratom Products with 7-Hydroxymitragynine
J Med Toxicol · Lydecker AG, Sharma A, McCurdy CR, Avery BA, Babu KM, Boyer EW
Key finding: We have found multiple packaged commercial Kratom products likely to contain artificially elevated concentrations of 7-hydroxymitragynine, the alkaloid responsible for M.
- Reviews & commentary2015
Following "the Roots" of Kratom (Mitragyna speciosa): The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries
Biomed Res Int · Cinosi E, Martinotti G, Simonato P, Singh D, Demetrovics Z, Roman-Urrestarazu A et al.
Key finding: Finally, it concludes that the use of kratom is not negligible, especially for self-medication, and more clinical, pharmacological, and socioanthropological studies as well as a better international collaboration are needed to tackle…
- Lab (in vitro)2011
Uniform assessment and ranking of opioid μ receptor binding constants for selected opioid drugs
Regul Toxicol Pharmacol · Volpe DA, McMahon Tobin GA, Mellon RD, Katki AG, Parker RJ, Colatsky T et al.
Key finding: These data add to the understanding of the pharmacology of opioid drugs and support the development of a more consistent labeling policies regarding safe disposal.
Pharmacology & chemistry76
- Case reports2026
Brugada Syndrome Unmasked by Kratom Use in a Young Man
JACC Case Rep · Matthews JG, Perkins DR, Adrejiya P, Donkor DKA
Key finding: Increased awareness of its cardiovascular risks is important for both clinicians and public health.
- Case reports2026
7-OH-Mitragynine-Induced Psychosis and Delirium
Prim Care Companion CNS Disord · Elrokhsi NS, Lam CK, Balasanova AA
No summary available; see the original.
- Case reports2026
Increasing Awareness of 7-Hydroxymitragynine and the Threat of Emerging Opioids
J Adolesc Health · Engle K, Downey AE, Vais S, Raymond-Flesch M
No summary available; see the original.
- Surveillance2026
CFSRE 2026 NPS Discovery Trend Reports Q1
Agency / organization document · CFSRE
No summary available; see the original.
- Surveillance2026
CFSRE 2026 Monograph Dihydro-7-Hydroxy Mitragynine
Agency / organization document · CFSRE
No summary available; see the original.
- Animal studies2026
Physiologically Based Pharmacokinetic Model for Clinical Translation and Prediction of Drug Interaction of the Major Kratom Alkaloid, Mitragynine
ACS Pharmacol Transl Sci · Chiang YH, Kanumuri SRR, Berthold EC, Kamble SH, Gour A, Kuntz MA et al.
Key finding: This comprehensive model supports the therapeutic development of MTG.
- Animal studies2026
Bayesian inference for integrated pharmacokinetic modelling of mitragynine and 7-hydroxymitragynine
ADMET DMPK · Notario D, Gunawan U, Kambira PFA, Wulandari E, Prasetyanto EA
Key finding: The pharmacokinetics of mitragynine and 7-hydroxymitragynine were successfully modelled simultaneously with two compartments and proportional residuals using Bayesian inference with high accuracy.
- Reviews & commentary2026
Cardiovascular Effects of Kratom (Mitragyna speciosa)
Cardiol Rev · Wu C, Gastelum S, Al-Fakhoury J, Bowes N, Khamashta K, Crupi J et al.
Key finding: Greater clinical awareness and prospective research using standardized kratom preparations are needed to clarify its cardiovascular risks, potential benefits, and clinically relevant drug interactions.
- Reviews & commentary2026
UW ADAI 2026 7-OH Explainer
Agency / organization document · UW
No summary available; see the original.
- Reviews & commentary2026
Labcorp 2026 Kratom and 7-OH Common Provider Questions
Agency / organization document · Labcorp
No summary available; see the original.
- Agency & legal documents2026
HHS 2026 Extension of Comment Period 7-OH Threshold FR 2026-17409
Agency / organization document · HHS
Key finding: Federal Register notice extending the comment period on the 7-OH threshold proposal.
- Case reports2025
A Kratomic Bomb: Cardiotoxicities From Mitragyna speciosa Extract
JACC Case Rep · Jain V, Lloyd MS
No summary available; see the original.
- Case reports2025
Case Report: Cannabis and kratom-induced self-amputation of ears and penis
Front Psychiatry · Broul M, Rudenko X, Bajus A, Král J, Kyenge DM, Staňková Z et al.
Key finding: This case underscores the importance of using a multidisciplinary approach to manage severe self-harm behaviors, and highlights the critical role of patient motivation in achieving positive outcomes.
- Case reports2025
Chronic kratom use as a precipitant for acquired Brugada syndrome
HeartRhythm Case Rep · Abubaker M, Adrejiya P, Berhe L, Chennareddy S, Kanugula A
No summary available; see the original.
- Surveillance2025
CFSRE 2025 NPS Discovery Public Alert 7-Hydroxy Mitragynine
Agency / organization document · CFSRE
No summary available; see the original.
- Surveillance2025
CFSRE 2025 Monograph Mitragynine Pseudoindoxyl
Agency / organization document · CFSRE
No summary available; see the original.
- Lab (in vitro)2025
In Vitro and In Vivo Pharmacokinetic Characterization of 7-Hydroxymitragynine, an Active Metabolite of Mitragynine, in Sprague-Dawley Rats
Eur J Drug Metab Pharmacokinet · Chiang YH, Kanumuri SRR, Kuntz MA, Senetra AS, Berthold EC, Kamble SH et al.
Key finding: This study reports the pharmacokinetic parameters of 7-HMG to help with the development of mitragynine, as a therapeutic.
- Lab (in vitro)2025
In Vitro Pharmacology of Mitragynine at α-Adrenoceptors
ACS Chem Neurosci · Chen Y, Seto J, Obeng S, Mottinelli M, Mukhopadhyay S, Tyagi R et al.
Key finding: Mitragynine's dual α2AR antagonist/α1R partial agonist pharmacology might contribute to mitragynine's psychostimulant-like properties.
- Reviews & commentary2025
What to Know About 7-OH, the New Vape Shop Hazard
JAMA · Anderer S
No summary available; see the original.
- Reviews & commentary2025
NC STAR 2025 Clinical Tip Sheet Kratom and 7-OH
Agency / organization document · NC
No summary available; see the original.
- Reviews & commentary2025
Pennsylvania DOH 2025 Health Advisory Kratom and 7-OH
Agency / organization document · Pennsylvania
No summary available; see the original.
- Reviews & commentary2025
Texas DSHS 2025 Serious Illnesses Associated with 7-OH Use
Agency / organization document · Texas
No summary available; see the original.
- Reviews & commentary2025
LA County DPH 2025 Health Alert 7-OH
Agency / organization document · LA
No summary available; see the original.
- Human studies2024
Effects of Itraconazole on Pharmacokinetics of Mitragynine and 7-Hydroxymitragynine in Healthy Volunteers
ACS Pharmacol Transl Sci · Mongar P, Jaisi A, Inkviya T, Wungsintaweekul J, Wiwattanawongsa K
Key finding: This study provides the first evidence of metabolic conversion of mitragynine to 7OH in humans.
- Lab (in vitro)2024
The Mitragyna speciosa (kratom) alkaloid mitragynine: Analysis of adrenergic α2 receptor activity in vitro and in vivo
Eur J Pharmacol · Obeng S, Crowley ML, Mottinelli M, León F, Zuarth Gonzalez JD, Chen Y et al.
Key finding: Together, these data demonstrate that mitragynine acts in vivo like an Aα2R agonist, although its failure to induce hypothermia or stimulate [35S]GTPγS binding in vitro, suggests that mitragynine maybe a low efficacy Aα2R agonist.
- Surveillance2023
Ventricular Arrhythmias Associated With Over-the-Counter and Recreational Opioids
J Am Coll Cardiol · Krantz MJ, Rudo TJ, Haigney MCP, Stockbridge N, Kleiman RB, Klein M et al.
Key finding: The nonprescription drugs loperamide and mitragynine are associated with disproportionate reports of life-threatening ventricular arrhythmia in North America.
- Surveillance2023
SAMHSA 2023 NSDUH 2022 Detailed Tables 8-21 to 8-23
Agency / organization document · SAMHSA
No summary available; see the original.
- Animal studies2023
Pharmacokinetic and Pharmacodynamic Consequences of Cytochrome P450 3A Inhibition on Mitragynine Metabolism in Rats
J Pharmacol Exp Ther · Kamble SH, Obeng S, León F, Restrepo LF, King TI, Berthold EC et al.
Key finding: These data highlight potential interactions between kratom and CYP3A inhibitors, which include numerous medications and citrus juices.
- Animal studies2023
Assessment of the potential of novel and classical opioids to induce respiratory depression in mice
Br J Pharmacol · Hill R, Sanchez J, Lemel L, Antonijevic M, Hosking Y, Mistry SN et al.
Key finding: In addition to providing effective anti-nociception, the novel opioids, oliceridine, tianeptine and SR-17018 depress respiration in male mice.
- Lab (in vitro)2023
Total Synthesis and Structural Plasticity of Kratom Pseudoindoxyl Metabolites
Angew Chem Int Ed Engl · Angyal P, Hegedüs K, Mészáros BB, Daru J, Dudás Á, Galambos AR et al.
Key finding: Synthetic-chemistry paper (link only; omitted from summary).
- Reviews & commentary2023
Understanding and countering opioid-induced respiratory depression
Br J Pharmacol · Bateman JT, Saunders SE, Levitt ES
Key finding: To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v180.7/issuetoc.
- Reviews & commentary2023
A Critical Review of the Neuropharmacological Effects of Kratom: An Insight from the Functional Array of Identified Natural Compounds
Molecules · Hossain R, Sultana A, Nuinoon M, Noonong K, Tangpong J, Hossain KH et al.
Key finding: In this context, this review focuses on the research gap to resolve ambiguities about the neuronal effects of kratom and demonstrate its prospects as a therapeutic target for neurological disorders associated with other pharmacological…
- Animal studies2022
The Lack of Contribution of 7-Hydroxymitragynine to the Antinociceptive Effects of Mitragynine in Mice: A Pharmacokinetic and Pharmacodynamic Study
Drug Metab Dispos · Berthold EC, Kamble SH, Raju KS, Kuntz MA, Senetra AS, Mottinelli M et al.
Key finding: The results of this study suggest a lack of involvement of 7HMG in the antinociceptive effects of MTG in mice.
- Animal studies2022
The respiratory depressant effects of mitragynine are limited by its conversion to 7-OH mitragynine
Br J Pharmacol · Hill R, Kruegel AC, Javitch JA, Lane JR, Canals M
Key finding: Both the anti-nociceptive effects and the respiratory depressant effects of mitragynine are partly due to its metabolic conversion to 7-OH mitragynine.
- Animal studies2022
Interactive Effects of µ-Opioid and Adrenergic-α 2 Receptor Agonists in Rats: Pharmacological Investigation of the Primary Kratom Alkaloid Mitragynine and Its Metabolite 7-Hydroxymitragynine
J Pharmacol Exp Ther · Obeng S, Leon F, Patel A, Zuarth Gonzalez JD, Chaves Da Silva L, Restrepo LF et al.
Key finding: When combined with Aα2R agonists, mitragynine could also produce hypothermic synergism.
- Lab (in vitro)2022
Metabolism of Speciociliatine, an Overlooked Kratom Alkaloid for its Potential Pharmacological Effects
AAPS J · Kamble SH, Berthold EC, Kanumuri SRR, King TI, Kuntz MA, León F et al.
Key finding: The metabolism of speciociliatine was predominantly mediated by CYP3A4 with minor contributions by CYP2D6.
- Reviews & commentary2022
Mechanisms of opioid-induced respiratory depression
Arch Toxicol · Baldo BA, Rose MA
Key finding: Methadone, administered to alleviate symptoms of NAS in humans, desensitizes rats to RD.
- Human studies2021
Is kratom (Mitragyna speciosa Korth.) use associated with ECG abnormalities? Electrocardiogram comparisons between regular kratom users and controls
Clin Toxicol (Phila · Leong Abdullah MFI, Tan KL, Narayanan S, Yuvashnee N, Chear NJY, Singh D et al.
Key finding: We found no link between regular kratom use and electrocardiographic abnormalities with an estimated average daily intake of 434.28 mg of mitragynine.
- Human studies2021
Kratom Use in the US: Both a Regional Phenomenon and a White Middle-Class Phenomenon? Evidence From NSDUH 2019 and an Online Convenience Sample
Front Pharmacol · Rogers JM, Smith KE, Strickland JC, Epstein DH
Key finding: In the interim, focus should be on our finding that lifetime nonmedical opioid use was associated with an up to five times greater likelihood of past-year kratom use, suggesting that drug-use history may presently be the strongest…
- Lab (in vitro)2021
Pharmacological Comparison of Mitragynine and 7-Hydroxymitragynine: In Vitro Affinity and Efficacy for μ-Opioid Receptor and Opioid-Like Behavioral Effects in Rats
J Pharmacol Exp Ther · Obeng S, Wilkerson JL, León F, Reeves ME, Restrepo LF, Gamez-Jimenez LR et al.
Key finding: These results are consistent with 7-hydroxymitragynine being a highly selective MOR agonist and with mitragynine having a complex pharmacology that combines low efficacy MOR agonism with activity at nonopioid receptors.
- Lab (in vitro)2021
Exploring the Chemistry of Alkaloids from Malaysian Mitragyna speciosa (Kratom) and the Role of Oxindoles on Human Opioid Receptors
J Nat Prod · Chear NJ, León F, Sharma A, Kanumuri SRR, Zwolinski G, Abboud KA et al.
Key finding: These findings have important implications for evaluating the combined effects of the minor oxindole alkaloids in the overall therapeutic activity of M.
- Lab (in vitro)2021
Activity of Mitragyna speciosa ("Kratom") Alkaloids at Serotonin Receptors
J Med Chem · León F, Obeng S, Mottinelli M, Chen Y, King TI, Berthold EC et al.
Key finding: The 5-HT1AR agonism by kratom alkaloids may contribute to the mood-enhancing effects associated with kratom use.
- Lab (in vitro)2021
Oxidative Metabolism as a Modulator of Kratom's Biological Actions
J Med Chem · Chakraborty S, Uprety R, Slocum ST, Irie T, Le Rouzic V, Li X et al.
Key finding: Our results indicate that the oxidative metabolism of the mitragynine template beyond 7-hydroxymitragynine may have implications in its overall pharmacology in vivo.
- Human studies2020
CYP450-Mediated Metabolism of Mitragynine and Investigation of Metabolites in Human Urine
J Anal Toxicol · Basiliere S, Kerrigan S
Key finding: In vitro rCYP studies were compared with phase I metabolites in urine from cases involving mitragynine.
- Animal studies2020
Bioanalytical method development and validation of corynantheidine, a kratom alkaloid, using UPLC-MS/MS, and its application to preclinical pharmacokinetic studies
J Pharm Biomed Anal · King TI, Sharma A, Kamble SH, León F, Berthold EC, Popa R et al.
Key finding: Corynantheidine was detected in the corpus callosum and some regions of the hippocampus.
- Animal studies2020
Evaluation of the rewarding effects of mitragynine and 7-hydroxymitragynine in an intracranial self-stimulation procedure in male and female rats
Drug Alcohol Depend · Behnood-Rod A, Chellian R, Wilson R, Hiranita T, Sharma A, Leon F et al.
Key finding: These initial findings indicate that mitragynine and 7-hydroxymitragynine are not rewarding in the ICSS procedure.
- Lab (in vitro)2020
Exploration of cytochrome P450 inhibition mediated drug-drug interaction potential of kratom alkaloids
Toxicol Lett · Kamble SH, Sharma A, King TI, Berthold EC, León F, Meyer PKL et al.
Key finding: In conclusion, MTG and COR may lead to clinically significant adverse drug interactions upon coadministration of drugs that are substantially metabolized by CYP2D6.
- Lab (in vitro)2020
Evaluating kratom alkaloids using PHASE
PLoS One · Ellis CR, Racz R, Kruhlak NL, Kim MT, Zakharov AV, Southall N et al.
Key finding: The verified binding profiles demonstrate the ability of PHASE to identify potential safety signals and provide a tool for prioritizing experimental evaluation of high-risk compounds.
- Lab (in vitro)2020
Chemical composition and biological effects of kratom (Mitragyna speciosa): In vitro studies with implications for efficacy and drug interactions
Sci Rep · Todd DA, Kellogg JJ, Wallace ED, Khin M, Flores-Bocanegra L, Tanna RS et al.
Key finding: All three kratom alkaloids tested inhibited select cytochrome P450 enzymes, suggesting a potential risk for adverse interactions when kratom is co-consumed with drugs metabolized by these enzymes.
- Reviews & commentary2020
Kratom-Pharmacology, Clinical Implications, and Outlook: A Comprehensive Review
Pain Ther · Eastlack SC, Cornett EM, Kaye AD
Key finding: This manuscript will discuss the most current epidemiology, pharmacology, toxicity, and management related to kratom, while seeking to provide a contemporary perspective on the issue and its role in the greater context of the opioid…
- Reviews & commentary2020
Combining opioids and benzodiazepines: effects on mortality and severe adverse respiratory events
Ann Palliat Med · Boon M, van Dorp E, Broens S, Overdyk F
Key finding: However, the risk for harm and benefit of the drug combination strongly correlates to its context and there are situations, such as in the hospice setting, where benefits may outweigh the risks.
- Animal studies2019
Rate and extent of mitragynine and 7-hydroxymitragynine blood-brain barrier transport and their intra-brain distribution: the missing link in pharmacodynamic studies
Addict Biol · Yusof SR, Mohd Uzid M, Teh EH, Hanapi NA, Mohideen M, Mohamad Arshad AS et al.
Key finding: The presented findings from this systematic investigation of brain pharmacokinetics of mitragynine and 7-hydroxymitragynine are essential for design and interpretation of in vivo experiments aiming to establish exposure-response…
- Lab (in vitro)2019
7-Hydroxymitragynine Is an Active Metabolite of Mitragynine and a Key Mediator of Its Analgesic Effects
ACS Cent Sci · Kruegel AC, Uprety R, Grinnell SG, Langreck C, Pekarskaya EA, Le Rouzic V et al.
Key finding: Further, they raise important questions about the interpretation of existing data on mitragynine and highlight critical areas for further research in animals and humans.
- Human studies2018
Assessment of gonadotropins and testosterone hormone levels in regular Mitragyna speciosa (Korth.) users
J Ethnopharmacol · Singh D, Murugaiyah V, Hamid SBS, Kasinather V, Chan MSA, Ho ETW et al.
Key finding: Regular kratom tea/juice consumption over prolonged periods (>2 years) was not associated with testosterone impairing effects in humans.
- Case reports2018
Kratom, an Emerging Drug of Abuse, Raises Prolactin and Causes Secondary Hypogonadism: Case Report
J Investig Med High Impact Case Rep · LaBryer L, Sharma R, Chaudhari KS, Talsania M, Scofield RH
Key finding: A number of adverse events or side effects have been reported, but this is the first report of hyperprolactinemia as the result of ingestion of kratom.
- Product testing2018
A Prospective Evaluation of Drug Discrimination in Pharmacology
Curr Top Behav Neurosci · Walker EA
Key finding: This final chapter represents one investigator's perspective on the utility and possibilities for a methodology that she fell in love with over 30 years ago.
- Reviews & commentary2017
Biochemical Benefits, Diagnosis, and Clinical Risks Evaluation of Kratom
Front Psychiatry · Fluyau D, Revadigar N
Key finding: Our data analysis has not determined if biochemical benefits of kratom may prove to outweigh its toxicity and risks.
- Surveillance2016
CDC MMWR 2016 Notes from the Field Kratom Exposures
Agency / organization document · CDC
No summary available; see the original.
- Lab (in vitro)2016
Synthetic and Receptor Signaling Explorations of the Mitragyna Alkaloids: Mitragynine as an Atypical Molecular Framework for Opioid Receptor Modulators
J Am Chem Soc · Kruegel AC, Gassaway MM, Kapoor A, Váradi A, Majumdar S, Filizola M et al.
Key finding: Molecular docking studies, in combination with the observed chemical SAR, suggest that Mitragyna alkaloids adopt a binding pose at the mu-opioid receptor that is distinct from that of classical opioids.
- Product testing2016
Drug discrimination: A versatile tool for characterization of CNS safety pharmacology and potential for drug abuse
J Pharmacol Toxicol Methods · Swedberg MD
Key finding: These and other findings will be discussed, and the application of drug discrimination procedures beyond the typical standard application of testing novel compounds against known and well characterized reference drugs will be addressed.
- Human studies2015
Pharmacokinetics of mitragynine in man
Drug Des Devel Ther · Trakulsrichai S, Sathirakul K, Auparakkitanon S, Krongvorakul J, Sueajai J, Noumjad N et al.
Key finding: This was the first pharmacokinetic study in humans, which demonstrated linearity and was consistent with the oral two-compartment model with a terminal half-life of about 1 day.
- Animal studies2015
Discriminative stimulus properties of mitragynine (kratom) in rats
Psychopharmacology (Berl · Harun N, Hassan Z, Navaratnam V, Mansor SM, Shoaib M
Key finding: The present study demonstrates that the discriminative stimulus effect of MG possesses both opioid- and psychostimulant-like subjective effects.
- Lab (in vitro)2014
Orally active opioid μ/δ dual agonist MGM-16, a derivative of the indole alkaloid mitragynine, exhibits potent antiallodynic effect on neuropathic pain in mice
J Pharmacol Exp Ther · Matsumoto K, Narita M, Muramatsu N, Nakayama T, Misawa K, Kitajima M et al.
Key finding: These findings suggest that MGM-16 could become a class of a compound with potential therapeutic utility for treating neuropathic pain.
- Lab (in vitro)2014
Evaluation of in vitro absorption, distribution, metabolism, and excretion (ADME) properties of mitragynine, 7-hydroxymitragynine, and mitraphylline
Planta Med · Manda VK, Avula B, Ali Z, Khan IA, Walker LA, Khan SI
Key finding: These data indicate the possibility of a drug interaction if mitragynine and 7-hydroxymitragynine are coadministered with drugs that are P-glycoprotein substrates.
- Lab (in vitro)2014
Evaluation of the cardiotoxicity of mitragynine and its analogues using human induced pluripotent stem cell-derived cardiomyocytes
PLoS One · Lu J, Wei H, Wu J, Jamil MF, Tan ML, Adenan MI et al.
Key finding: Our study indicates that Mitragynine and its analogues may potentiate Torsade de Pointes through inhibition of IKr in human cardiomyocytes.
- Product testing2009
Phytochemical characterization of the leaves of Mitragyna speciosa grown in U.S.A
Nat Prod Commun · León F, Habib E, Adkins JE, Furr EB, McCurdy CR, Cutler SJ
Key finding: Biological studies are currently underway to test these compounds for opioid activity.
- Animal studies2008
MGM-9 [(E)-methyl 2-(3-ethyl-7a,12a-(epoxyethanoxy)-9-fluoro-1,2,3,4,6,7,12,12b-octahydro-8-methoxyindolo[2,3-a]quinolizin-2-yl)-3-methoxyacrylate], a derivative of the indole alkaloid mitragynine: a novel dual-acting mu- and kappa-opioid agonist with potent antinociceptive and weak rewarding effects in mice
Neuropharmacology · Matsumoto K, Takayama H, Narita M, Nakamura A, Suzuki M, Suzuki T et al.
Key finding: Taken together, the results suggest that MGM-9 is a promising novel analgesic that has a stronger antinociceptive effect and weaker adverse effects than morphine.
- Animal studies2006
Involvement of mu-opioid receptors in antinociception and inhibition of gastrointestinal transit induced by 7-hydroxymitragynine, isolated from Thai herbal medicine Mitragyna speciosa
Eur J Pharmacol · Matsumoto K, Hatori Y, Murayama T, Tashima K, Wongseripipatana S, Misawa K et al.
Key finding: This compound induced more potent antinociceptive effects and was less constipating than morphine.
- Animal studies2006
Using drug-discrimination techniques to study the abuse-related effects of psychoactive drugs in rats
Nat Protoc · Solinas M, Panlilio LV, Justinova Z, Yasar S, Goldberg SR
Key finding: Although training can be lengthy (up to several months), the pharmacological specificity of DD procedures make them a perfect complement to other techniques used to study drug-abuse phenomena, such as intravenous self-administration and…
- Lab (in vitro)2004
Antinociceptive effect of 7-hydroxymitragynine in mice: Discovery of an orally active opioid analgesic from the Thai medicinal herb Mitragyna speciosa
Life Sci · Matsumoto K, Horie S, Ishikawa H, Takayama H, Aimi N, Ponglux D et al.
Key finding: It was found that 7-hydroxymitragynine is a novel opioid agonist that is structurally different from the other opioid agonists, and has potent analgesic activity when orally administered.
- Reviews & commentary2003
Guidelines and methodological reviews concerning drug abuse liability assessment
Drug Alcohol Depend · Balster RL, Bigelow GE
Key finding: Thus, another goal of this review has been to identify areas where critical thinking and new guideline development are needed.
- Reviews & commentary2003
Principles of drug abuse liability assessment in laboratory animals
Drug Alcohol Depend · Ator NA, Griffiths RR
Key finding: A key consideration for cross-cutting and specific methodological issues is that choices made enable confident interpretation of both positive and negative results.
- Lab (in vitro)2002
Studies on the synthesis and opioid agonistic activities of mitragynine-related indole alkaloids: discovery of opioid agonists structurally different from other opioid ligands
J Med Chem · Takayama H, Ishikawa H, Kurihara M, Kitajima M, Aimi N, Ponglux D et al.
Key finding: Synthetic-chemistry paper (link only; omitted from summary).
- Lab (in vitro)1999
Opioid receptor agonistic characteristics of mitragynine pseudoindoxyl in comparison with mitragynine derived from Thai medicinal plant Mitragyna speciosa
Gen Pharmacol · Yamamoto LT, Horie S, Takayama H, Aimi N, Sakai S, Yano S et al.
Key finding: The present study demonstrates that mitragynine pseudoindoxyl, a novel alkaloid structurally different from other opioid agonists, acts on opioid receptors, leading to a potent inhibition of electrically stimulated contraction in the…
- Product testing1994
A New Indole Alkaloid, 7 alpha-Hydroxy-7H-mitragynine, from Mitragyna speciosa in Thailand
Planta Med · Ponglux D, Wongseripipatana S, Takayama H, Kikuchi M, Kurihara M, Kitajima M et al.
No summary available; see the original.
- Human studies1975
A study of kratom eaters in Thailand
Bull Narc · Suwanlert S
No summary available; see the original.
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