Kratom leaves , kratom has been studied in cells and in animals, but no clinical trials have been conducted in the United States. The U.S. Drug Enforcement Administration (DEA) said in 2013 that there is no legitimate medical use for kratom. and in 2019, the U.S. Food and Drug Administration (FDA) said that there is no evidence that kratom is safe or effective for treating any condition, and that there are no approved clinical uses for kratom. Kratom leaves are commonly used by chewing, as a tea, powdered in capsules or pills, or extracted for use in liquids. Kratom is rarely smoked. Because some anecdotal reports claim that red vein varieties of kratom native to Bali tend to produce different effects than green and white vein varieties native to Malaysia, it has been speculated that different varieties of kratom contain different relative proportions of alkaloids. Traditional use In cultures where the plant grows, kratom has been used in traditional medicine. The leaves are chewed to relieve musculoskeletal pain and increase energy, appetite, and sexual desire in ways similar to khat and coca. The leaves or extracts from them are used to heal wounds and as a local anesthetic. Extracts and leaves have been used to treat coughs, diarrhea, and intestinal infections. They are also used as intestinal deworming agents in Thailand. Kratom is often used by workers in laborious or monotonous professions to stave off exhaustion as well as a mood enhancer and painkiller. In Thailand, kratom was "used as a snack to receive guests and was part of the ritual worship of ancestors and gods". The herb is bitter and is generally combined with a sweetener. Opioid withdrawal , there have been no formal trials to study the efficacy or safety of kratom to treat opioid addiction. Kratom is not approved for this or any other medical use. However, because the withdrawal effects of kratom are often reported to be less severe than those associated with traditional opioids, some people use kratom in the attempt to manage opioid use disorder. While some literature reviews claim that kratom has less potential for dependence or overdose than traditional opioids, other reviews note that kratom withdrawal itself can still be quite severe. Data on how often it is used worldwide are lacking, as it is not detected by typical drug-screening tests. Rates of kratom use appear to be increasing among those who have been self-managing chronic pain with opioids purchased without a prescription and are cycling (but not quitting) their use. In 1836, kratom was reported to have been used as an opium substitute in Malaysia. Kratom was also used as an opium substitute in Thailand in the nineteenth century. Recreational uses At low doses, kratom produces euphoric effects comparable to coca. At higher doses, kratom produces opioid-like effects. The onset of effects typically begins within five to ten minutes and lasts for two to five hours. Some anecdotal reports describe increased work capacity, alertness, talkativeness, sociability, increased sexual desire, positive mood, and euphoria following the consumption of kratom. According to the U.S. DEA and a 2020 survey, kratom is used in the public to alleviate pain, anxiety, depression, or opioid withdrawal. In Thailand, a 2007 survey found that the lifetime, past year, and past 30 days kratom usage rates were 2.32%, 0.81% and 0.57%, respectively, among respondents aged 12–65 years, and was the most widely used drug in Thailand. Kratom may be mixed with other psychoactive drugs, such as caffeine and codeine. Starting in the 2010s, a tea-based cocktail known as "4×100" became popular among some young people across Southeast Asia and especially in Thailand. It is a mix of kratom leaves, cough syrup, Coca-Cola, and ice. Around 2011, people who consumed the cocktail were often viewed more negatively than users of traditional kratom, but not as negatively as users of heroin. , use of the cocktail was a severe problem among youth in three provinces along the border of Malaysia and southern Thailand. In the U.S., , kratom was available in head shops and over the Internet; the prevalence of its use was unknown at the time. In the United States, kratom use increased rapidly between 2011 and 2017. By 2020, it was estimated that 15 million people in the U.S. use kratom.
Mitragyna speciosa
Craniopagus parasiticus
Piedraia hortae
Cedecea davisae
Ephedra distachya
Arcanum joviale
Gongylonema pulchrum
Cerbera odollam