{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:23:21Z","timestamp":1782516201121,"version":"3.54.5"},"reference-count":96,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>Kratom (<jats:italic>Mitragyna speciosa<\/jats:italic>, Korth.) is an evergreen tree that is indigenous to Southeast Asia. When ingested, kratom leaves or decoctions from the leaves have been reported to produce complex stimulant and opioid-like effects. For generations, native populations in Southeast Asia have used kratom products to stave off fatigue, improve mood, alleviate pain and manage symptoms of opioid withdrawal. Despite the long history of kratom use in Asia, it is only within the past 10\u201320\u00a0years that kratom has emerged as an important herbal agent in the United States, where it is being used for the self-treatment of pain, opioid withdrawal symptoms, and mood disorders. The increase in the use of kratom in the United States has coincided with the serious epidemic of opioid abuse and dependence. Since 2015, efforts to restrict access to prescription opioids have resulted in a marked increase in the use of \u201cstreet\u201d opioids such as heroin and illicit fentanyl. At the same time, many patients with chronic pain conditions or opioid use disorder have been denied access to appropriate medical help. The lack of access to care for patients with chronic pain and opioid use disorder has been magnified by the emergence of the COVID-19 pandemic. In this report, we highlight how these converging factors have led to a surge in interest in kratom as a potential harm reduction agent in the treatment of pain and opioid use disorder.<\/jats:p>","DOI":"10.3389\/fphar.2021.729220","type":"journal-article","created":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T12:22:25Z","timestamp":1630412545000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":22,"title":["Kratom Use Within the Context of the Evolving Opioid Crisis and the COVID-19 Pandemic in the United States"],"prefix":"10.3389","volume":"12","author":[{"given":"Walter C.","family":"Prozialeck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Lamar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"Michael","family":"Krupp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Moon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura E.","family":"Phelps","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Grundmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,8,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.2174\/156802611795371305","article-title":"Mitragyna Speciosa, a Psychoactive Tree from Southeast Asia with Opioid Activity","volume":"11","author":"Adkins","year":"2011","journal-title":"Curr. Top. Med. Chem."},{"key":"B2","unstructured":"AKA GMP Qualified Vendors:2020"},{"key":"B3","unstructured":"American Kratom Association; HHS Recinds Scheduling Recommendation for Kratom but FDA Failed to Notify the Public for 2 1\/2 Years2021"},{"key":"B4","unstructured":"The Increase in Consumer Use of Kratom in the united States2019"},{"key":"B5","unstructured":"Kratom Users Say Ban Will Lead to More Drug Abuse\n            AnsonP.\n          2016"},{"key":"B6","doi-asserted-by":"publisher","first-page":"748","DOI":"10.15585\/mmwr.mm6529a4","article-title":"Notes from the Field: Kratom (Mitragyna Speciosa) Exposures Reported to Poison Centers - United States, 2010-2015","volume":"65","author":"Anwar","year":"2016","journal-title":"MMWR. Morb. Mortal. Wkly. Rep."},{"key":"B7","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1053\/jpmn.2000.5833","article-title":"The New JCAHO Pain Standards: Implications for Pain Management Nurses","volume":"1","author":"Berry","year":"2000","journal-title":"Pain Manag. Nurs."},{"key":"B8","first-page":"11","article-title":"Kratom and the Opioid Crisis","volume":"15","author":"Bestha","year":"2018","journal-title":"Innov. Clin. Neurosci."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1111\/j.1360-0443.2008.02209.x","article-title":"Self-Treatment of Opioid Withdrawal Using Kratom (Mitragynia Speciosa Korth)","volume":"103","author":"Boyer","year":"2008","journal-title":"Addiction"},{"key":"B10","unstructured":"The Pendulum Has Swung Too Far; Treating Pain in Primary Care\n            BrookesL.\n          2019"},{"key":"B11","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1007\/s11606-020-06436-3","article-title":"COVID-19 Adaptations in the Care of Patients with Opioid Use Disorder: a Survey of California Primary Care Clinics","volume":"36","author":"Caton","year":"2021","journal-title":"J. Gen. Intern. Med."},{"key":"B12","first-page":"10","article-title":"CDC Grand Rounds: Prescription Drug Overdoses - a U.S. Epidemic","volume":"61","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"B13","unstructured":"Provisional Drug Overdose Death Counts2021"},{"key":"B14","doi-asserted-by":"publisher","first-page":"968786","DOI":"10.1155\/2015\/968786","article-title":"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","volume":"2015","author":"Cinosi","year":"2015","journal-title":"Biomed. Res. Int."},{"key":"B15","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.drugalcdep.2019.05.005","article-title":"Kratom as a Substitute for Opioids: Results from an Online Survey","volume":"202","author":"Coe","year":"2019","journal-title":"Drug Alcohol Depend"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1102","DOI":"10.1177\/0269881119862530","article-title":"Characteristics of Deaths Associated with Kratom Use","volume":"33","author":"Corkery","year":"2019","journal-title":"J. Psychopharmacol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1016\/j.ajem.2017.07.051","article-title":"Clinical Outcomes after Kratom Exposures: A Poison center Case Series","volume":"36","author":"Cumpston","year":"2018","journal-title":"Am. J. Emerg. Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1080\/00952990.2020.1836185","article-title":"A Comparative Analysis of Kratom Exposure Cases in Thailand and the United States from 2010-2017","volume":"47","author":"Davidson","year":"2021","journal-title":"Am. J. Drug Alcohol. Abuse"},{"key":"B19","unstructured":"Docket Folder Summary\/Schedules of Controlled Substances: Temporary Placement of Mitragynine and 7-hydroxymitragynine into Schedule I"},{"key":"B20","first-page":"49661","article-title":"Schedules of Controlled Substances: Rescheduling of Hydrocodone Combination Products from Schedule III to Schedule II. Final Rule","volume":"79","year":"2014","journal-title":"Fed. Regist."},{"key":"B21","unstructured":"Schedules of Controlled Substances: Temporary Placement of Mitragynine and 7-Hydroxymitragynine into Schedule I"},{"key":"B22","unstructured":"Withdrawal of Notice of Intent to Temporarily Place Mitragynine and 7-Hydroxymitragynine into Schedule I"},{"key":"B23","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1080\/14737167.2020.1807944","article-title":"In Our War against the Opioid Epidemic, Could \u2018weed' Be a winner?","volume":"20","author":"Ding","year":"2020","journal-title":"Expert Rev. Pharmacoecon Outcomes Res."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.rr6501e1","article-title":"CDC Guideline for Prescribing Opioids for Chronic Pain--United States, 2016","volume":"65","author":"Dowell","year":"2016","journal-title":"MMWR. Recomm. Rep."},{"key":"B25","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1007\/s40122-020-00151-x","article-title":"Kratom-Pharmacology, Clinical Implications, and Outlook: A Comprehensive Review","volume":"9","author":"Eastlack","year":"2020","journal-title":"Pain Ther."},{"key":"B26","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1002\/phar.2280","article-title":"Kratom Use and Toxicities in the United States","volume":"39","author":"Eggleston","year":"2019","journal-title":"Pharmacotherapy"},{"key":"B27","unstructured":"FDA Announces Seizure of Adulterated Dietary Supplements Containing Kratom2021"},{"key":"B28","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1002\/ajim.21998","article-title":"Bending the Prescription Opioid Dosing and Mortality Curves: Impact of the Washington State Opioid Dosing Guideline","volume":"55","author":"Franklin","year":"2012","journal-title":"Am. J. Ind. Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"107849","DOI":"10.1016\/j.drugalcdep.2020.107849","article-title":"Kratom (Mitragyna Speciosa): User Demographics, Use Patterns, and Implications for the Opioid Epidemic","volume":"208","author":"Garcia-Romeu","year":"2020","journal-title":"Drug Alcohol Depend"},{"key":"B30","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1111\/add.15173","article-title":"Kratom Use in the United States: A Diverse and Complex Profile","volume":"116","author":"Grundmann","year":"2021","journal-title":"Addiction"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1951","DOI":"10.1111\/add.14371","article-title":"The Therapeutic Potential of Kratom","volume":"113","author":"Grundmann","year":"2018","journal-title":"Addiction"},{"key":"B32","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.drugalcdep.2017.03.007","article-title":"Patterns of Kratom Use and Health Impact in the US-Results from an Online Survey","volume":"176","author":"Grundmann","year":"2017","journal-title":"Drug Alcohol Depend"},{"key":"B33","volume-title":"Drugs and Society","author":"Hanson","year":"2006"},{"key":"B34","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1007\/s00213-017-4813-4","article-title":"The Abuse Potential of Kratom According the 8 Factors of the Controlled Substances Act: Implications for Regulation and Research","volume":"235","author":"Henningfield","year":"2018","journal-title":"Psychopharmacology (Berl)"},{"key":"B35","doi-asserted-by":"publisher","first-page":"105851","DOI":"10.1016\/j.ypmed.2019.105851","article-title":"Risk of Death Associated with Kratom Use Compared to Opioids","volume":"128","author":"Henningfield","year":"2019","journal-title":"Prev. Med."},{"key":"B36","article-title":"The New Report on Kratom Overdoses Is Scary but Kind of Misleading","author":"Hicks","year":"2019"},{"key":"B37","doi-asserted-by":"publisher","first-page":"108617","DOI":"10.1016\/j.drugalcdep.2021.108617","article-title":"Impacts of the COVID-19 Pandemic on Healthcare Access Among Patients Receiving Medication for Opioid Use Disorder","volume":"221","author":"Jacka","year":"2021","journal-title":"Drug Alcohol Depend"},{"key":"B38","doi-asserted-by":"publisher","first-page":"e2118223","DOI":"10.1001\/jamanetworkopen.2021.18223","article-title":"Methadone Access for Opioid Use Disorder During the COVID-19 Pandemic Within the United States and Canada","volume":"4","author":"Joudrey","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"B39","doi-asserted-by":"publisher","first-page":"108270","DOI":"10.1016\/j.jsat.2020.108270","article-title":"Substance Use Treatment in Appalachian Tennessee amid COVID-19: Challenges and Preparing for the Future","volume":"124","author":"Kedia","year":"2021","journal-title":"J. Subst. Abuse Treat."},{"key":"B40","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/wfs2.1420","article-title":"Kratom: A Systematic Review of Toxicological Issues","author":"Kerrigan","year":"2021","journal-title":"Wires Forensic Sci."},{"key":"B41","doi-asserted-by":"publisher","first-page":"6754","DOI":"10.1021\/jacs.6b00360","article-title":"Synthetic and Receptor Signaling Explorations of the Mitragyna Alkaloids: Mitragynine as an Atypical Molecular Framework for Opioid Receptor Modulators","volume":"138","author":"Kruegel","year":"2016","journal-title":"J. Am. Chem. Soc."},{"key":"B42","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.neuropharm.2017.08.026","article-title":"The Medicinal Chemistry and Neuropharmacology of Kratom: A Preliminary Discussion of a Promising Medicinal Plant and Analysis of its Potential for Abuse","volume":"134","author":"Kruegel","year":"2018","journal-title":"Neuropharmacology"},{"key":"B43","doi-asserted-by":"publisher","first-page":"108158","DOI":"10.1016\/j.jsat.2020.108158","article-title":"A Clash of Epidemics: Impact of the COVID-19 Pandemic Response on Opioid Overdose","volume":"120","author":"Linas","year":"2021","journal-title":"J. Subst. Abuse Treat."},{"key":"B44","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1093\/pm\/pnaa396","article-title":"Cannabis Significantly Reduces the Use of Prescription Opioids and Improves Quality of Life in Authorized Patients: Results of a Large Prospective Study","volume":"22","author":"Lucas","year":"2021","journal-title":"Pain Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"ES9","DOI":"10.36076\/ppj.2012\/15\/es9","article-title":"Opioid Epidemic in the United States","volume":"15","author":"Manchikanti","year":"2012","journal-title":"Pain Physician"},{"key":"B46","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1007\/s40122-021-00243-2","article-title":"COVID-19 and the Opioid Epidemic: Two Public Health Emergencies that Intersect With Chronic Pain","volume":"10","author":"Manchikanti","year":"2021","journal-title":"Pain Ther."},{"key":"B47","doi-asserted-by":"publisher","first-page":"106595","DOI":"10.1016\/j.vascn.2019.05.012","article-title":"Pharmacological Characterization of Mitragynine, the Primary Constituent in Kratom, as a Potential Medication for Opioid Use Disorder","volume":"99","author":"McMahon","year":"2019","journal-title":"J. Pharmacol. Toxicol. Methods"},{"key":"B48","doi-asserted-by":"publisher","first-page":"594816","DOI":"10.3389\/fpsyt.2020.594816","article-title":"Can Kratom (Mitragyna Speciosa) Alleviate COVID-19 Pain? A Case Study","volume":"11","author":"Metastasio","year":"2020","journal-title":"Front. Psychiatry"},{"key":"B49","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1093\/pm\/pnaa446","article-title":"The Early Impact of COVID-19 on Chronic Pain: A Cross-Sectional Investigation of a Large Online Sample of Individuals with Chronic Pain in the United States, April to May, 2020","volume":"22","author":"Mun","year":"2021","journal-title":"Pain Med."},{"key":"B50","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1080\/08897077.2021.1900981","article-title":"A Health Crisis within a Health Crisis: Opioid Access in the COVID-19 Pandemic","volume":"42","author":"Narayan","year":"2021","journal-title":"Subst. Abus."},{"key":"B51","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1001\/jama.2012.8165","article-title":"Curbing the Opioid Epidemic in the United States: the Risk Evaluation and Mitigation Strategy (REMS)","volume":"308","author":"Nelson","year":"2012","journal-title":"JAMA"},{"key":"B52","doi-asserted-by":"publisher","first-page":"103236","DOI":"10.1016\/j.drugpo.2021.103236","article-title":"Pathways between COVID-19 Public Health Responses and Increasing Overdose Risks: A Rapid Review and Conceptual Framework","volume":"93","author":"Nguyen","year":"2021","journal-title":"Int. J. Drug Pol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1021\/acs.jmedchem.9b01465","article-title":"Investigation of the Adrenergic and Opioid Binding Affinities, Metabolic Stability, Plasma Protein Binding Properties, and Functional Effects of Selected Indole-Based Kratom Alkaloids","volume":"63","author":"Obeng","year":"2020","journal-title":"J. Med. Chem."},{"key":"B54","doi-asserted-by":"publisher","first-page":"326","DOI":"10.15585\/mmwr.mm6814a2","article-title":"Notes from the Field: Unintentional Drug Overdose Deaths with Kratom Detected - 27 States, July 2016-December 2017","volume":"68","author":"Olsen","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"B55","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/15563650.2019.1688341","article-title":"Natural Psychoactive Substance-Related Exposures Reported to United States Poison Control Centers, 2000-2017","volume":"58","author":"O\u2019Neill-Dee","year":"2019","journal-title":"Clin. Toxicol."},{"key":"B56","unstructured":"Past-year Kratom Use in the U.S.: Estimates from a Nationally Representative Sample\n            PalamarJ.\n          2021"},{"key":"B57","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1093\/ajhp\/zxab003","article-title":"Leveraging Pharmacists to Maintain and Extend Buprenorphine Supply for Opioid Use Disorder amid COVID-19 Pandemic","volume":"78","author":"Peckham","year":"2021","journal-title":"Am. J. Health Syst. Pharm."},{"key":"B58","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1001\/jama.284.4.423b","article-title":"JCAHO Pain Management Standards Are Unveiled. Joint Commission on Accreditation of Healthcare Organizations","volume":"284","author":"Phillips","year":"2000","journal-title":"JAMA"},{"key":"B59","doi-asserted-by":"publisher","first-page":"100007","DOI":"10.1016\/j.etdah.2021.100007","article-title":"Exploring the Use of Kratom (Mitragyna Speciosa) via the YouTube Data Tool: A Novel Netnographic Analysis","volume":"1","author":"Prevete","year":"2021","journal-title":"Emerging Trends Drugs Addictions, Health"},{"key":"B60","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.drugpo.2019.05.003","article-title":"Kratom Policy: The challenge of Balancing Therapeutic Potential with Public Safety","volume":"70","author":"Prozialeck","year":"2019","journal-title":"Int. J. Drug Pol."},{"key":"B61","doi-asserted-by":"publisher","first-page":"5512","DOI":"10.3390\/ijerph17155512","article-title":"Evaluation of the Mitragynine Content, Levels of Toxic Metals and the Presence of Microbes in Kratom Products Purchased in the Western Suburbs of Chicago","volume":"17","author":"Prozialeck","year":"2020","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B62","doi-asserted-by":"publisher","first-page":"792","DOI":"10.15358\/9783800644254_792","article-title":"Pharmacology of Kratom: an Emerging Botanical Agent with Stimulant, Analgesic and Opioid-like Effects","volume":"112","author":"Prozialeck","year":"2012","journal-title":"J. Am. Osteopath. Assoc."},{"key":"B63","doi-asserted-by":"publisher","first-page":"802","DOI":"10.7556\/jaoa.2016.156","article-title":"Update on the Pharmacology and Legal Status of Kratom","volume":"116","author":"Prozialeck","year":"2016","journal-title":"J. Am. Osteopath Assoc."},{"key":"B64","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/j.bpa.2020.07.001","article-title":"Impact of COVID-19 Pandemic on Chronic Pain Management: Looking for the Best Way to Deliver Care","volume":"34","author":"Puntillo","year":"2020","journal-title":"Best Pract. Res. Clin. Anaesthesiol"},{"key":"B65","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1111\/jcpt.12676","article-title":"Nature's First \"Atypical Opioids\": Kratom and Mitragynines","volume":"43","author":"Raffa","year":"2018","journal-title":"J. Clin. Pharm. Ther."},{"key":"B66","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1097\/YCO.0000000000000621","article-title":"Kratom (Mitragyna Speciosa): Worldwide Issues","volume":"33","author":"Ramanathan","year":"2020","journal-title":"Curr. Opin. Psychiatry"},{"key":"B67","volume-title":"Drugs, Society and Human Behavior","author":"Ray","year":"1996"},{"key":"B68","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.mayocp.2017.12.020","article-title":"How Good Intentions Contributed to Bad Outcomes: The Opioid Crisis","volume":"93","author":"Rummans","year":"2018","journal-title":"Mayo Clin. Proc."},{"key":"B69","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1007\/s13181-012-0270-y","article-title":"Abuse-Deterrent Formulations, an Evolving Technology against the Abuse and Misuse of Opioid Analgesics","volume":"8","author":"Schaeffer","year":"2012","journal-title":"J. Med. Toxicol."},{"key":"B70","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1111\/add.15082","article-title":"Prevalence and Description of Kratom (Mitragyna Speciosa) Use in the United States: a Cross-Sectional Study","volume":"116","author":"Schimmel","year":"2021","journal-title":"Addiction"},{"key":"B71","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s40265-019-01242-6","article-title":"Kratom (Mitragyna Speciosa) Liver Injury: A Comprehensive Review","volume":"80","author":"Schimmel","year":"2020","journal-title":"Drugs"},{"key":"B72","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1080\/17425255.2021.1853706","article-title":"Assessing the Therapeutic Potential and Toxicity of Mitragyna Speciosa in Opioid Use Disorder","volume":"17","author":"Sharma","year":"2021","journal-title":"Expert Opin. Drug Metab. Toxicol."},{"key":"B73","doi-asserted-by":"publisher","first-page":"574483","DOI":"10.3389\/fpsyt.2020.574483","article-title":"Current and Future Potential Impact of COVID-19 on Kratom (Mitragyna Speciosa Korth.) Supply and Use","volume":"11","author":"Singh","year":"2020","journal-title":"Front. Psychiatry"},{"key":"B74","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1080\/02791072.2018.1511879","article-title":"Severity of Kratom (Mitragyna Speciosa Korth.) Psychological Withdrawal Symptoms","volume":"50","author":"Singh","year":"","journal-title":"J. Psychoactive Drugs"},{"key":"B75","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.brainresbull.2016.05.004","article-title":"Traditional and Non-Traditional Uses of Mitragynine (Kratom): A Survey of the Literature","volume":"126","author":"Singh","year":"2016","journal-title":"Brain Res. Bull."},{"key":"B76","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1080\/02791072.2018.1443234","article-title":"Severity of Pain and Sleep Problems during Kratom (Mitragyna Speciosa Korth.) Cessation Among Regular Kratom Users","volume":"50","author":"Singh","year":"","journal-title":"J. Psychoactive Drugs"},{"key":"B77","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000876","article-title":"The Use of Kratom (Mitragyna Speciosa Korth.) Among People Who Co-Use Heroin and Methamphetamine in Malaysia","author":"Singh","year":"2021","journal-title":"J. Addict. Med."},{"key":"B78","doi-asserted-by":"publisher","first-page":"108879","DOI":"10.1016\/j.drugalcdep.2021.108879","article-title":"Therapeutic Benefit with Caveats?: Analyzing Social media Data to Understand the Complexities of Kratom Use","volume":"226","author":"Smith","year":"2021","journal-title":"Drug Alcohol Depend"},{"key":"B79","doi-asserted-by":"publisher","first-page":"108420","DOI":"10.1016\/j.drugalcdep.2020.108420","article-title":"Cannabis Use Is Associated with Reduced Risk of Exposure to Fentanyl Among People on Opioid Agonist Therapy during a Community-Wide Overdose Crisis","volume":"219","author":"Soc\u00edas","year":"2021","journal-title":"Drug and Alcohol Dependence"},{"key":"B80","first-page":"54","article-title":"Pharmacotherapy for Management of 'Kratom Use Disorder': A Systematic Literature Review With Survey of Experts","volume":"120","author":"Stanciu","year":"2021","journal-title":"WMJ"},{"key":"B81","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1097\/ACO.0b013e328357a24a","article-title":"Opioids, Pain Management and the Law","volume":"25","author":"Stayner","year":"2012","journal-title":"Curr. Opin. Anaesthesiol"},{"key":"B82","doi-asserted-by":"publisher","first-page":"1290","DOI":"10.1111\/acem.13040","article-title":"Choosing Opioid Policies Our Patients Can Live With","volume":"23","author":"Stolbach","year":"2016","journal-title":"Acad. Emerg. Med."},{"key":"B83","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1080\/02791072.2015.1096434","article-title":"Experiences of Kratom Users: A Qualitative Analysis","volume":"47","author":"Swogger","year":"2015","journal-title":"J. Psychoactive. Drugs"},{"key":"B84","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.drugalcdep.2017.10.012","article-title":"Kratom Use and Mental Health: A Systematic Review","volume":"183","author":"Swogger","year":"2018","journal-title":"Drug Alcohol Depend"},{"key":"B85","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1080\/20009666.2018.1468693","article-title":"Kratom: A Dangerous Player in the Opioid Crisis","volume":"8","author":"Tayabali","year":"2018","journal-title":"J. Community Hosp. Intern. Med. Perspect."},{"key":"B86","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1331\/JAPhA.2012.12532","article-title":"The Prescription Drug Misuse and Abuse Epidemic","volume":"52","author":"Thompson","year":"2012","journal-title":"J. Am. Pharm. Assoc. (2003)"},{"key":"B87","doi-asserted-by":"publisher","first-page":"19158","DOI":"10.1038\/s41598-020-76119-w","article-title":"Chemical Composition and Biological Effects of Kratom (Mitragyna Speciosa): In Vitro Studies with Implications for Efficacy and Drug Interactions","volume":"10","author":"Todd","year":"2020","journal-title":"Sci. Rep."},{"key":"B88","doi-asserted-by":"publisher","first-page":"8381","DOI":"10.1021\/acs.jmedchem.6b00748","article-title":"Mitragynine\/Corynantheidine Pseudoindoxyls as Opioid Analgesics with Mu Agonism and Delta Antagonism, Which Do Not Recruit \u03b2-Arrestin-2","volume":"59","author":"V\u00e1radi","year":"2016","journal-title":"J. Med. Chem."},{"key":"B89","doi-asserted-by":"publisher","first-page":"640218","DOI":"10.3389\/fpsyt.2021.640218","article-title":"Case Report: Treatment of Kratom Use Disorder With a Classical Tricyclic Antidepressant","volume":"12","author":"Vento","year":"2021","journal-title":"Front. Psychiatry"},{"key":"B90","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.drugpo.2009.12.003","article-title":"The Informal Use of Ketum (Mitragyna Speciosa) for Opioid Withdrawal in the Northern States of Peninsular Malaysia and Implications for Drug Substitution Therapy","volume":"21","author":"Vicknasingam","year":"2010","journal-title":"Int. J. Drug Pol."},{"key":"B91","unstructured":"Timeline: WHO's COVID-19 Response2021"},{"key":"B92","doi-asserted-by":"publisher","first-page":"102715","DOI":"10.1016\/j.drugpo.2020.102715","article-title":"The Internet Market for Kratom, an Opioid Alternative and Variably Legal Recreational Drug","volume":"78","author":"Williams","year":"2020","journal-title":"Int. J. Drug Pol."},{"key":"B93","doi-asserted-by":"publisher","first-page":"108310","DOI":"10.1016\/j.drugalcdep.2020.108310","article-title":"Lyophilized Kratom Tea as a Therapeutic Option for Opioid Dependence","volume":"216","author":"Wilson","year":"2020","journal-title":"Drug Alcohol Depend"},{"key":"B94","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1007\/s10571-020-01034-7","article-title":"Kratom Alkaloids, Natural and Semi-Synthetic, Show Less Physical Dependence and Ameliorate Opioid Withdrawal","volume":"41","author":"Wilson","year":"2021","journal-title":"Cell Mol Neurobiol"},{"key":"B95","unstructured":"Feds Declare War on Herb Touted as A Solution to Opioid Addiction\n            WingN.\n          2016"},{"key":"B96","unstructured":"New Kratom Death Reports Still Leave More Questions Than Answers\n            WingN.\n          2018"}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2021.729220\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T12:22:40Z","timestamp":1630412560000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2021.729220\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,26]]},"references-count":96,"alternative-id":["10.3389\/fphar.2021.729220"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2021.729220","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,26]]},"article-number":"729220"}}