Kratom, a plant indigenous to Southeast Asia, is used by individuals for its stimulant effects and as an opioid substitute, but because of its uncertain and inconsistent purity levels and quantities, the drug can pose significant health risks to users.  A recent study published in the Journal of Psychoactive Drugs evaluated 15 kratom product samples that were either directly advertised as kratom or were listed in the results of a web search (not directly advertised as kratom).

Kratom consists of two different psychoactive chemicals, which possess both stimulant (mitragynine) and narcotic (7-hydroxymitragynine) properties. This explains how kratom may appeal to different types of drug users as it has been used for a number of recreational purposes and for pain management. When abused, it can produce opioid-like effects and adverse effects such as agitation, irritability, tachycardia, nausea, drowsiness, and hypertension. In this study, laboratory testing found that all 15 products marketed as kratom contained mitragynine but not 7-hydroxymitragynine.  

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On August 30, 2016, the Drug Enforcement Agency (DEA) announced its intent to classify the active ingredients in kratom as Schedule I of the Controlled Substances Act to avoid an imminent hazard to public safety. Kratom has been seized by law enforcement in different forms such as powder, plant capsules, tablets, liquids, gum/resin, and drug patch.

Factors such as a high abuse potential with no currently accepted medical use for treatment and a lack of accepted safety for use under medical supervision make up a Schedule I controlled substance. 

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