Kratom Crackdown: FDA Intensifies Warnings with Limited, Inconclusive Data. To Scientists, Kratom-Linked Salmonella Outbreak Signals Need for Quality Control, Not a Ban

ABSTRACT

Kratom is a tropical, evergreen, broad-leafed tree that can grow to 25 meters (82 feet) tall. It is native to peninsular Thailand, southeastern Myanmar, Malaysia, Borneo, Sumatra, the Philippines, and New Guinea. The species belongs to the madder (Rubiaceae) family, a large plant family that also includes coffee (Coffea arabica, C. canephora). The name "kratom" originates from Thailand and likely derives from the Sanskrit kadam, a name that refers to Neolamarckia cadamba (Rubiaceae), a widespread tree that is sacred in Hinduism. Similar names are used for various related tree species in the region. Preparations of kratom leaves have been used for centuries in Southeast Asia for a wide range of purposes, including to treat cough, diarrhea, and diabetes; to manage pain and opioid withdrawal; and to stave off fatigue. Leaf preparations of the plant, including powders and teas, act on the central nervous system. At low doses, they can produce stimulant effects, while higher doses often produce sedative and intoxicating effects.