Kratom Abuse Potential: Key Research Findings

Kratom Abuse Potential: Updated Eight‑Factor Controlled Substances Act Analysis

Global Regulation Survey (Eight‑Factor Analysis & Import Alerts)

Prozialeck et al. (2021) present an updated eight‑factor abuse‑potential assessment of kratom and its alkaloids—reviewing history, pharmacology, public health data and regulatory actions. They document the DEA’s 2016 temporary scheduling proposal (later withdrawn), FDA import alerts on unapproved kratom products, and evolving state‑level controls PMC.

Abstract

An eight‑factor analysis under the US Controlled Substances Act was updated with over 100 studies (2018–2021), evaluating abuse potential, pharmacology, public health risks and benefits of mitragynine and 7‑OH. Findings favour continued access over scheduling, recommending targeted product quality regulation. (pmc.ncbi.nlm.nih.gov)

Introduction

Drug scheduling under the CSA requires rigorous abuse‑potential assessment across eight factors, including pharmacology, chemistry, public health data, and history of use. Earlier analyses (2018) of kratom alkaloids prompted reevaluation as new literature emerged.

Methods

Systematic searches identified English‑language studies (2018–2021) on kratom’s abuse, toxicity, and therapeutic potential. Data were mapped to the eight CSA factors, with Factors 4–6 consolidated for public health relevance.

Results

  • Factor 1: Limited self‑administration and conditioned place preference (CPP) in animal models.
  • Factors 2–3: Analgesic efficacy documented; CYP‑mediated metabolism of mitragynine to 7‑OH.
  • Factors 4–6: Survey data indicate primary use for health benefits (e.g., pain, mood, OUD mitigation).
  • Factor 7: Structure–activity consistent with controlled substances, but with a wider therapeutic window than schedule I opioids.
  • Factor 8: Kratom remains unscheduled at the federal level.

Overall, risks of scheduling include hindering opioid use disorder (OUD) management and limiting research opportunities. (pmc.ncbi.nlm.nih.gov)

Discussion

The comprehensive eight‑factor review indicates kratom alkaloids’ abuse potential parallels or falls below many currently legal substances. Regulatory focus should shift to improving product quality standards and expanding consumer education rather than implementing outright scheduling.

Conclusion

The updated analysis supports maintaining kratom’s unscheduled legal status while implementing safety‑driven federal guidelines to minimise adulteration and guide public health policy.

References

Henningfield JE, Wang DW, Huestis MA, et al. Kratom Abuse Potential 2021: An Updated Eight Factor Analysis. Front. Pharmacol. 2022;12:8860177. (pmc.ncbi.nlm.nih.gov)