Phytomedicine Plus Comprehensive Kratom Review: Balancing Traditional Use, Therapeutic Potential, and Global Safety Concerns

Why it matters

This open-access peer-reviewed review synthesizes kratom's ethnopharmacology, phytochemistry, pharmacology, toxicology, and worldwide regulatory status—providing a globally relevant reference as policymakers navigate rapidly changing kratom regulations.

The big picture

Kratom has been used in Southeast Asia for centuries as both a stimulant and pain reliever, but Western scientific literature remains fragmented. With U.S. states moving in divergent directions on kratom policy, a comprehensive multidisciplinary review integrating traditional knowledge with modern pharmacology is increasingly valuable for healthcare providers, researchers, and legislators.

Key findings

• Kratom (Mitragyna speciosa) has a centuries-long traditional use in Thailand and Southeast Asia as both stimulant at low doses and sedative at high doses
• Mitragynine and 7-OH are the primary bioactive alkaloids; dozens of additional alkaloids contribute to the plant's complex pharmacological profile
• Dose-dependent effects make kratom's clinical behavior highly variable; human clinical research remains limited compared to animal studies
• Toxicological concerns include liver toxicity, cardiovascular effects, and addiction potential, though evidence levels vary across conditions
• Regulatory status varies dramatically globally—some countries have long banned kratom while others permit open sale; U.S. state laws now span the full spectrum

What they say

"Collaborative research integrating traditional knowledge with modern science is essential to validate its medicinal potential, ensure sustainable sourcing, and harmonize regulations," the authors conclude. "Policymakers must balance accessibility with safety to protect public health and indigenous rights."

Bottom line

A comprehensive open-access review in Phytomedicine Plus offers the most current multidisciplinary synthesis of kratom science and regulation, serving as a key reference for evidence-based policymaking worldwide.