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Abstract
Salvia divinorum and Mitragyna speciosa (“Kratom”), two unscheduled dietary supplements whose active agents are opioid receptor agonists, have discrete psychoactive effects that have contributed to their increasing popularity. Salvia divinorum contains the highly selective kappa- opioid receptor agonist salvinorin A; this compound produces visual hallucinations and synesthesia. Mitragynine, the major alkaloid identified from Kratom, has been reported as a partial opioid agonist producing similar effects to morphine. An interesting minor alkaloid of Kratom, 7-hydroxymitragynine, has been reported to be more potent than morphine. Both Kratom alkaloids are reported to activate supraspinal mu- and delta- opioid receptors, explaining their use by chronic narcotics users to ameliorate opioid withdrawal symptoms. Despite their widespread Internet availability, use of Salvia divinorum and Kratom represents an emerging trend that escapes traditional methods of toxicologic monitoring. The purpose of this article is to familiarize toxicologists and poison control specialists with these emerging psychoactive dietary supplements.
Acknowledgments
The authors gratefully acknowledge the contribution of Fire Erowid and Earth Erowid of www.erowid.org, and Drs. Melisa W. Lai and Robert S. Hoffman to the generation of this article. Dr. Boyer is supported by NIH grant R21 DA14929.
Notes
8. Herbal Smoke and Legal Bud Shop. (http://iamshamanshop.com/). (2 Januaey 2007).
17. “Salvia divinorum/ Maria Pastora” keyword search for 2000–2005. American Association of Poison Control Centers database. Conducted April 26, 2006.
36. “Mitragyna speciosa” keyword search for 2000–2005. American Association of Poison Control Centers database. Conducted April 26, 2006.