The abuse potential of kratom according the 8 factors of the controlled substances act: implications for regulation and research.

The abuse potential of kratom according the 8 factors of the controlled substances act: implications for regulation and research.
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DOI:
10.1007/s00213-017-4813-4
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发表时间:
2018-03
期刊:
影响因子:
3.4
通讯作者:
Wang DW
Wang DW
中科院分区:
医学3区
文献类型:
--
作者:
Henningfield JE;Fant RV;Wang DW

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美国缉毒局和食品药品监督管理局考虑将kratom列入《受控物质法》(CSA)附表一,需要在公共卫生背景下评估其滥用潜力。该研究的目的是根据CSA的8个因素对kratom滥用潜力及其评估进行审查。Kratom叶和提取物已在东南亚和其他地方使用了几个世纪来管理疼痛和其他疾病,到二十世纪中叶,用于管理阿片类药物戒断。Kratom有一些阿片类药物的作用,但与滥用阿片类药物相比,呼吸抑制和滥用潜力较低。这似乎是由于其非阿片衍生的和类似的分子结构,最近被称为偏向激动剂。到21世纪初,kratom在美国越来越多地被用作改善情绪和生活质量的天然药物,并作为处方和非法阿片类药物的替代品,用于管理寻求戒除阿片类药物的人的疼痛和阿片类药物戒断。没有任何文件证明对公共健康构成威胁,似乎需要将这些产品紧急列入附表,列入《全面保障协定》附表一有可能造成严重的公共健康问题。虽然kratom似乎具有支持某种程度的列表的药理特性,但如果它是一种批准的药物,将其列入附表一,从而禁止它,可能会造成目前不存在的公共卫生问题。此外,FDA的适当监管对于确保适当和安全使用至关重要。本文的在线版本(10.1007/s 00213 -017-4813-4)包含补充材料,可供授权用户使用。
Consideration by the US Drug Enforcement Administration and Food and Drug Administration of placing kratom into Schedule I of the Controlled Substances Act (CSA) requires its evaluation of abuse potential in the context of public health. The objective of the study is to provide a review of kratom abuse potential and its evaluation according to the 8 factors of the CSA. Kratom leaves and extracts have been used for centuries in Southeast Asia and elsewhere to manage pain and other disorders and, by mid-twentieth century, to manage opioid withdrawal. Kratom has some opioid effects but low respiratory depression and abuse potential compared to opioids of abuse. This appears due to its non-opioid-derived and resembling molecular structure recently referred to as biased agonists. By the early 2000s, kratom was increasingly used in the US as a natural remedy to improve mood and quality of life and as substitutes for prescription and illicit opioids for managing pain and opioid withdrawal by people seeking abstinence from opioids. There has been no documented threat to public health that would appear to warrant emergency scheduling of the products and placement in Schedule I of the CSA carries risks of creating serious public health problems. Although kratom appears to have pharmacological properties that support some level of scheduling, if it was an approved drug, placing it into Schedule I, thus banning it, risks creating public health problems that do not presently exist. Furthermore, appropriate regulation by FDA is vital to ensure appropriate and safe use. The online version of this article (10.1007/s00213-017-4813-4) contains supplementary material, which is available to authorized users.
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