Nature's first "atypical opioids": Kratom and mitragynines

Area of Science:

• Pharmacology
• Pain Research
• Ethnobotany

Background:

• Many pain conditions involve multiple (multimechanistic) underlying causes.
• Effective pain relief with fewer side effects is achieved with multimechanistic analgesics.
• Modern analgesics include

Purpose of the Study:

• To explore the pharmacology of kratom and its dual opioid and non-opioid properties.
• To understand the basis for conflicting opinions on kratom's use and abuse potential.
• To highlight Nature's evolution of atypical opioids predating modern drug discovery.

Main Methods:

• Review of basic kratom pharmacology.
• Analysis of opioid and non-opioid mechanisms of action.
• Comparison with traditional opioids and modern atypical opioids.

Main Results:

• Kratom exhibits both opioid and non-opioid mechanisms of action.
• These dual properties explain the divergent views on kratom.
• Mitragynines in kratom represent Nature's evolution of atypical opioids.

Conclusions:

• Kratom's unique pharmacological profile, possessing both opioid and non-opioid activities, accounts for differing perspectives on its use.
• Nature evolved atypical opioids, such as mitragynines found in kratom, paralleling modern pharmaceutical developments.
• Understanding kratom's multimechanistic nature is key to navigating its complex therapeutic and societal implications.