Advancing Kratom Science and Regulation: A Comparative Framework With Cannabis.
Journal of addiction medicine June 3, 2026 Ynhi T Thomas, Mubeen Iqbal, Chung J Mun et al.
Kratom, a psychoactive botanical used historically in Southeast Asia and increasingly in the United States, has limited evidence for its analgesic, stimulant, and mood-altering effects. This narrative review distinguishes between whole leaf products and those enriched with active constituents or semisynthetic derivatives, which differ in chemistry, pharmacology, and risk. Priorities include developing chemically defined botanical preparations, validated analytical methods, and human studies linking exposure to effect. The authors suggest a dual regulatory track: enhanced quality standards for botanical products and conventional drug development pathways for enriched or semisynthetic constituents. Coordinated federal support is needed to align product standardization, early phase trials, and comparative evaluations across product classes to examine therapeutic applications while safeguarding public health.