桔井使用影响的当前观点

IF 5.1 Q1 SUBSTANCE ABUSE Substance Abuse and Rehabilitation Pub Date : 2019-07-01 DOI:10.2147/SAR.S164261
Charles A. Veltri, O. Grundmann
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引用次数: 88

摘要

摘要咖啡科植物Mitragyna speciosa的叶子,通常被称为桔梗,在东南亚的原生栖息地被广泛用作在艰苦的白天劳动中维持能量的兴奋剂,以及阿片类止痛药和镇静剂。基于叶提取物的作用,传统和现代用途重叠,过去二十年来,叶提取物在美国和欧洲也越来越受欢迎。Kratom已经并正在用于缓解阿片类药物戒断症状,并作为一种减少伤害的药物,少数使用者随后对该提取物产生依赖。Kratom的人口使用模式在东南亚和西方世界各不相同。虽然纯奎托姆主要由日工使用,东南亚的年轻人将其与咳嗽药一起滥用,但美国的大多数使用者都是中年人,至少有中等收入,有私人医疗保险,并完成了一些大学学业。欧洲和美国都有报告称使用奎托姆导致死亡,但东南亚没有。尽管在死者血液中检测到奎托姆是生物碱mitragynine,但由于接触了多种药物,几乎所有病例都无法确定因果关系。值得注意的是,桔梗可以引起草药和药物的相互作用,尤其是与其他中枢神经系统活性物质的相互作用。鉴于西方国家的Kratom产品市场大多不受监管,消费者可能会接触到掺假或受污染的产品,尤其是通过网站或暗网购买的产品。许多国家已经将奎托姆列为候选药物,因为它具有类似兴奋剂和阿片类药物的作用,并且生物碱米特拉甘碱与阿片受体之间存在既定的相互作用。
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Current perspectives on the impact of Kratom use
Abstract The leaves from the tree Mitragyna speciosa, commonly known as Kratom, in the coffee plant family (Rubiaceae) are commonly used in their native habitat of Southeast Asia as a stimulant to sustain energy during hard day labor and as an opioid-like analgesic and sedative. Traditional and modern uses overlap based on the effects of the leaf extract which has also gained popularity in the United States and Europe in the last two decades. Kratom has and is being used for the mitigation of opioid withdrawal symptoms and as a harm reduction agent with a minority of users subsequently developing a dependence on the extract. The respective demographic use patterns of Kratom differ between Southeast Asia and the Western world. While pure Kratom is primarily used by day laborers and misused in conjunction with cough medicine by youth in Southeast Asia, a majority of users in the United States is middle-aged, has at least middle income, private health insurance, and completed some college. Deaths attributed to the use of Kratom have been reported in Europe and the United States but not in Southeast Asia. Although Kratom was detected as the alkaloid mitragynine in the blood of the decedents, causality could not be established in almost all cases because of poly-drug exposures. It is notable that Kratom can cause herb–drug interactions, especially with other central nervous system -active substances. Given the mostly unregulated market for Kratom products in Western countries, consumers may be exposed to adulterated or contaminated products, especially if purchased through websites or the darknet. A number of countries have scheduled Kratom because of its stimulant- and opioid-like effects and the established interaction of the alkaloid mitragynine with opioid receptors.
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审稿时长
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期刊最新文献
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