Kratom in Clinical Practice: What Physicians Need to Know.

{"Kratom":[0,24],"use":[1],"is":[2,125],"increasingly":[3],"encountered":[4],"in":[5,92,130],"clinical":[6,70],"practice,":[7],"yet":[8],"products":[9,47],"marketed":[10],"under":[11],"this":[12],"name":[13],"encompass":[14],"markedly":[15],"different":[16],"substances":[17],"with":[18,36,60,83],"distinct":[19],"pharmacologic":[20],"and":[21,41,72,89,100,104,133,148],"risk":[22,144],"profiles.":[23],"leaf":[25],"(Mitragyna":[26],"speciosa)":[27],"contains":[28],"a":[29],"complex":[30],"mixture":[31],"of":[32,138],"alkaloids,":[33,56],"primarily":[34],"mitragynine,":[35],"serving":[37],"size":[38],"dependent":[39],"stimulant":[40],"sedative":[42],"effects,":[43,71],"whereas":[44],"many":[45],"modern":[46],"labeled":[48],"as":[49],"kratom":[50,78],"contain":[51],"concentrated,":[52],"semi-synthetic,":[53],"or":[54],"synthetic":[55],"particularly":[57],"7-hydroxymitragynine":[58],"(7-OH),":[59],"substantially":[61],"greater":[62],"opioid-like":[63],"potency.":[64],"This":[65],"review":[66],"summarizes":[67],"the":[68,136],"pharmacology,":[69],"safety":[73],"data":[74,106],"related":[75],"to":[76,113,127,142],"natural":[77],"leaf,":[79],"contrasts":[80],"these":[81],"findings":[82],"evidence":[84],"on":[85],"high-potency":[86],"alkaloid":[87,118],"products,":[88],"examines":[90],"limitations":[91],"adverse":[93],"event":[94],"surveillance":[95],"resulting":[96],"from":[97],"exposure":[98],"misclassification":[99],"polysubstance":[101],"use.":[102],"Clinical":[103],"toxicologic":[105],"suggest":[107],"that":[108],"severe":[109],"acute":[110],"harms":[111],"attributed":[112],"\\"kratom\\"":[114],"disproportionately":[115],"involve":[116],"concentrated":[117],"formulations":[119],"rather":[120],"than":[121],"whole-leaf":[122],"products.":[123],"Guidance":[124],"provided":[126],"assist":[128],"physicians":[129],"screening,":[131],"counseling,":[132],"documentation,":[134],"emphasizing":[135],"importance":[137],"distinguishing":[139],"product":[140],"type":[141],"support":[143],"assessment,":[145],"harm":[146],"reduction,":[147],"patient":[149],"safety.":[150]}