It has been estimated that a typical chewing session of khat results in the absorption of its active constituents with an activity equivalent to that of approximately 5 mg of amphetamine. The pharmacological effects of increased alertness, euphoria, hyperthermia, anorexia, increased respiration rate, heart rate and blood pressure. Fatalities associated with the sole consumption of khat have not yet been reported. However, prolonged use of khat has been linked to adverse effects that range from psychiatric disturbances (from psychosis to depression) to damage of major organs of the body, as well as to similar neurological disorders to those associated with amphetamine and cocaine use.
In spite of the increasing use of this substance,generic viagra pharmacy order amoxicillin medication phentermine 37.5mg scientific literature about the effects and toxicity of kratom alone remains very scarce. Kratom is a central nervous system stimulant, from which over 40 alkaloids have been isolated. In low doses it is reported to have stimulant effects (used to combat fatigue during long hours of work), while at high doses, it can have sedative-narcotic effects. In 1921, the major alkaloid found in this plant, ‘Mitragynine’, was first isolated. Mitragynine has an opioid agonistic activity and its derivative 7-hydroxymitragynine (7-OH-mitragynine) is reported to be more potent than mitragynine or morphine.
Nine fatal cases of intoxication associated with the use of ‘krypton’, a mixture of mitragynine and O-desmethyltramadol, have been described in scientific literature. However, these fatalities have been attributed to the addition of O-desmethyltramadol to the dried kratom leaves.
Animal studies have shown low toxicity and low addictive potential for salvia divinorum. Like other plant-based substances, there are limited scientific studies in humans that report acute or chronic toxicity associated with its use, but clinical observations have indicated lasting psychosis in vulnerable individuals. Thus far, there are no reports on fatalities from use of salvia divinorum. However, toxicological analyses have proved difficult as salvinorin A and other diterpenoids of the plant are not detected by conventional drug screening methods.
References Dhaifalah I. and Santavy J., ‘Khat habit and its health effect. A natural amphetamine’, Biomedical Papers, 2004, 148, 11-5
 Kelly, J.P., ‘Cathinone derivatives: a review of their chemistry, pharmacology and toxicology’, Drug Testing and Analysis, 2011, 3, 439-53 Hoffman, R. and Al’absi, M., ‘Khat use and neurobehavioural functions: suggestions for future studies’, Journal of Ethnopharmacology, 2010, 132, 554; Morrish, P.K., Nicolaou, N., Brakkenberg, P. and Smith, P.E., ‘Leukoencephalopathy associated with khat misuse’, Journal of Neurology, Neurosurgery, and Psychiatry, 1999, 67, 556; Odenwald, M., ‘Chronic khat use and psychotic disorders: a review of the literature and future prospects’, Sucht, 2007, 53, 9-22
 European Monitoring Centre for Drugs and Drug Addiction, ‘kratom’, Drug Profiles (www.emcdda.europa.eu)
 Kikura-Hanajiri, R., Kawamura, M., Maruyama, T., Kitajima, M., Takayama, H. and Goda, Y., ‘Simultaneous analysis of mitragynine, 7-hydroxymitragynine, and other alkaloids in the psychotropic plant “kratom” (Mitragynaspeciosa) by LC-ESI-MS’, Forensic Toxicology, 2009, 27 (2), 67-74
 Kronstrand, R., Roman, M., Thelander, G. and Eriksson, A., ‘Unintentional fatal intoxications with mitragynine and O-desmethyltramadol from the herbal blend krypton’, Journal of Analytical Toxicology, 2011, 35 (4), 242-7
 Mowry, M., Mosher, M., and Briner, W., ‘Acute physiologic and chronic histologic changes in rats and mice exposed to the unique hallucinogen salvinorin A’, Journal of Psychoactive Drugs, 2003, 35, 379-82
 European Monitoring Centre for Drugs and Drug Addiction, ‘Salviadivinorum’, Drug Profiles (www.emcdda.europa.eu)
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