Kratom Use, Synthetic Cannabinoids (K2), and Trends in the Drug Supply.

Kolosionek, Timothy J; Amaducci, Alexandra M · Prim Care · 2026

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Abstract

Kratom and synthetic cannabinoids (SCs), often known as K2, are psychoactive substances gaining popularity, aided by a lack of regulation, despite serious health risks. Kratom is a plant-based substance containing mitragynine and 7-hydroxymitragynine, which cause opioid and stimulant effects. Users are at risk of opioid toxicity and withdrawal, as well as consequences of product contamination. SCs are cannabinoid receptor agonists despite a lack of structural similarity to cannabis. Adverse effects include increased rates of psychosis as well as seizures, stroke, and myocardial infarction, as well as dependent behaviors. SC regulation has limited effectiveness as new compounds often bypass existing policies.

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