Publication Name	World Journal of Psychiatry
Manuscript ID	126485
DOI	10.5498/wjp.126485
Country	United States

Category	Psychiatry
Manuscript Type	Minireviews
Article Title	Fentanylization of Kratom: A narrative mini-review of escalating potency, access, and psychiatric complications
Manuscript Source	Invited Manuscript
All Author List	Cody Abbott, Matthew Karow and Heather Murray
Funding Agency and Grant Number
Corresponding Author	Cody Abbott, MD, Department of Psychiatry, University of Colorado School of Medicine, Anschutz Health Sciences Building 1890 N Revere Ct Suite 4003 Mail Stop F546, Aurora, CO 80045, United States. cody.abbott@cuanschutz.edu
Key Words	Kratom; 7-hydroxymitragynine; Mitragynine pseudoindoxyl; Kratom alkaloids; Serotonin syndrome; Drug-drug interactions; CYP450; Psychopharmacology; Substance use disorder; Psychosis
Core Tip	This review proposes the term “fentanylization” as a conceptual framework for the market-driven escalation of potency of recreationally used substances relevant to psychiatric populations, with specific emphasis on Kratom-derived alkaloids. In this paper, we describe the largely unregulated synthesis of increasingly potent Kratom-alkaloid derivatives (notably 7-hydroxymitragynine and mitragynine pseudoindoxyl) via alkaloid enrichment beyond whole-leaf material, semi-synthetic modification(s), and ever-expanding commercialization within the United States. We describe the term both generally as a depiction of how potency of analogous drug products tends to outpace consumer awareness as well as regulatory oversight, utilizing Kratom as a specific case-study of this phenomenon. This analogy compares Kratom and illicit fentanyl, highlighting a shared trajectory of escalating potency across drug classes rather than asserting equivalent lethality, as Kratom alkaloids have not shown a comparable population-level mortality profile.
Citation	Abbott C, Karow M, Murray H. Fentanylization of Kratom: A narrative mini-review of escalating potency, access, and psychiatric complications. World J Psychiatry 2026; In press DOI: https://doi.org/10.5498/wjp.126485
PDF	126485-in-press.pdf

Received	2026-08-05 06:19
Peer-Review Started	2026-08-05 06:20
First Decision by Editorial Office Director
Return for Revision	2026-09-02 03:13
Revised	2026-09-16 03:29
Publication Fee Transferred
Second Decision by Editor	2026-10-19 06:06
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-10-20 09:46
Articles in Press	2026-10-20 09:46
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3206 (online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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