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35 These alkaloids, along with their metabolites, including 7-hydroxymitragynine, differentially engage with opioid ( , , and ), adrenergic ( 1 and 2 ), and serotonergic (5-HT 1A and 5-HT 2B ) receptors, resulting in an entourage effect. 4,69 The widespread availability of kratom via internet vendors or at gas stations, head shops, smoke shops, and kratom-specific cafs has led to a marked increase in usage over the last decade

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