Evaluation of the unregulated online kratom market in two east-central European countries: test purchase and analysis of potential toxicological consequences

The online kratom market in East-Central Europe poses a significant public health threat, particularly to individuals seeking its enhancement effects. The significant variability in the mitragynine content, combined with the lack of safety information creates a high-risk environment. Toxicological data revealed a high incidence of serious adverse reactions, particularly in cases of polysubstance use. These findings highlight the urgent need for regulatory oversight and harm reduction strategies.