According to the 1979 Narcotic Act of Thailand, Mitragyna speciosa (Korth.) Havil. or Kratom falls under type 5 narcotics. PSU is particularly interested in conducting research about the plant, indigenous to the South of Thailand and is popularly-used in the region. The comprehensive research has thus been initiated since 2002 till present, covering aspects of culture, behavior, health, science, and law.
Use of Kratom and health benefits
The research found that common folks chew on 1-3 fresh Kratom leaves varying from once a day, every one hour to couple of hours, or in some cases all day. Most reported to use Kratom together with other beverages or palm leave cigar. Majority of users are workers relying on Kratom to relieve exhaustion from monotonous and laborious work, or simply for recreational purpose, or treatment. Most users report to be high when using for the first time, continuously chewing too much, or chewing on an empty stomach. Adverse effects include weak limbs, blushing or numb faces, tinnitus, numb or hot ears, sleepiness, sluggishness, numb tongue, dizziness, headache, exhaustion, nausea, vomit, hypotension, sweating, increased urge to urinate or defecate though unable to/constipation. These symptoms usually dissipate in 5-10 minutes. If too severe, resting, overexerting to sweat it off, taking a cold bath, drinking cold water, eating sour fruits or food might remedy these symptoms.
By international standard, Kratom addiction qualifies as narcotic addiction including withdrawal syndrome. Characteristics unique to Kratom addiction are the following:
- Increased need to use. Must have it to go on a trip or else would refuse to travel. This behavior clearly impacts work and daily life.
- Unable to control the use including failing to quit using.
- Exhibits withdrawal symptoms when decrease or stop using.
- Increased tolerance, which means having to up the amount to pacify the need.
- Obsessive use, must be chewing constantly or regularly. Increased anxiety over how to obtain more supply.
Thai southerners sometimes use Kratom for its healing properties to remedy cough, diarrhea, stomachache, toothache, or for chronic health issues like diabetes, hypertension, heroine/meth/alcohol withdraw, for example. However, some users use Kratom so regularly instead of other narcotic substances that they become addicted to the plant.
Today, Kratom is available in powdered or desiccated form designed for easy use. One other more convenient and popular way is to boil and mix with other substances/drugs. A well-known brand of this format is 4x100, which is a mix of Kratom extract and another ingredient such as Coca Cola, cough suppressant, among others. The change of product translates to the shift in users, from labored workers to teens who use for recreational purposes which often led to petty crimes or violence. The impact of 4x100 drink depends on its co-ingredient; Kratom affects neuropsychology while soda contains caffeine which stimulates central region of the brain, cough suppressant causes drowsiness, or other substances could serve as sedatives effect. These ingredients combined with Kratom could cast a longterm health affect.
Kratom contains mitragynine, primary alkaloids which can reduce consumption of food and water as well as movement in the upper small intestine, relax muscles, relieve pain, increase amount and rate of glucose absorption into cells, and relieve ethanol and morphine withdrawal symptoms (in lab animals). The study of toxicology in Kratom found that acute extract of methanol (4.90 gram/kg) or high amount of alkaloid extract (173.20 mg/kg) of Kratom leaves led to 50% death of lab animals (LD50). Methanol extract increases Triglyceride, a liver enzyme, and cholesterol while 1,000 mg/kg of the extract increases creatinine which leads to toxicity in liver but no effect on body weight, consumption of food or water, or hematological index. However, chronic consumption of Kratom extract did not result in any toxicity in white rats. Therefore, well-regulated use of Kratom is not hazardous. The study also developed ELISA method to analyze mitragynine in Kratom.
Obviously, the study provides useful information to help regulate use of Kratom, addiction and its symptoms, for example. Southern Thailand presents as the most appropriate setting in which the study is to continue. The research shall benefit further development of public policy and regulations regarding narcotics, which heavily rely on scientific and social research evidence.
Prof. Dr. Sawitri Assanangkornchai and Dr. Darika Saingam
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University
Assoc. Prof. Dr. Juraithip Wungsintaweekul
Faculty of Pharmaceutical Sciences, Prince of Songkla University
Assoc. Prof. Dr. Ekkasit Kumarnsit, Dr. Dania Cheaha, Dr. Supattra Limsuwanchote, Dr. Somchai Sriwiriyajan, Asst. Prof. Dr. Wandee Udomuksorn, and Assoc. Prof. Somsmorn Chittrakarn
Faculty of Science, Prince of Songkla University