- Henry
100 facts about Kratom
1
Known as Kratom, its botanical name is Mitragyna speciosa.
https://en.wikipedia.org/wiki/Mitragyna_speciosa
2
It was given its botanical name Mitragyna speciosa, by Pieter Korthals a botanist who worked for the East India Company in 1839.
https://www.zamnesia.com/content/257-history-of-kratom
3
Kratom is from the same plant family as the coffee plant, rubiacecia and like coffeeKratom is also a stimulant.
http://www.sagewisdom.org/kratomguide.html
4
Its leaves are mini pharmacy full of plant pharmaceuticals and chemicals beneficial to human health.
https://www.arizonakratom.com/what-is-kratom-s/109.htm
5
Kratom is indigenous to Thailand, Malaysia, Indonesia, and Papua New Guinea.
Ahmad and Aziz 2012
https://www.ncbi.nlm.nih.gov/pubmed/22440259
6
Its an evergreen tree that can grow to a height of around 25 m or 80 feet tall. The leaves are dark green and glossy and oval in shape with 12 to 17 pairs of veins.
http://www.mitragyna.com/botany
7
There are three strains of Kratom – white, red and green vein kratom. They differ in their pharmacological effects. Red vein, for example, is solely a product of Thailand. According to internet drug forums, red vein kratom is known to be more sedative, whereas green and white kratom are the more stimulating strains.
http://www.kratomfacts.com/kratom-facts/types-of-kratom
8
It was used by male manual labourers to enhance physical endurance and as a means to overcome stress.
Ahmad and Aziz, 2012
https://www.ncbi.nlm.nih.gov/pubmed/22440259
9
Historically, kratom was used as a treatment for malaria, cough, hypertension, diarrhoea, depression, pain killer and fever reduction.
Griffin et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/27669103
10
There is also an early record of kratom being used in Thailand and Malaysia as an affordable opium substitute.
Tanguay, 2011
https://www.tni.org/files/download/kratom-briefing-dlr13.pdf
11
as a herbal medicine Kratom has the following actions;
Analgesic(pain), antipyretic (fever), antitussive (prevent cough), antidiarrheal,euphoric, anti-depressant, and anxiolytic (reduces anxiety)
Ling-Yi Feng et al 2017
http://www.sciencedirect.com/science/article/pii/S1021949817300844
12
Kratom can be ingested in many forms, including smoking or chewing the leaves;
brewing the leaves into a tea;
powdered leaves in capsule or pill form;
or an extract can be made into a liquid dose.
Additives, such as sugar or honey, are often added to kratom to reduce its bitter taste.
Griffin et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/27669103
Chemistry
13
Kratom is not a drug, an opiate or a synthetic substance. It is a naturally occurring plant medicine.
American Kratom Association
http://www.americankratom.org/facts
14
The key psychoactive compounds in Kratom are mitragynine and 7-hydroxymitragynin. But there are more than 40 compounds in kratom leaves.
Shellard 1974
https://www.ncbi.nlm.nih.gov/pubmed/4607551
15
The mitragynine contents in kratom vary with location and season. When kratom tree is grown in Southeast Asia, the amounts of mitragynine tend to be higher, but in elsewhere they tend to be low or non-existent.
Ward et al. 2011
https://www.ncbi.nlm.nih.gov/pubmed/22133323
Pharmacology
16
The pharmacology of kratom is still being developed and so what we know is still the subject of on going research and debate.
Warner et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/26511390
17
Kratom has been described as exerting both stimulant (at low doses), sedative (at high doses).
Babu et al., 2008
http://www.sagewisdom.org/babuetal.pdf
18
Whole leaves of kratom are stimulating while mitragynine is a depressant, suggesting the pharmacological importance of secondary alkaloids.
Shellard, 1989
https://www.ncbi.nlm.nih.gov/pubmed/2716343
19
The effects of the main alkaloids, i.e., mitragynine and 7-hydroxymitragynine have mainly been explained by interactions with the opioid, serotonin and dopamine receptors.
Boyer et al 2008
https://www.ncbi.nlm.nih.gov/pubmed/18482427
20
7-hydroxymitragynine found is Kratom has been shown to be 13 times stronger than morphine in animal studies.
Matsumoto et al 2004)
https://www.ncbi.nlm.nih.gov/pubmed/14969718
Health benefits
21
Kratom is recognised as a remedy for opioid withdrawal
The predominant alkaloid of kratom, mitragynine, binds with the mu- and kappa-opioid receptors, but has additional receptor affinities that might augment its effectiveness at mitigating opioid withdrawal.
Boyer et al 2008
https://www.ncbi.nlm.nih.gov/pubmed/18482427
22
At least two studies have demonstrated that mitragynine exerts an antidepressant effect. So Kratom could be used to treat depression.
Kumarnsit et al., 2007
https://www.ncbi.nlm.nih.gov/pubmed/17316993
Idayu et al. 2011
https://www.ncbi.nlm.nih.gov/pubmed/20869223
23
Kratom has traditionally been used to improve libido and sexual performance.
Cinosi et al 2015
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657101/
24
Research suggests that Kratom reduces food and water intake leading to a suppression of body weight gain and to weight loss.
Kumarnsit et al., 2006)
https://www.ncbi.nlm.nih.gov/pubmed/16781828
25
Kratom has also been used to self-manage alcohol withdrawal symptoms according to a German study.
Havemann-Reinecke, 2011
http://www.sciencedirect.com/science/article/pii/S0924933811717618
26
Users on the website erowid.org report the following effects:
euphoria, a sense of wellbeing, relaxation, enhanced sociability, more energy, analgesia and sensory enhancement
Swogger et al., 2015
http://blogs.ubc.ca/walshlab/files/2015/06/kratom.pdf
27
Kratom is used as a traditional medicine in Thailand and Malaysia in cases of chronic musculoskeletal pain, coughs, diabetes and hypertension.
Pantano et al 2016
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849036/
28
Kratom as a stimulant, increases physical energy is increased, the mind is more focused and one feels more motivated to get things done.
Swogger et al., 2015
http://blogs.ubc.ca/walshlab/files/2015/06/kratom.pdf
29
According to another study Kratom has an anti-inflammatory effect.
Shaik Mossadeq et al., 2009
https://www.ncbi.nlm.nih.gov/pubmed/19648761
Warnings and precautions
30
You should never drive, operate heavy machinery, use power tool or climb ladderswhile under the influence of kratom.
C Ulbricht et al. J Diet Suppl 10 (2), 152-170. 6 2013
https://www.ncbi.nlm.nih.gov/labs/articles/23725528/
31
Kratom products are sold in a wide variety of forms and as a result kratom products can vary in their mitragynine concentration.
https://www.accessdata.fda.gov/cms_ia/importalert_1137.html
32
According to one research paper Kratom should be used cautiously with patients who have thyroid disorders, liver disorders, gastrointestinal disorders or neurologic disorders.
C Ulbricht et al. J Diet Suppl 10 (2), 152-170. 6 2013
https://www.ncbi.nlm.nih.gov/labs/articles/23725528/
33
More recently, kratom has gained popularity among young people for its euphoric effects giving a ‘legal’ high and as an alternative to other sedative and stimulant type drugs and caution should be excised when using stimulates.
Warner et al., 2016
https://www.ncbi.nlm.nih.gov/pubmed/26511390
34
Combinations of kratom with other substances are also being sold via the internet promising a more powerful high.
One such concoction is ‘krypton’ which combines powdered Kratom leaves with O-Desmethyltramadol.
Nine cases of death in less than a year linked to the overdose of this combination in Sweden.
Kronstrand et al. 2011
https://www.ncbi.nlm.nih.gov/pubmed/21513619
35
Avoid during pregnancy or lactation, and with children, due to a lack of available evidence.
C Ulbricht et al. J Diet Suppl 10 (2), 152-170. 6 2013
https://www.ncbi.nlm.nih.gov/labs/articles/23725528/
36
Kratom’s stimulating and analgesic effects means that it can be beneficial for sports performance enhancement.
Kratom has been detected in professional sports. In 2015, for the first time, mitragynine was detected in four official doping control samples originating from strength sports.
Guddat et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/27001139
Interactions
37
Kratom can interact with;
alcohol, pain killers (analgesics), benzodiazepines, caffeine, cocaine, diuretics, gastrointestinal agents, hepatotoxins, monoamine oxidase inhibitors (MAOI’s) – anti depressants, neurological agents, opioids, sedatives, stimulants and thyroids hormones.
Ulbricht et al 2013
https://www.ncbi.nlm.nih.gov/labs/articles/23725528/
38
You should always discuss your medication with your prescribing doctor before making changes.
http://www.mitragyna.com/warning
Toxology
39
Although the use of kratom is increasing, scientific research of its adverse effects and toxicity is still limited.
Lung-Yi Feng et al 2017
http://www.sciencedirect.com/science/article/pii/S1021949817300844
40
A 2015 literature review in the International Journal of Legal Medicine found that “Kratom is considered minimally toxic,”
Warner et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/26511390
41
The pharmacologic effects of kratom leaves and their constituents are dose-dependent.
The more you use the stronger the effect.
Satariya Trakulsrichai et al 2015
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425236/
42
In the past 5 years, there were nine fatal cases of intoxication associated with the use of kratom-based product known as “Krypton”, a mixture of and O-desmethyltramadol. However, the mortalities have been ascribed to the addition of O-desmethyltramadol.
Kronstrand et al 2011
https://www.ncbi.nlm.nih.gov/pubmed/21513619
43
Only one study in Thailand has documented cases of kratom poisoning and adverse withdrawal symptoms among users.
Most of the respondents who reported kratom poisoning and withdrawal symptoms were found to be under the influence of other illicit drugs at the time.
Trakulsrichai et al., 2013
https://www.ncbi.nlm.nih.gov/pubmed/24592666
44
There have also been reports of people making up their own concoctions of kratom with codeine or cough syrup.
Tungtananuwat and Lawanprasert, 2010
45
Although some cases have been reported of deaths attributed to kratom use, no solid evidence has yet been provided where the substance was the sole contributor to the fatality
Warner et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/26511390
Side effects
46
The side effects of kratom in the Western context have to be deduced from case reportsas no large face-to-face surveys of users have been conducted.
Pantano et al 2016
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849036/
47
Some individuals may experience anxiety, irritability due to stimulant effects if high-doses are consumed.
https://www.drugs.com/illicit/kratom.html
48
Hyper-pigmentation of the cheeks, tremor, anorexia and weight loss have been noted in individuals with long-term use of kratom.
Sangun 1975
http://psycnet.apa.org/psycinfo/1977-10558-001
49
Negative side effects, reported by users of the website erowid.org included nausea, stomach aches, alternating between chills and sweats, dizziness, vomiting, itching, numbness in the mouth and throat, sedation, visual alterations and unsteadiness were filed.
https://erowid.org/plants/kratom/kratom.shtml
50
However, regular users are prone to develop tolerance and often increase their intake over time and kratom may be addictive just like any substance that reduces pain.
Singh et al., 2014
https://www.ncbi.nlm.nih.gov/labs/articles/24698080/
51
Two cases of kratom use linked with seizures were reported, though these links could not be firmly established.
Roche et al., 2009
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550469/
52
One case of hypothyroidism in a kratom using male.
there is a possibility that mitragynine might interfere with the functioning of the thyroid gland.
Sheleg and Collins, 2011
https://www.ncbi.nlm.nih.gov/pubmed/21817918
53
Injury to the liver has also been linked to kratom ingestion.
A report from Germany described the case of a 25-year-old man who developed impaired flow of bile inside the liver after consuming high doses of kratom powder for two weeks.
Kapp et al 2011
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550198/
54
A similar case of a man aged 58 suffering from cholestatic hepatitis was linked to prolonged use of kratom.
Singh et al., 2014
https://www.ncbi.nlm.nih.gov/labs/articles/24698080/
55
Researchers speculate that the pharmacological pure mitragynine consumed in the West and the unprocessed leaf used in South East Asia may also explain the difference socio cultural experiences of Kratom since the unprocessed leaf may contain other substances that modify the effects of the plant.
Jansen and Prast (1988a,b),
http://www.tandfonline.com/doi/abs/10.1080/02791072.1988.10472519?journalCode=ujpd20
56
The limited information on the risks and benefits of kratom in humans contrasts with sensationalistic, and often inaccurate, reports in the popular media regarding the dangers of kratom use.
Swogger et al 2015
http://www.tandfonline.com/doi/full/10.1080/02791072.2015.1096434
Addictive
57
At the moment there is no standard criteria to assess addiction to kratom – so at the moment its difficult to claim when Kratom addiction occurs.
http://ensobotanicals.com/kratom-addiction/
58
Many still believe that kratom has addictive potential.
Hassan et al. 2013
https://www.ncbi.nlm.nih.gov/pubmed/23206666
59
Although kratom has a similar mechanism of action as many opiate pain medications it does not appear to be nearly as addictive.
Ismail et al 2017
https://www.ncbi.nlm.nih.gov/pubmed/28443503
60
Research found that kratom is sometimes sought by heroin users when they are unable to obtain any heroin.
Swogger et al 2015
http://www.tandfonline.com/doi/full/10.1080/02791072.2015.1096434
61
Kratom is still viewed as an addictive psychotropic plant since its effects resemble those of other psycho tropic substances.
Tanguay, 2011
https://www.tni.org/files/download/kratom-briefing-dlr13.pdf
62
Kratom is not habit forming when it is used responsibly. If used occasionally as a recreational substance, rather than daily, there is virtually no risk of becoming dependent on it.
http://www.sagewisdom.org/kratomguide.html
63
However, kratom may have wide appeal among drug users because it produces stimulant-like effects, opiate-like effects, and can be used as a legal means to treat opiate withdrawal.
Griffin et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/27669103
64
Kratom, like many substances [e.g. alcohol, coffee, tobacco, etc.] if used on a daily basis for a prolonged period of time, could become a habit hard to break.
Meurk et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/27142450
65
Of course, people who are using kratom to overcome a preexisting opiate addiction may need to use kratom daily to avoid opiate withdrawal.
Hassan et al 2013
http://www.sciencedirect.com/science/article/pii/S0149763412002023
66
People suffering from chronic pain may also need to take pain medications on a daily basis, and some people choose to use kratom instead of pharmaceutical pain killers.
Hassan et al 2013
http://www.sciencedirect.com/science/article/pii/S0149763412002023
67
While kratom use can produce dependency, kratom withdrawal symptoms appear to be more moderate than withdrawal symptoms from opiates.
Griffin et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/27669103
68
A number (10.6%) of individuals reported successfully using kratom as a substitute to help abstain from the use of other substances perceived as addictive and/or causing harm.
These substances were primarily opioids, benzodiazepines and antidepressants.
Swogger et al 2015
http://www.tandfonline.com/doi/full/10.1080/02791072.2015.1096434
Withdrawal effects
69
Withdrawal symptoms were reported to include; aching muscles and bones, jerky movements of the limbs, anorexia, weight loss, insomnia, and psychosis.
Yusoff et al 2014
https://www.ncbi.nlm.nih.gov/pubmed/25262913
70
The psychological symptoms include restlessness, tension, aggression, sadness, nervousness, delusion, hallucination, and intense craving.
Feelings of anxiety, depression, moodiness and insomnia were also reported.
Singh et al., 2014
https://www.ncbi.nlm.nih.gov/labs/articles/24698080/
71
Recent evidence has demonstrated that kratom is used regularly with only small impairments of social functioning, in contrast to opiates.
Griffin et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/27669103
72
Some long-term users may have difficulty giving up regular kratom use.
Singh et al., 2014
https://www.ncbi.nlm.nih.gov/labs/articles/24698080/
73
Other report that while kratom withdrawal symptoms are annoying and distracting, they were not as painful as in the case of opiate withdrawal symptoms.
Tanguay (2011)
https://www.tni.org/files/download/kratom-briefing-dlr13.pdf
74
A survey of users in Malaysia found that respondents who consumed ≥3 glasses of kratom juice daily had higher odds of developing kratom dependence and withdrawal symptoms.
It was also noted that the withdrawal symptoms usually disappear after 1–3 days.
Singh et al., 2014)
https://www.ncbi.nlm.nih.gov/labs/articles/24698080/
75
Despite kratom dependence, many users remain in good health and functioned normally.
Singh et al 2015
https://www.ncbi.nlm.nih.gov/pubmed/25950592
76
More recently, a Malaysian study found no significant impairment in the social-functioning of kratom users.
Furthermore, none of the respondents were involved in risky drug using or criminal behaviours.
Singh et al., 2015
http://www.tandfonline.com/doi/abs/10.1080/02791072.2015.1012610
77
Insomnia and restlessness can follow the cessation of use.
Kapp et al. 2011
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550198/
78
A male with alcohol dependence in the UK complained of anxiety, restlessness, tremor, sweating, craving, itch, and feelings of dread.
However, the symptoms were described as being ‘short and benign’.
McWhirter and Morris, 2010
https://www.karger.com/Article/Abstract/320288
Legal Status
79
Kratom is currently banned and controlled under the Poisons Act 1953 in Malaysia. Those found guilty of distributing kratom leaves or preparations illegally can be fined or be sentenced to jail for up to 4 years.
Vicknasingam et al., 2010
https://www.ncbi.nlm.nih.gov/pubmed/20092998
80
The cultivation of kratom is, however, not an offence in Malaysia.
Despite legal sanctions, processed kratom juice can be acquired with ease from illegal kratom traders in the community.
Vicknasingam et al., 2010
https://www.ncbi.nlm.nih.gov/pubmed/20092998
81
In Thailand, kratom was first regulated under the Kratom Act 1943 but has been reclassified in 1979 under the Narcotic Act.
The planting, possession, import and export of kratom leaves are now considered illegal.
Assanangkornchai et al., 2007a
http://www.drugandalcoholdependence.com/article/S0376-8716(06)00211-0/fulltext
82
Though Kratom is legal in the U.S., some states have and/or are taking regulatory or legislative action to ban this wonderful plant.
US Drug Enforcement Administration has placed Kratom on its list of “Drugs and Chemicals of Concern.
American Kratom Association
http://www.americankratom.org/legal_status
83
Though the Food and Drug Administration (FDA) of US has released an import alert cautioning the side-effects of kratom use in humans, kratom is still not regulated in the US.
Cinosi et al., 2015
https://www.ncbi.nlm.nih.gov/pubmed/26640804
84
Kratom is currently controlled in several EU member states such as Denmark, Finland, Lithuania, Poland, Romania and Sweden.
Forrester, 2013
http://www.emcdda.europa.eu/publications/drug-profiles/kratom#control
85
Kratom is banned in Australia, Bhutan, Malaysia, Myanmar (Burma), and Thailand.
Some of these countries impose severe penalties for possession of Kratom.
http://kratomlegend.com/legal-status-of-kratom/the-legal-status-of-kratom-in-australia/
86
Kratom has just been made illegal in Ireland. It is now a schedule 1 drug giving it the same status as heroin.
http://health.gov.ie/wp-content/uploads/2017/05/si174.pdf
87
Most of the Irish politicians who voted for this new law have probably never heard of Kratom or its alkaloids mitragynine and 7-hydroxymitragynine but based on the scare mongering scientists they just vote on bills with out reading the evidence! I will further document this fact in due course as I am currently seeking from the department of health, the evidence they use to support the ban. They are having difficulties providing this information. Politicians I contacted in relation to Kratom, did not know if it was legal or illegal even though it was now passed into law.
https://en.wikipedia.org/wiki/List_of_Irish_politicians
88
There is a risk that anti drug rhetoric fuelled by fear and ignorance will damage the reputation of kratom and lead to more countries making it illegal.
Swogger et al 2015
http://www.tandfonline.com/doi/full/10.1080/02791072.2015.1096434
Social status
89
Users in the northern Malaysian were relying on kratom for these purposes because it was cheap, and easily available and, in the case of those facing opiate withdrawal symptoms, obviated the need to approach government facilities that might expose their identities.
Vicknasingam et al. 2010
https://www.ncbi.nlm.nih.gov/pubmed/20092998
90
More importantly, it enables self- treatment that avoids stigmatisation as a drug dependent.
These claims merit further serious scientific investigation since it holds out the possibility of kratom being developed as a low-cost alter- native therapy, particularly in developing countries.
Singh et al 2016
http://www.tandfonline.com/doi/abs/10.1080/02791072.2015.1012610
91
There are also reports a more recent drug use trend among the young (teenagers to individuals in their 30s) in Thailand who boil kratom leaves as a base for a cocktail named, ‘4 × 100’.
It is made up of kratom tea, cough syrup, Coca-Cola and ice cubes.
Tanguay, 2011
https://www.tni.org/files/download/kratom-briefing-dlr13.pdf
92
Fears of censure from the community and arrests by law enforcement agencies have therefore pushed the use of such concoctions to ‘hidden settings’.
Singh et al 2015
https://www.ncbi.nlm.nih.gov/pubmed/25950592
93
Kratom is viewed as an economical alternative to self-treat pain from prescription opioid withdrawal as well.
McIntyre et al., 2015
https://academic.oup.com/jat/article-lookup/doi/10.1093/jat/bku137
94
Both in South East Asia and the West, kratom has moved away gradually from its traditional uses (to increase physical endurance and to treat several physical maladies) to newer uses with potential promise.
Singh et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/27178014
95
In South East Asia, while users may face rebuke from family for engaging in the ‘wasteful’ kratom use habit they are neither discriminated against, nor are they stereo- typed as drug users.
Ahmad and Aziz, 2012
https://www.ncbi.nlm.nih.gov/pubmed/22440259
96
The majority of regular kratom users are older individuals, with regular employment,and are married and living with their family.
Assanangkornchai et al., 2007a
http://www.drugandalcoholdependence.com/article/S0376-8716(06)00211-0/fulltext
The future of Kratom
97
Recent findings suggest that kratom is purchased from internet sources by some of the40 million Americans with chronic pain to self-manage opioid withdrawal.
Boyer et al 2007
https://www.ncbi.nlm.nih.gov/labs/articles/18482427/
98
Kratom holds the potential to be developed as a treatment option for opiate dependence.
Singh et al 2016
http://www.tandfonline.com/doi/abs/10.1080/02791072.2015.1012610
99
“Deaths associated with kratom” are not necessarily caused by kratom. “Kratom is considered minimally toxic,”. “Although death has been attributed to kratom use, there is no solid evidence that kratom was the sole contributor to an individual’s death.”
Warner et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/26511390
100
The DEA argue that Kratom is dangerous because there were 660 calls related to kratom exposure” from 2010 through 2015, an average of 110 a year.
By comparison, exposures involving analgesics accounted for nearly 300,000 calls in 2014, while cosmetics and personal care products, cleaning solutions, antidepressants and antihistamines each accounted for more than 100,000.
Warner et al 2016
https://www.ncbi.nlm.nih.gov/pubmed/26511390
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