Kratom: What Is It?

[Alfa]

Kratom: What Is It?

by Murple
Mon May 29 2000
(Distribute Freely)


<HR SIZE=2>

Kratom refers to the plant Mitragyna speciosa Korth., a tree indigenous to Thailand; it is mostly grown in the central and southern regions of the country, and only rarely in the north. The Mitragyna genus, part of the family Rubiaceae, is found in tropical and sub-tropical regions of Asia and Africa. Asian Mitragynas are often found in rainforests, while the African species (which are sometimes still classed in a separate genus, Hallea) are often found in swamps. Most species are arborescent, some reaching heights of almost 100 feet. The genus was given its name by Korthals because the stigmas in the first species he examined resembled the shape of a bishop's mitre. This genus is characterized by a globular flowering head, bearing up to 120 florets each. During the flower bud stage, the developing florets are surrounded and completely covered by numerous overlapping bracteoles. Mitragyna species are used medicinally as well as for their fine timber through the areas they grow.

Mitragyna speciosa itself reaches heights of 50 feet with a spread of over 15 feet. The stem is erect and branching. Flowers are yellow. Leaves are evergreen, and are a dark glossy green in color, ovate-acuminate in shape, and opposite in growth pattern. Kratom is evergreen rather than deciduous, and leaves are constantly being shed and being replaced, but there is some quasi-seasonal leaf shedding due to environmental conditions. During the dry season of the year leaf fall is more abundant, and new growth is more plentiful during the rainy season. When grown outside their natural tropical habitat, leaf fall occurs with colder temperatures, around 4 degrees Celsius.

Kratom prefers wet, humusy soils in a protected position. Being a heavy feeder, it requires very rich, fertile soil. It is drought sensitive, and if grown out of its native habitat, sensitive to frost. Propagation is by very fresh seed or cuttings. There is a low strike rate, due to an endogenous fungus which attacks xylem tissue.


<HR align=center width=200>

Over 25 alkaloids have been isolated from kratom. The most abundant alkaloids consist of three indoles and two oxindoles. The three indoles are mitragynine, paynanthine, and speciogynine - the first two of which appear to be unique to this species. The two oxindoles are mitraphylline and speciofoline. Other alkaloids present include other indoles, and oxindoles such as ajmalicine, corynanthedine, mitraversine, rhychophylline, and stipulatine.

Mitragynine is the dominant alkaloid in the plant. It was first isolated in 1907 by D. Hooper, a process repeated in 1921 by E. Field who gave the alkaloid its name. Its structure was first fully determined in 1964 by D. Zacharias, R. Rosenstein and E. Jeffrey. It is structurally related to both the yohimbe alkaloids and voacangine. It is more distantly related to other tryptamine-based psychedelic drugs such as psilocybin or LSD. Chemically, mitragynine is 9-methoxy-corynantheidine. It has the molecular formula C23H30N2O4 and a molecular weight of 398.5. Physically the freebase is a white, amorphous powder with a melting point of 102-106 degrees and a boiling point of 230-240 degrees. It is soluble in alcohol, chloroform and acetic acid. The hydrochloride salt has a melting point of 243 degrees.

The alkaloid content of the leaves of Mitragyna speciosa is about 0.5%, about half of which is mitragynine. An average leaf weighs about 1.7 grams fresh or 0.43 grams dried. Twenty leaves contain approximately 17mg of mitragynine. All leaves appear to contain mitragynine, speciogynine, paynanthine, and small quantities of speciociliatine. Oxindole alkaloids usually occur only in small or trace ammounts.

Alkaloid content varies from place to place and at different times. Within each location, there is a quantitative variation in alkaloid content from month to month. While indole content seems to be fairly stable, oxindole content shows tremendous variation.


<HR align=center width=200>

Kratom is traditionally only used in Thailand, although some use in Malaysia has been reported. Besides kratom (or krathom), it also goes by the names ithang, kakuam, and in southern regions, thom. Use dates far enough back that its beginning can't be determined. In addition to being used as a narcotic drug in its own right, it is often used as a substitute for opium when opium is unavailable, or to moderate opium addiction. In folk medicine, it is often used to tread diarrhea. A small minority of users use kratom to prolong sexual intercourse.

Users distinguish different types of kratom, two main kinds being distinguished by the color of veins in the leaf - red or green/white. The green-veined variety is supposed to have a stronger effect. One study which surveyed Thai kratom users found that most users preferred a mixture of both, followed by red-veined alone and then white-veined alone. Growers in Australia report that both red and white veining occurs at different times in different plants which were all cloned from the same mother plant. They have not yet undertaken comparisons between the two.

Nearly all kratom use is by chewing fresh leaves. Other ways it is taken include grinding up and eating fresh, dried, or reconstituted dried leaves. Some villagers use the leaves in cooking. When preparing fresh leaf, the vein is extracted and sometimes salt is added to try and prevent constipation. Consumption of the leaf is usually followed by drinking something hot, such as warm water or coffee. Leaves can also be smoked, made into a tea, or a crude resin extraction can be made. This resin extract is made by preparing a water extract of the leaves, boiling it down, and then shaping it into small balls which are rolled in a material such as flour, then stored until use. This is apparently a quite popular method of consumption.

Users of kratom tend to be peasants, laborers, and farmers who use the plant to overcome the burdens of their hard work and meager existences. Female users are apparently quite rare. Age of usage onset seems to be higher than for other drugs. Some studies have found no addiction problems in villagers using kratom, while others apparently have. It seems likely that if used in doses high enough for mu receptor crossover (discussed below), addiction is a strong possibility. Heavy users may chew kratom between 3 and 10 times a day. While new users may only need a few leaves to obtain the desired effects, some users find with time they need to increase doses to 10-30 leaves or even more per day.

In some parts of the country, it was said that parents would choose to give their daughters in marriage to men who used kratom rather than men who used marijuana. The belief is that kratom users are hard working, while marijuana users are lazy. This belief is also maintained by many of the users themselves, who report beginning use because of a desire to work more efficiently, and who say using the drug gives them a strong desire to do work.

The Thai government passed the Kratom Act 2486 which went into effect on August 3, 1943. This law makes planting the tree illegal and requires existing trees to be cut down. This law was not found effective, since the tree is indigenous to the country. Today, kratom is classed in the same enforcement group as cocaine and heroin by Thai law, and has the same penalties. One ounce of extract is punishable by death. As with prohibition laws elsewhere in the world, this has succeeded only at increasing black market prices. A related species, Mitragyna javanica, is often used as a substitute to get around the law, but it is not considered as effective. The dominant alkaloid in this species is mitrajavine, which has not yet been pharmacologically tested.


<HR align=center width=200>

While the main alkaloids in kratom are structurally related to psychedelics, there appears to be no psychedelic activity. The dominant effects seem to be similar to opiate drugs, and include analgesia and cough suppression. These effects are roughly comparable in strength to codeine. Mitragynine suppresses opiate withdrawal, but its effects are not reversed by the opiate antagonist nalorphine. These opiate-like effects appear to be mediated mostly by delta and mu opioid receptors. In lower dosages, mitragynine exhibits a yohimbine-like binding to alpha-adrenergic receptors, as well as some binding to the delta opioid receptors. As doses increase, binding to delta receptors increases, and in yet higher doses, crossover to mu receptors occurs. Interestingly, mu crossover is increased by the presence of opiate drugs. While delta receptor selective opiate drugs have little abuse potential, it seems that they could be used as a primer which would allow mitragynine to more effectively bind to the mu receptor, which mediates the euphoric high produced by narcotics such as morphine.

Other effects of mitragynine are a reduction in smooth muscle tone, local anesthesia, and central nervous system depression. Acute side effects include dry mouth, increased urination, loss of appetite, and constipation coupled with small, blackish stools. Unlike opiates, mitragynine does not appear to cause nausea or vomiting. Heavy use can result in a prolonged sleep.

Side effects from long term use include anorexia and weight loss, insomnia, and a darkening of the skin, particularly on the cheeks, giving an appearance similar to a hepatic face. Among addicts, 30% report limited sexual desire and the need to use a combination of kratom and alcohol to become sexually stimulated. One study found 5 people who had psychotic conditions which may or may not have been revealed by very heavy kratom use. As discussed earlier, addiction seems to be a possibility if high doses are used. Some withdrawal symptoms reported by addicts include hostility, aggression, wet nose, inability to work, flow of tears, muscle and bone aches, and jerky limb movement.

While one study of Thai users reported that it is sedative in low doses changing over to stimulation in higher doses, this seems to be incorrect. Most other sources say that it is a stimulant in lower doses, becoming sedative in higher doses, which is consistent with mitragynine's receptor binding profile. Effects come on within five to ten minutes after use, and last for several hours. The feeling has been described as happy, strong, and active, with a strong desire to do work. The mind is described as calm. The Swiss biologist Claude Rifat experimented with a low dose of three smoked leaves and reported the effects reminded him somewhat of SSRIs, in that it blocked motivation, induced indifference, made doing everything boring, and brought on a strong laziness. It seems likely that these two almost opposite results may be influenced by cultural expectations.


<HR align=center width=200>

Inspired by traditional use, H. Ridley reported In 1897 that the leaves of Mitragyna speciosa were a cure for opium addiction. In more recent times, mitragynine has been used in New Zealand for methadone addiction detox. Kratom was smoked whenever the patient experienced withdrawal symptoms, over a 6 week treatment period. Patients reported a visualization effect taking place at night in the form of vivid hypnagogic dreams. While working on plans for ibogaine experiments in the USA, Cures Not Wars activist Dana Beal suggested that mitragynine could be used as an active placebo for comparison in the study. Acting Deputy Director of the NIDA Charles Grudzinskas rejected the proposal, however, saying that even less was known about mitragynine than ibogaine.

Although chemically similar, ibogaine and mitragynine work by different pathways, and have different applications in treatment of narcotic addiction. While ibogaine is intended as a one time treatment to cure addiction, mitragynine used to gradual wean the user off narcotics. The fact that mitragynine's mu crossover is increased by the presence of opiate drugs may be exploitable in the treatment of narcotics addiction, because it directs binding to where it is needed, automatically regulating the attachment ratio and modulating it towards the delta receptors over a short time. Within a few days, the addict would stop use of the narcotic they are addicted to, and the cravings and withdrawal will be moderated by the binding of mitragynine to the delta receptors. Mitragynine could also perhaps be used as a maintenance drug for addicts not wishing to quit but trying to moderate an out of hand addiction.

In 1999, Pennapa Sapcharoen, director of the National Institute of Thai Traditional Medicine in Bangkok said that kratom could be prescribed both to opiate addicts and to patients suffering from depression, but stressed that further research is needed. Chulalongkorn University chemists have isolated mitragynine which researchers can obtain for study.


<HR align=center width=200>

In conclusion, there seems to be much more research done into this plant and its active constituents. Although kratom has been used since time immemorial by Thai natives, Western science hasn't paid it that much attention. What research does exist contains some apparent conflicts. Knowledge even of the plant's existence outside of Thailand has been limited to ethnobotanists and a handful of pharmacology researchers. Availability of live plants and dried leaves has been practically non-existent until very recently.

There is much to learn.


<HR align=center width=200>

[Alfa]

<H1>A study of kratom eaters in Thailand</H1>
<H2>Details</H2>


Author: Sangun SUWANLERT
Pages: 21 to 27
Creation Date: 1975/01/01
<H3></H3>
<H2><A name=21>A study</A><A name=bnu05></A> of kratom eaters in Thailand</H2>
<H3></H3>


M.D. Sangun SUWANLERT Srithunya Hospital, Nondhaburi, Thailand

<H3><A name=s010>Introduction </A></H3>


Kratom is indigenous to Thailand. Market gardeners, peasants and labourers often become addicted to kratom leaf use. In certain respects kratom addiction resembles addiction to a drug with narcotic properties, except that long-term kratom addicts develop a dark skin, particularly on the cheeks. The age of onset is apparently later than in heroin addiction, and females are rare amongst those who use the substance.


Because of the harmful effects which may result from the use of the kratom leaf, the Government of Thailand passed a law (Kratom Act 2486) which came into force on 3 August 1943 and by virtue of which it is forbidden to plant the tree; and existing ones are to be cut down.


Kratom, known botanically as Mitragyna speciosa Korth., is a large tropical tree cultivated in Thailand, especially in the central and southern regions; it is rarely found in the northern and north-eastern parts of the country. The kratom leaf has long been known to possess narcotic properties and the beginning of its use in Thailand cannot be dated. Kratom is also called Kakuam, Ithang and, in the south of the country, Thom. In Thai folk medicine the leaf is used for the treatment of diarrhoea and as a substitute in cases of opium addiction. Some villagers use it as an ingredient for cooking. Market gardeners, peasants and labourers become easily addicted to the use of the leaf; they reason that it helps them to overcome the burden of their hard work and meager existence. Several alkaloids have been derived from the plant such as mitragynine, speciofoline, rhychophylline, and stipulatine (Phillipson and Shellard, 1965).


In the present study thirty male and female cases of kratom addiction were selected from the Nondhaburi province and from the suburbs of Bangkok for the purpose of an intensive study. The interview method was used with a questionnaire consisting of 30 items. In addition five cases of psychotic patients with a history of kratom addiction were studied at Srithunya Psychiatric Hospital in Nondhaburi. Findings from psychiatric and physical examination as well as treatment results were evaluated.
<H3><A name=s020>Results </A></H3>
<H4><A name="">DEMOGRAPHIC CHARACTERISTICS </A></H4><A name=22></A>


Table 1 shows the demographic data collected from the subject sample. Twenty-nine of the kratom users were male and one was female. The addicts ranged in age between 31 and 77 years. Market gardeners, peasants and labourers were the predominant occupations in the sample. The social composition was: middle-class cultivators, low-class peasants and labourers.<A name=nu05></A>


<TT>* Based on a paper read at the 31st International Congress on Alcoholism and Drug Dependence held at Bangkok in February 1975, organized by the International Council on Alcohol and Addictions. </TT><A name=nu10></A>


<TT>** For further details please see "The alkaloids of Mitragyna", by E. J. Shellard in: Bulletin on Narcotics, vol. XXVI, No. 2 (1974). </TT>


TABLE 1


Demographic characteristics of 30 Thai kratom eaters


<A name=t01></A>
<TABLE align=center border=1>
<TBODY>
<TR>
<TH>Characteristic</TH>
<TH>Number of subjects</TH></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Age</DIV></TD>
<TD>
<DIV></DIV></TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Under 20</DIV></TD>
<TD vAlign=top align=right>0</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>20-29</DIV></TD>
<TD vAlign=top align=right>0</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>30-49</DIV></TD>
<TD vAlign=top align=right>15</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>50-59</DIV></TD>
<TD vAlign=top align=right>6</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>60-69</DIV></TD>
<TD vAlign=top align=right>6</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>70 or over</DIV></TD>
<TD vAlign=top align=right>3</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Sex</DIV></TD>
<TD>
<DIV></DIV></TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Male</DIV></TD>
<TD vAlign=top align=right>29</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Female</DIV></TD>
<TD vAlign=top align=right>1</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Marital status</DIV></TD>
<TD>
<DIV></DIV></TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Single</DIV></TD>
<TD vAlign=top align=right>1</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Married</DIV></TD>
<TD vAlign=top align=right>26</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Divorced</DIV></TD>
<TD vAlign=top align=right>2</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Widowed</DIV></TD>
<TD vAlign=top align=right>1</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Social class</DIV></TD>
<TD>
<DIV></DIV></TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Upper</DIV></TD>
<TD vAlign=top align=right>1</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Middle</DIV></TD>
<TD vAlign=top align=right>19</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Lower</DIV></TD>
<TD vAlign=top align=right>10</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Ethnic background</DIV></TD>
<TD>
<DIV></DIV></TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Thai</DIV></TD>
<TD vAlign=top align=right>30</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Chinese</DIV></TD>
<TD vAlign=top align=right>0</TD></TR></TBODY></TABLE>


TABLE 2


Onset and duration of kratom addiction


<A name=t02></A>
<TABLE align=center border=1>
<TBODY>
<TR>
<TH>Chctracteristic</TH>
<TH>Number of subjects</TH></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Age at onset</DIV></TD>
<TD>
<DIV></DIV></TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Under 20</DIV></TD>
<TD vAlign=top align=right>2</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>20-29</DIV></TD>
<TD vAlign=top align=right>7</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>30-39</DIV></TD>
<TD vAlign=top align=right>13</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>40-49</DIV></TD>
<TD vAlign=top align=right>8</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Date of onset</DIV></TD>
<TD>
<DIV></DIV></TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>1945-1949</DIV></TD>
<TD vAlign=top align=right>6</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>1950-1954</DIV></TD>
<TD vAlign=top align=right>4</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>1955-1959</DIV></TD>
<TD vAlign=top align=right>9</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>1960-1964</DIV></TD>
<TD vAlign=top align=right>4</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>1965-1970</DIV></TD>
<TD vAlign=top align=right>6</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>1971-1975</DIV></TD>
<TD vAlign=top align=right>1</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>Number of years addicted</DIV></TD>
<TD>
<DIV></DIV></TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>1-5</DIV></TD>
<TD vAlign=top align=right>1</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>6-10</DIV></TD>
<TD vAlign=top align=right>6</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>11-15</DIV></TD>
<TD vAlign=top align=right>4</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>16-20</DIV></TD>
<TD vAlign=top align=right>9</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>21-25</DIV></TD>
<TD vAlign=top align=right>4</TD></TR>
<TR>
<TD vAlign=top align=left>
<DIV>26-30</DIV></TD>
<TD vAlign=top align=right>6</TD></TR></TBODY></TABLE>
<H4><A name="">METHOD OF CONSUMPTION AND ONSET AND DURATION OF ADDICTION </A></H4><A name=23></A>


There are two kinds of popular kratom uses among Thai addicts in this area; the kratom leaf contains either a red or a white vein and the latter has a stronger effect. The persons in the sample preferred either a mixture of the red and white vein (73.3%), red vein (16.6%) or a white vein (10%). 90% of kratom use is by chewing the fresh leaf or by grinding the dried leaf. This can then be eaten without further preparation or after having been placed into warm water. Some people also grind the fresh kratom leaf. For each preparation the vein in the leaf is extracted and in some cases salt is added to prevent constipation. Consumption is usually followed by a drink of warm liquid: warm water (40%); warm water and hot coffee (30%) or hot coffe alone (30%). In the early stages of addiction the user may take only a few leaves to obtain satisfactory results. The dosage is then increased in varying degrees among individual subjects: 10-20 leaves daily (40%); 21-30 leaves daily (36.6%); while the remainder of the sample increased its daily use to an indefinite number of leaves. The addicts chew about 3-10 times a day, depending on their sensation of weariness to be overcome. Amattayakul (1960) reported that an average green leaf weighs about 1.7 g and a dry leaf about 0.43 g. Twenty kratom leaves contain about 17 mg of mitragynine.
<H4 align=center>Kratom tree (tall one)</H4>


<A name=i01></A>http://IMG alt=Full size image: 64 k..._small.gif&gt;


Table 2 shows the onset and duration of kratom addiction and the duration of addiction at five year intervals. Almost all subjects in the sample became addicted to kratom because they wanted to work more efficiently. The subjects in this sample had been addicted for a period of from 3 years to 30 years, with a mean of 18.6 years.
<H4><A name="">PSYCHOLOGICAL EFFECTS </A></H4><A name=24></A>


Five to ten minutes after kratom consumption the user described himself as feeling happy, strong and active. The most important aspect for this kind of addict is a strong desire to work on his plot, in the rice field, or do other manual work.
<H4 align=center>Kratom leaf: white and red</H4>


<A name=i02></A>http://IMG alt=Full size image: 18 k..._small.gif&gt;
<H4 align=center>Kratom leaves and flowers</H4>


<A name=i03></A>http://IMG alt=Full size image: 64 k..._small.gif&gt;<A name=25></A>


He can work from morning until evening, even though it may be very hot and the sun bright at midday. Addicts are, however, afraid of the rain which causes.them to catch cold easily. They mention that their mind is calm and that they prefer to stay alone. Sexual desire is limited in about 30% of the subjects under study who need a combination of kratom and alcohol for sexual stimulation (26.3%). In 63.3% there was a normal sex life and only 6.6% used the leaf to prolong sexual intercourse. Anorexia, weight loss and insomnia are common among long-term kratom addicts. As these symptoms are similar to those of depression, it might be difficult to differentiate between depression and kratom addiction if one were to ignore an addict's case history.
<H4 align=center>Kratom flower</H4>


<A name=i04></A>http://IMG alt=Full size image: 38 k..._small.gif&gt;<A name=26></A>
<H4 align=center>Kratom, dried and fresh flower</H4>


<A name=i05></A>http://IMG alt=Full size image: 51 k..._small.gif&gt;
<H4><A name="">PHYSIOLOGICAL EFFECTS </A></H4>


Long term addicts become thin, their skin darkens, particularly in the face on both cheeks which gives an appearance similar to a hepatic face. Dryness in the mouth is common as well as frequent micturition and often constipation. Some mention that the faeces are black and tend to be small in shape similar to goat faeces (Norakarnphadung, 1968). Withdrawal symptoms include, for example, hostility, aggression, flow of tears, wet nose, inability to work, aching in the muscles and bones, jerky movement of the limbs. These are all typical symptoms of kratom addicts.
<H4><A name="">KRATOM PSYCHOSIS </A></H4>


There were five cases of kratom addiction revealing psychotic symptoms; these had been seen by the author in the last year (1974) in the outpatient department. Initially three cases were suspected of having kratom psychosis on the basis of their history of addiction and their general appearance and on psychiatric examination.


Case 1: A 55-year old Thai subject had begun eating kratom at the age of 20. His complaints were convulsions and mental confusion over the past few weeks. He was thin, his skin had become dark, particularly in the face on both cheeks, and it had an appearance similar to a hepatic face. Clouding of consciousness, experiencing of delusions and hallucinations were clearly evident.


Case 2: This 32-year old Thai was a labourer. He had begun using the kratom leaf daily at the age of 22 and had combined his kratom addiction with alcohol consumption for the past two years. He was confused and experienced persecutory ideation. He was admitted for two weeks; the result of the treatment was satisfactory.


Case 3: This 31-year old Thai was a married labourer who had begun eating kratom when he was 14. He complained of dizziness and headaches. He experienced hallucinations, delusion and confusion.


Only case 2 was admitted to the hospital, where major tranquillizers and supportive treatment were given. Cases 1 and 3 were out-patients, treated with major tranquillizers.


Cases 4 and 5 were psychotic patients. They had been multiple addicts, combining the use of kratom with alcohol, amphetamines and heroin. There were two cases of schizophrenia who had a history of kratom addiction and who were still users. While they were limited in social activity, they were good workers. None of them has relapsed during the past 10 years.
<H3><A name=s190>Discussion </A></H3><A name=27></A>


Kratom addicts in the sample studied were all Thai subjects, no Chinese addict was found in the area. The only discovered kratom addiction occurred among the Thai ethnic group. Norakarnphadung (1968) analysed data of drug addicts in 1960. There Were 3,384 cases registered who were admitted to the government opium treatment centre at Rangsit. Of these, only 2,000 were selected for investigation. These patients were divided into three groups: (i) Thai heroin addicts with a recent date of onset of use, combining heroin with kratom, about 5.5%; no Chinese were amongst these users; (ii) opium users who had switched to heroin, using the kratom leaf as well, about 11.5%; in this group Chinese users were represented by 0.93%; (iii) opium addicts also using the kratom leaf, 6.5%, with no Chinese amongst this group. It may be concluded that kratom addiction is culture-bound.


The reasons for starting the use of kratom are different from those given by opium users (Westermeyer, 1974). There was no subject in the sample who took kratom because of chronic illness. Kratom users have a strong desire to do more work and to make more money. They learned how to use the leaf from others. One factor in kratom leaf addiction is its cheapness and relative availability within the area, another is the cost factor, 100 kratom leaves costing 5 baht (25 United States cents).


Subjects in the sample began addictive use between adolescence and their mid30s. The mean age is higher than that of heroin addicts (Norakarnphadung, 1968). The proportion between male and female Thai addicts indicated a much higher ratio for the male group. Kratom use is rural in origin, with a cultural factor playing an important role; apparently society accepts male addicts who work to support their family, but do not accept female addicts.


Progression to kratom addiction is a gradual process with increases in dosage and frequency of use. Withdrawal symptoms of either minor or major severity are similar to those observed during withdrawal from other narcotics. There was only one who wanted to terminate addiction. In the early stages of addiction subjects can work hard and make good progress in semi-skilled and unskilled manual work. However after prolonged addiction their energy store often drops because of physical and psychiatric disturbances. There is no report of kratom use amongst students.


The measure chosen by law to control kratom addiction by banning the cultivation of the tree has not been found to be effective, since it is a local plant. It is hoped that drug education for the rural youth in areas where kratom can be grown will be a more effective step towards its control.
<H3><A name=s200>Acknowledgement </A></H3>


The author is deeply indebted to Professor Phon Sansingkeo for his help in the preparation of this paper, and to many co-workers without whose co-operation these studies could not have been accomplished.
<H3>Bibliography</H3>


Amattayakul T., The kraton leaves. J. Department of Medical Sciences, Thailand, vol. 2: 2, 104-108, 1960.


Norakarnphadung P., Analytic Data of Drug Addicts in Management of Narcotic Drug Dependence in Thanyarak Hospital, Thailand, 1968.


Phillipson D. J. and J. E. Shellard. The Alkaloid Content of some Asian Species of Mitragyna. School of Pharmacy, Chelsea College of Science and Technology, London, 1965.


Westermeyer J., Opium Smoking in Laos: A survey of 40 addicts. Am. J. Psychiatry, 131: 2, 165-170, 1974.<IFRAME id=kpfLogFrame style="DISPLAY: none" src= "http://localhost:44501/pl">
</IFRAME>
<SCRIPT type=text/javascript>
<!--
nopopups();
//-->
</SCRIPT>

[jj42099]

Is kratom an opiate and does it create false positives for opiates in drug tests?

[sands of time]

No and no. The alkaloids in kratom bind to the mu and delta opiod receptors in the brain, but kratom will not cause false positives on a drug test.

[Ninja Master]

great thread. this makes me want to hug my kratom tree. even more it makes me want to post a picture of it here. ill run off and figure out how to post pictures using the new forum software. great thread for a great plant!