Kratom: Kratom Overview“New Psychoactive substances…” article analysis continued (part 2)

Overview of Kratom:

In the author’s overview of kratom, they dictate what little they know of kratom’s usage from the points of two different sources. First, they say that “People often use fresh kratom leaves to alleviate pain” and that “depending upon the dose consumption, the effects of psychostimulant and opiate like efficacy have been reported.” This checks out with everything that you’ll find on the internet, what you’ve heard from the typical kratom user, and other research.

 

The first source referred to by the journal article is called “Opioid receptors and legal highs: Salvia divinorum and Kratom.” The abstract, which was all I could access, says that kratom (Mitragyna speciosa)

“[is an] opioid receptor [agonist which has] discrete psychoactive effects that have contributed to [its] increasing popularity…an interesting minor alkaloid of Kratom, 7-hydroxymitragynine, has been reported to be more potent than morphine. Both Kratom alkaloids are reported to activate supraspinal mu- and delta- opioid receptors, explaining their use by chronic narcotics users to ameliorate opioid withdrawal symptoms…Kratom represents an emerging trend that escapes traditional methods of toxicologic monitoring.”

 

The “opiate like efficacy” will be discussed later in another post. But suffice it to say that the effects of kratom are less than that of many other psychoactive substances which contributes to the growing trend towards kratom.

Also note that it is the extracted alkaloid by itself that has the effects of morphine, and only at certain dosages.

This is not necessarily a bad thing unless users are regulating their own use without supervision and doctor’s approval or self-control. In the hands of a responsible, self-disciplined person, kratom has less potential for harm. In addition, as the excerpt I included above explains, some narcotics users utilize kratom “to ameliorate opioid withdrawal symptoms.” In other words, the activation of those particular receptors helps people addicted to narcotics by ameliorating withdrawal symptoms (or in other words, reducing or limiting withdrawal symptoms).

You can find a testimony of this here: https://news.vice.com/story/some-people-addicted-to-opioids-are-using-kratom-to-avoid-withdrawal
The second cited source is “The informal use of ketum (Mit.Speciosa) for opioid withdrawal in the northern states of peninsular Malyasia and implications for drug substitution therapy” says “Ketum (krathom) has been mentioned in the literature as a traditional alternative to manage drug withdrawal symptoms though there are no studies indicating its widespread use for this purpose. The study examines the reasons for ketum consumption in the northern areas of peninsular Malaysia where it is widely used.”  

The study mentioned in the above paragraph details that there were 136 active users of kratom in Malaysia tested using on-site urine screening with which they also tested for other substance use. This allows us to draw conclusions on why kratom was taken, how it mixed with other substances, and/or if the results could be conclusive about its effects on previous or current drug users. Unfortunately, this is a limited number of participants, making it difficult to draw conclusions based on long-term or short-term effects of kratom alone. However, I’d like to note that it is beneficial to know that kratom may be one factor that led to cessation of drug usage of other kinds.

The findings of the study were that “Longer term users…consuming more than the average three glasses of ketum a day[reported] better appetite. Short term users had higher odds of having ever used heroin, testing positive for heroin and of using ketum to reduce addiction to other drugs. Both groups used ketum to reduce their intake of more expensive opiates, to manage withdrawal symptoms, and because it was cheaper than heroin. These finding differ from those in neighboring Thailand where ketum was used primarily to increase physical endurance.” Based on these findings, it is unclear what a “more than average” dosage is, and what solid resolution can be drawn by the fact that those who used ketum were less likely to use other drugs like heroin. What is clear is that these subjects used kratom to “manage withdrawal” at some point or other.

In the conclusions on this study in Malaysia, it is also mentioned that “Ketum was described as affordable, easily available and having no serious side effects despite prolonged use. It also permitted self-treatment that avoids stigmatisation as a drug dependent. The claims of so many subjects on the benefits of ketum merits serious scientific investigation. If prolonged use is safe, the potential for widening the scope and reach of substitution therapy and lowering its cost are tremendous particularly in developing countries.”

I can’t say it better, people.


Kratom is worth the investigation because of its affordability and medical potential.

 

The following facts are facts that would cause me to believe that kratom is one of those Magic Bullets of Biology: “In the leaves, the primary psychoactive constituents are mitragynine and 7 hydroxymitragynine, both being found only in kratom.” This is the only plant that contains these alkaloids and beyond that, many people marvel at kratom because of its versatility of use.

 

The authors of NPS affirm this versatility and potential for positive outcomes when using kratom by saying, “During long working hours, low kratom dosage has provocative effects against lassitude. However, it can have sedative-anesthetic effects at higher doses.”

The dosage is the key (or at least one key) to using kratom responsibly.

Too much and it becomes a sedative with the potential to help people sleep, just enough and it is a very good option for increasing energy for people who work long hours or grow weary from their work. This option is just as they said: provocative. The authors of the article also say that “Kratom is regarded as an opium substitute in traditional medicine” though they do not comment on whether the implications of this are positive or negative.

 

Kratom is either not well-known or liked enough to be under the surveillance of the national drug abuse surveys mentioned below, or its effects are not widespread and negative enough to warrant its mention, but it is “Because kratom was not often under surveillance in national drug abuse surveys, the information for the prevalence of kratom use has been limited. Kratom and its active alkaloids are not listed under the 1961 and 1971 Conventions, but several countries have made control policies on kratom, mitragynine and 7-hydroxymitragynine.”

 

It is worth pursuing the truth about this plant because of its potential use and because of all of the claims we hear about kratom helping with opioid withdrawal symptoms. The problem that halts the progress of kratom for the people who need it most is the fact that no studies have been done to prove that it helps:“No previous study has shown the use of ketum to manage opioid withdrawal symptoms except for a single case reported in the US.” Although this is the case, I would also draw an arrow back to the study done in Malaysia. That although there are no cases reported, it doesn’t mean that success stories do not exist.

So, my conclusion based on the lack of conclusions is that we need a conclusion.

 

The way to get that conclusion is to test kratom. We must test its purity and all its attributes, and we must do scientific and medical studies so that more people can benefit from this amazing plant or at least use it in a way that we are sure won’t harm the human body. Kratom is becoming a trend, but because it has such limited evidence to back it up, it can’t be used on a broader scale. 

Continue reading about the Chemistry of Kratom in part 3.

 

The credit for all the quotes goes to:
Feng, Ling-Yi , et al. New psychoactive substances of natural origin: a brief review. Journal of Food and Drug Administration.