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Presented by: UT El Paso / Austin Cooperative Pharmacy Program & Paso del Norte Health Foundation

Kratom


Compilation by Armando Gonzalez Stuart, PhD.
Kratom

Scientific Name:

Rubiaceae

Other Common Name:

Biak-biak, giam, gra-tom, kadamba. ketum, akuam, kraton, ithang, lugub, thom, mambog, puri (Pantano et al, 2016; Quattrocchi, 2012).

Common names in Spanish:

Unknown.

Where is it found?

Kratom is a medium-sized tree that is native to Southeast Asia (Mabberley, 2008; Ratsch, 2005), but related species (M. ciliata, M. stipulosa, and M. inermis, for example) can be found in tropical Africa as well (Iwu, 2014; Assi and Guinko, 1991).

Parts of the plant used:

The leaves.

How is it used?

The leaves are steeped in hot water to make a tea (with honey or other sweeteners in order to reduce its bitter taste), as well as heated and pounded to be applied externally as poultices, or pulverized and taken as capsules. The leaves are smoked and can also be chewed fresh or dried. Some botanical supplements may contain Kratom alone or in combination with other plants (Pantano et al., 2016; Quattrocchi, 2012; Ratsch, 2005).

What is it used for?

The leaves contain various active ingredients (mainly alkaloids) that are hallucinogenic, and can cause psychosis, stimulation (euphoria), and sedation as well. Additionally, the phytochemicals contained in the plant have analgesic, astringent, stimulant, and tonic actions. The plant has been popularly used as a substitute for opium, but has been banned in various countries across the globe due to the potentially addictive nature of some of its components (Anwar, 2016; Pantano, 2016). Kratom contains chemical substances that posses opioid (analgesic or sedative) effects. Additionally, this species contains two psychoactive chemicals, which have both stimulant (mitragynine) as well as sedating or narcotic (7-hydroxymitragynine) effects (Griffin, 2016; Ratsch, 2011). Studies by Váradi et al. (2016), suggest that the chemical compounds and their analogs contained in kratom could potentially be a promising new generation of novel pain relievers. Until the discovery of kratom’s chemical constituents, opioid compounds were thought to be found only in the opium poppy (Papaver somniferum-Papaveaceae

Kratom preparations are also used in Asia as local anesthetics, as well as to treat various health problems such as hypertension, diabetes, dysentery, gastrointestinal parasites, and stomachaches. The leaves are also applied externally as poultices, alone to treat wounds or in combination with other medicinal plants for splenomegaly (abnormal enlargement of the spleen). Natives in various Asian countries consume the leaves for their stimulant ability, as well as to combat fatigue and as a substitute for opium. The plant chemicals exert a morphine-like effect at high doses (Pantano et al., 2016).

Kratom has also been used as a treatment against opium addiction (Wiart, 2002). Products made from this plant are used in Thailand and Malaysia to treat various health problems, including intestinal worms, cough, diabetes, hypertension, chronic musculoskeletal pain, and gastroenteritis. The leaves are also used for their antipyretic (fever reducing), anti-inflammatory, and analgesic effects. Even though the plant has been proven to possess important medicinal applications, the irresponsible “recreational” use of kratom, alone or in combination with other substances (including caffeine, alcohol, and pharmaceutical drugs), has spread to various countries around the world, including the United States. Reports from Thailand mention that a combination (“cocktail”) of kratom with various other chemical substances, including certain pharmaceuticals, has caused various deaths. Additionally, in Sweden, a product purportedly containing kratom as well as caffeine, and a pharmaceutical analgesic (O-desmethyltramadol), caused the death of nine people (Pantano et al., 2016). Various kratom products advertised on the internet purportedly contain some of its main active ingredients (Griffin et al., 2016).

Anwar et al. (2016) evaluated the calls made to U.S. poison centers related to exposure to kratom in a five-year period (from 2010 to 2015). There was a tenfold increase in the number of calls (from 26 in 2010 to 263 in 2015). Approximately 90.2% (595) of the people who called stated they had ingested the plant. Within these calls, some reported using kratom combined with other substances (multiple exposures). The other substances commonly reported included ethanol (alcohol), other plants, benzodiazepinic drugs, narcotics, and acetaminophen (paracetamol).

Safety / Precautions

  • The irresponsible use of kratom can lead to severe adverse health effects, especially when the plant is consumed along with alcohol and / or other drugs for “recreational purposes” (Anwar et al., 2016).
  • The Drug Enforcement Agency (2016) considers kratom as a dangerous plant and is considering its classification as a Schedule I drug (a dangerous substance with no known medical properties). If so, this would make the use of kratom illegal in the United States.

Before you decide to take any medicinal herb or herbal supplement, be sure to consult with a health care professional first. Avoid self-medication and self-diagnosis: Always be on the safe side!

References:

Anwar M, Law R, Schier J. Notes from the Field. Kratom (Mitragyna speciosa) Exposures Reported to Poison Centers — United States, 2010–2015. MMWR Morb Mortal Wkly Rep 2016; 65:748–749. DOI: http://dx.doi.org/10.15585/mmwr.mm6529a4.

Assi LA, Guinko S. Plants used in traditional medicine in West Africa.
Basel, Switzerland: Editiones Roche; 1991; pp. 116-117.

Drug Enforcement Administration (DEA). DEA Announces Intent to Schedule Kratom. https://www.dea.gov/divisions/hq/2016/hq083016.shtml. Retrieved October 11, 2016.
Griffin OH, Daniels JA, Gardner EA. Do You Get What You Paid For? An Examination of Products Advertised as Kratom. J Psychoactive Drugs. 2016, 26:1-6.

Iwu M. Handbook of African Medicinal Plants 2nd ed.
Boca Raton, FL: CRC Press; 2014; pp. 257-258.

Mabberley D J. Mabberley’s Plant Book 3rd ed.
London: Cambridge University Press; 2008; p. 550.

Pantano F, Tittarelli R, Mannocchi G, Zaami S, Ricci S5, Giorgetti R, Terranova D, Busardò FP, Marinelli E. Hepatotoxicity Induced by "the 3Ks": Kava, Kratom and Khat.
Int J Mol Sci. 2016 ;17(4):580. doi: 10.3390/ijms17040580.

Quattrocchi U. World Dictionary of Medicinal and Poisonous Plants (Vol. 4).
Boca Raton, FL: CRC Press; 2012; p. 172.

Ratsch C. Encyclopedia of Psychoactive Plants.
Rochester, VT: Park Street Press; 2005; pp. 366-368.

Váradi A, Marrone GF, Palmer TC, Narayan A, Szabó MR, Le Rouzic V, Grinnell SG, Subrath JJ, Warner E, Kalra S, Hunkele A, Pagirsky J, Eans SO, Medina JM, Xu J, Pan YX, Borics A, Pasternak GW, McLaughlin JP, Majumdar S. Mitragynine/Corynantheidine Pseudoindoxyls As Opioid Analgesics with Mu Agonism and Delta Antagonism, Which Do Not Recruit β-Arrestin-2. J Med Chem. 2016; 59(18):8381-97. doi: 10.1021/acs.jmedchem.6b00748.

Wiart C. Medicinal Plants of Southeast Asia 2nd ed.
Selangor, Malaysia: Prentice Hall; 2002; pp. 285-286.