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Kratom (Thai: กระท่อม), Mitragyna speciosa, is
a medicinal leaf harvested from a large tree in the Rubiaceae family native to Southeast Asia in the Indochina and Malesia floristic regions.[clarification needed] The
plant has been traditionally used for its medicinal properties.[clarification needed] It was
first formally documented by the Dutch colonial botanist Pieter Korthals. The genus was given its
Mitragyna name by Korthals because the stigmas in the first species he
examined resembled the shape of a bishop's mitre. It is botanically related to
the Corynanthe, Cinchona and Uncaria genera and shares some similar biochemistry.
- 1 Description
- 2 Effects
- 3 Legal status
- 4 See also
- 5 References
- 6 Further
Mitragyna speciosa, kratom trees, usually grow to a height of 12–30 ft
(3.7–9.1 m) tall and 15 ft (4.6 m) wide, although under the right conditions,
certain species can reach up to 40 ft (12 m)–100 ft (30 m) in height. The stem
is erect and branching. The leaves of the kratom tree are a dark green colour
and can grow to over 7 inches (180 mm) long and 4 inches (100 mm) wide.,
ovate-acuminate in shape, and opposite in growth pattern.
The flowers are yellow and grow in clusters. 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.
Kratom 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. The kratom
tree grows best in wet, humid, fertile soil, with medium to full sun exposure,
and an area protected from strong winds.
Kratom contains many alkaloids including mitragynine (once thought to be the primary active
constituent), mitraphylline, and 7-hydroxymitragynine (which is currently the most
likely candidate for the primary active chemical in the plant). Although
7-hydroxymitragynine and mitragynine are structurally related to yohimbine and other tryptamines, their pharmacology is quite different,
acting primarily as mu-opioid receptor agonists. Other active chemicals in
kratom include raubasine (best known from Rauwolfia serpentina) and some yohimbe
alkaloids such as corynantheidine.
Also, as stated by and according to references on erowid.org, there are
several countries in which the cultivation and usage of this herb (flora) are
forbidden, some with very harsh sentencing recommendations. The native countries
(in the Eastern part of the world i.e. Thailand, etc.) have enacted laws
forbidding the plants' usage for any "medical" reason. There is limited research
on this plant because of the restrictions, and as of the past 10 (ten) years,
this plants' popularity as a "recreational" drug have become widely noticed.
References to this fact are countless; it can be bought as both whole leaf, or
"isolate" which has the active alkaloids in it. The claims that this drug can be
used as a "substitution" for opiate dependence are rare and the studies that do
exist are sparse; therefore, it is up to the reader to take note to the laws of
the country they reside in as to weather or not this plant bears ANY medical
use. There are varied reports that cannot be cited properly due to poor testing
conditions regarding the plant's supposed medical benefits. However, individual
experiences with this herb (flora) have shown results ranging from that of a
placebo effect to noticeable effects dealing with opiate withdraw. More studies
are needed before accurate citation is possible.
Dried kratom leaf
Kratom's primary pharmacology is mediated by the alkaloids 7-hydroxymitragynine and mitragynine. While these molecules share structural
similarities to the psychedelics, there is no psychedelic activity or
similarities in effects to such substances. Instead these alkaloids primarily
interact with the opioid receptors. Accordingly, kratom is known to prevent or
delay withdrawal symptoms in an opiate dependent individual, and it is often
used for this purpose. It can also be used for other medicinal purposes and is
sometimes used recreationally.
Kratom has been traditionally used in regions such as Malaysia, Thailand, and
Indonesia, but was discovered by Western civilization during the 19th century.
Besides kratom (or krathom), in Southeast Asia and the Pacific Islands it also
goes by the names ithang, biak biak, ketum, kakuam, and in southern regions,
thom. In these areas kratom has a history of use by laborers and in folk
medicine for opium dependence and diarrhea.
Of the two main active constituents, mitragynine has been studied more
thoroughly than 7-hydroxymitragynine. At lower doses, 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.
7-hydroxymitragynine was only recently understood to be the main active
ingredient. Limited animal research suggests it is a potent opiate agonist, but
with a ceiling effect that limits the potential for respiratory depression and
euphoria. No fatal overdose of kratom is known to have occurred.
While one study of Thai users reported that kratom has sedative effects 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. However, recent publications indicate that different
alkaloids may be at work to achieve stimulation versus sedation: whereas higher
concentrations of mitragynine are attributed to act as a stimulant,
7-hydroxymitragynine is the most significant alkaloid for sedation with more
potent analgesic activity than that of morphine. 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.
Side effects, although rare, may include dry mouth, increased or decreased
urination, loss of appetite, and nausea or vomiting. Heavy use can result in a
prolonged sleep. Possible side effects from long term use include anorexia and
weight loss, insomnia, and dependence. Comprehensive scientific and clinical
studies have yet to be conducted to establish the potential health risks
associated with consistent long term consumption of kratom.
Young kratom tree
Kratom has recently become more known and used in Europe and North America where it has been prized for its
applications to many conditions and ailments, primarily pain, depression,
anxiety, and opiate withdrawal.
This section does not cite any references
or sources. Please help improve this section by adding citations to reliable
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Inspired by traditional use, H. Ridley reported In 1897 that the leaves of
Mitragyna speciosa were a cure for opium dependence. In more recent times,
mitragynine has been used in New Zealand for methadone dependence 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 drug dependence. While
ibogaine is intended as a one time treatment to cure opiate dependence,
mitragynine is used to gradually wean the user off opiates. The fact that
mitragynine's mu crossover is increased by the presence of opiate drugs may be
exploitable in the treatment of drug dependence, 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, a person
dependent on opiates would stop use of opiates, 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 substitution or maintenance drug to
manage dependence. In Southern Thailand, many heroin users have been using
kratom to break their dependence and to manage painful withdrawal symptoms.
In 1999, Pennapa Sapcharoen, director of the National Institute of Thai
Traditional Medicine in Bangkok said that kratom could be prescribed both for
opiate dependence 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.
In 1897 Ridley reported the leaves and bark of Mitragyna speciosa as a cure
for the opium habit and this was quoted by Hooper (1907) In 1907 Holmes had
referred to the leaves and possibly, the leaves of M. parvifolia as well, as an
opium substitute. Certainly the leaves of M. speciosa have been chewed for many
years under the local name 'kratom' by the native population of Thailand as a
stimulant though the practice is now forbidden. As a consequence the leaves of
M. javanica are frequently used as a substitute but are not considered to be as
effective. The natives will also distinguish between different kratoms, for
example, those with red and those with green midribs (Tantivatana, 1965).
Mitragynine was the only constituent isolated from Mitragyna speciosa it was
assumed to be the physiologically active constituent having morphine-like
properties, Grewel (1932) reported to be a protozoal poison but in 1933
Raymond-Hamet and Millat undertook a more critical examination and reported it
to have markedly depressant properties. This was substantiated in 1934 by
Masson. More recently Macko, Weisbach and Douglas (1972) reported that
mitragynine possesses pain threshold elevating and antitussive properties but no
addictive properties.
Recent drug use trends in Thailand indicate that a emerging pattern and
profile is emerging in relation to kratom use. Around 2005, young people aged
between 13 to 30 years old started boiling kratom leaves (15 to 100 leaves at a
time) to produce a tea as a base for a cocktail coined 4x100 (สี่คูณร้อย). The
basic 4x100 cocktail includes the kratom tea, cough syrup, Coca-Cola, and ice.
The cocktail is generally prepared twice or more per day, depending on
availability of leaves and is consumed for recreational purposes.
Although kratom has been shown to help people suffering from opiate addiction
and withdrawal symptoms, kratom itself is believed to be similarly addictive if
abused. Daily kratom users can develop a dependency similar to that of opiate
addiction; however, withdrawals from kratom are said to be substantially less
severe and shorter in duration. If used responsibly and on a non-daily basis the
chances of developing a kratom dependency are shown to be remote.
Kratom is a controlled substance in Thailand, Bhutan, Australia, Finland,
Denmark, Poland, Lithuania and Sweden as of September, 1, 2011.  Malaysia
and Myanmar (Burma). In Malaysia, kratom is scheduled under the Poisons Act.
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 scheduled in category 5 of the
Narcotics Acts (1979), in the same category as cannabis and magic mushrooms (the
least punitive category). 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.
Kratom is currently an unscheduled substance.
Although kratom has not been approved by Health Canada for human consumption,
it currently does not fall under the purview of the Controlled Drugs and
Substances Act  thus,
remaining largely unregulated.