Introduction:

Kratom, botanically known as Mitragyna speciosa Korth, is a tropical tree indigenous to Thailand, Malaysia, Myanmar and other areas of South East Asia. Kratom is in the same family as the coffee tree (Rubiaceae). The tree reaches heights of 50 feet with a spread of over 15 feet.

Kratom has been used by natives of Thailand and other regions of Southeast Asia as an herbal drug for decades. Traditionally, kratom was mostly used as a stimulant by Thai peasants, laborers, and farmers to overcome the burdens of hard work. Thai natives chewed the leaves to make them work harder and feel good. Kratom was also used in Southeast Asia and by Thai natives to alleviate opium withdrawal. In 1943, the Thai government passed the Kratom Act 2486 that made planting of the tree illegal. In 1979, the Thai government enacted the Narcotics Act B.E. 2522, placing kratom along with marijuana in Category V of a five category classification of narcotics.

Kratom remains a popular drug in Thailand. As of December 2006, kratom is the third most popular drug within southern Thailand, after methamphetamine and marijuana. In a November 2005 article in the Bangkok Post, it was reported that young Thai militants were offered to drink a "4x100" kratom formula to make them "more bold and fearless and easy to control." The two "4x100" kratom formulas are described as a mixture of a boiled kratom leaves and mosquito coils and cola or a mixture of boiled cough syrup, kratom leaves and cola served with ice. In this report it was also mentioned use of that the "4x100" formula was gaining popularity among Muslim youngsters in several districts of Yala (Southern Thailand) and was available in local coffee and tea shops.

Kratom is promoted as a legal psychoactive product on numerous websites in the U.S. On those websites, topics range from vendors listings, preparation of tea and recommended doses, to alleged medicinal uses, and user reports of drug experiences.

There is no legitimate medical use for kratom in the U. S.

Over 25 alkaloids have been isolated from kratom, of which the indole alkaloid, mitragynine, is the most important. Mitragynine, chemically known as 9-methoxy-corynantheidine, is the primary active alkaloid in the plant.

Pharmacology studies show that mitragynine has opioid-like activity in animals. It inhibits electrically stimulated ileum and vas deferens smooth muscle contraction. Through actions on centrally located opioid receptor, it inhibits gastric secretion and reduces pain response.

Kratom has been described as producing both stimulant and sedative effects. At low doses, it produces stimulant effects, with users reporting increased alertness, physical energy, talkativeness and sociable behavior. At high doses, it produces sedative and euphoric effects, and possibly an aphrodisiac effect. Effects occur within 5 to 10 minutes after ingestion and last for 2 to 5 hours. Acute side effects include nausea, itching, sweating, dry mouth, constipation, increased urination, and loss of appetite.

Kratom consumption can lead to addiction. In a study of Thai kratom addicts, it was observed that some addicts chewed kratom daily for 3 to 30 years (mean of 18.6 years). Long-term use of kratom produced anorexia, weight loss, insomnia, skin darkening, dry mouth, frequent urination, and constipation. A withdrawal syndrome was observed, consisting of symptoms of hostility, aggression, emotional lability, wet nose, achy muscles and bones, and jerky movement of the limbs. Furthermore, several cases of kratom psychosis were observed, where kratom addicts exhibited psychotic symptoms that included hallucinations, delusion and confusion.

Information on the illicit use of kratom in the U.S. is anecdotal. Based on information posted on the Internet, kratom is mainly being abused orally as a tea. Chewing kratom leaves is another method of consumption. Doses in the range of 2 to 10 grams are recommended to achieve the desired effects. Users report that the dominant effects are similar to those of psychostimulant drugs.

Other countries are reporting emerging new trends in the use of kratom. In the United Kingdom, kratom is promoted as an "herbal speedball." In Malaysia, kratom (known as ketum) juice preparations are illegally available.

Information on user population in the U.S. is very limited. Kratom abuse is not monitored by any national drug abuse surveys.

Kratom is widely available on the Internet. There are numerous vendors within and outside of the U.S. selling kratom, many of which sell other uncontrolled psychoactive products such as Salvia divinorum. Forms of kratom available through the Internet, includes leaves (whole or crushed), powder, extract, encapsulated powder and extract resin "pies" (40 g pellets made from reduced extract). The kratom available from these vendors through the Internet is allegedly imported from Thailand, Bali, New Guinea and Hawaii. Seeds and whole trees are also available from some vendors through the Internet, suggesting the possibility of domestic cultivation.

Kratom is not a controlled substance in the U.S. It is illegal to possess kratom in Thailand, Australia, Malaysia, and Myanmar.