Kratom, scientifically known as Mitragyna Speciosa is a tropical evergreen tree belonging to the Rubiaceae family (commonly known as the coffee family). These trees are found in Southeast Asia, particularly in Thailand, Malasia, Indonesia, Myanmar, and Papua New Guinea. Kratom for more than a century has been used for recreational and medicinal purposes. It was first introduced by Dutch Botanist Pieter Korthals with the name of Stephegyne speciosa in the year 1839 followed by multiple classifications till George Darby Haviland gave its final name in 1859, the one which is being used till now.
The leaves of Kratom contain about 25 alkaloids and have a total alkaloid content of 0.5%-1.5%. The primary active alkaloids present in Kratom are Mitragynine (60% of the total alkaloid content) and 7-HMG (2% of the total alkaloid content). Alkaloids like speciogynine, speciociliatine, and paynantheine are present at concentrations of 7%, 9% and, 10% respectively of the whole alkaloid content. Few other alkaloids which occupy a very small amount of alkaloid concentration (less than 1%) are mitraphylline, mitralactonal, raubasine, rhynchophylline, and mitragynaline. It is also found that the mitragynine alkaloid has a structure similar to those of yohimbine, Uncaria, and voacangine, and has opioid-like potency of approximately thirteen times that of morphine. 7-HMG, another alkaloid present in Kratom CNS stimulant that is about fourteen times that of morphine and four times that of mitragynine, when consumed orally. These two alkaloids can produce sedation and pleasure as well as decrease pain as they are selective and agonists of mu-opioid receptors present in the brain when taken in large amounts. Mitragynine is also known as a central stimulant. When consumed in low doses, it is seen that it increases energy, alertness, and sociability. By controlling the strain of Kratom, one can keep a check on the stimulant and sedative effects as different strains contain different concentrations of inherent alkaloids. For example, the red vein variety of Kratom has more powerful analgesic effects, and the white and green vein varieties lead to more CNS stimulation and mood-enhancing effects.
In a lot of parts of Southeast Asia, where Kratom is grown, it is used in different forms as traditional medicine. The leaves of this plant are used to relieve musculoskeletal pain as well as increase appetite, energy, and sexual desire. Due to its energy-giving properties, it has also been compared to khat and coca. The leaves are also used as a local anesthetic and for curing wounds. Locally, the extracts are also used to cure diarrhea, anxiety, cough, and intestinal infections. Particularly in Thailand, Kratom is also used as an intestinal deworming agent. It has also been seen that it is used for enhancing mood and as a painkiller.
Apart from its medicinal uses, in a lot of cultures, in Thailand to be more specific, it was used in rituals to worship ancestors and gods.
Usage in Opioid Withdrawal
Despite the fact that there have been no formal statements regarding the effectiveness of Kratom in treating opioid addiction, it has been used in Thailand and Malaysia as an opium substitute from the 19th century onwards. In the present times, due to lack of data and monitoring, one cannot be sure how much of Kratom is used for the same purpose and how safe it is to use.
Usage in Alcohol Withdrawal
There has been no clinical data released on the successful and effective use of Kratom during alcohol withdrawal in humans but at the same time, experiments have been done on rats. Since antidepressants are not very useful in the management of alcohol withdrawal followed by a reduction in rapid eye movement (REM) sleep, the effect of Mitragyna speciosa alkaloid extract, and fluoxetine (common antidepressant used as a reference drug) were observed separately on rats during alcohol withdrawal and on sleeping patterns. In the case of the antidepressant i.e fluoxetine, there was a significant reduction in rapid eye movement (REM) sleep whereas there was no significant impact on REM sleep by the usage of MItragyna speciosa (i.e., Kratom). However, in all other cases such as electroencephalogram (EEG) patterns, the effect of both M.speciosa alkaloid and fluoxetine antidepressant were similar to each other.
Asia Kratom - This strain of Kratom is one of the rarest in the world. It is grown in a limited amount in very few farms and private forests. This is done so as to maintain its long-term sustainability. Some of the products of Asia kratom for sale include Green Asia kratom powder and capsules, Red Asia kratom powder and capsules, White Asia kratom powder, and capsules.
Bali Kratom - One of the most commonly used kratom strains, Bali kratom is considered one of the best out there. Despite the fact that this strain of kratom is named after the Indonesian region of Bali, it is not grown there, in fact, jungles of Borneo and Sumatra are its place of origin. Some of the most common products of Bali Kratom for sale are Red Bali kratom powder and capsules, Gold Bali kratom powder and capsules, Green Bali powder and capsules, and White Bali kratom powder and capsules.
Elephant Kratom - Elephant kratom’s characteristics are as captivating as its name. This strain derives its name from the similarities that its leaves have with that of an elephant’s ears. Its leaves have a shape somewhat similar to the shape of an elephant’s ear and are flappy and spread out too. It is one of the most popular kratom varieties in the West. it is usually sold in two forms - Super green elephant kratom powder and super green elephant kratom capsules.
Maeng Da Kratom - Maeng Da translates to ‘best grade’ and as the name suggests is one of the best quality kratom strains out there. It exists in various varieties and colors. Some of the commonly used products of this strain are Green Maeng Da kratom powder and capsules, White Vein Maeng Da kratom powder and capsules, and Red Maeng Da kratom capsules and powder.
Vietnam Kratom - One of the non-traditional varieties of kratom, this strain as the name suggests is grown in the region of Vietnam. It is generally sold in the form of two products - Yellow Vietnam kratom capsules and Yellow Vietnam kratom powder.
Sumatra Kratom - This variety of kratom is found on the Sumatra island of Indonesia. This strain similar to other varieties comes in three colors, green, red, and white. As a product, it is generally found in the form of Red Sumatra kratom capsules and powder, Green Sumatra kratom capsules and powder, and White Sumatra capsules and powder.
Kratom can cause various adverse effects. The food and drug administration during the year 2017 issued a health advisory in which they advised the consumers against the usage of kratom or any such products that contain it. The statement released by the administration alerted about the risks of kratom use, some of which include addiction, abuse, and fatal reactions. More adverse effects listed by the FDA include decreased appetite, insomnia, seizures, constipation, anorexia, hyperpigmentation, and liver damage. It is also noted that kratom can have stimulant-like effects and can result in withdrawal symptoms like aggression, pain in muscle and bones, excessive tearing, and jerky limb movements. When taken in small doses like 1g to 5g of leaves, conditions like contracted pupils, anxiety, agitation, and blushing can occur and in case of high doses, i.e., 5g to 15g of dried leaves, diarrhea is one of the most common occurrings. The after-effects of consuming very high kratom doses such as nausea, sweating, dizziness, and dysphoric effects, unlike opioid, subside very quickly.
Toxicology basically refers to the measurement and analysis of potential toxins, intoxicating, or banned substances present in a person’s body. In the case of Kratom, there has been no clearance given to the substance in terms of its safety and effectiveness. In fact, according to the statements released by FDA in 2018, there have been 36 deaths related to the use of kratom-containing products. In the month of March 2018, organizations like the US FDA and CDC announced investigations related to the outbreak of Salmonella infections which were said to have some relation with kratom use. Since then consumers were advised not to use kratom or any such products that had kratom in them.
In the six-year span, from 2010 to 2015, the US poison control centers say a 10 fold increase in the number of calls related to kratom exposure. Some of the most commonly reported substances include ethanol, narcotics, acetaminophen which were used in combination with kratom. Out of the cases reported, 41.7% were non-life-threatening and could be cured using treatments. The other 24.5% exposure reactions had mild symptoms that were resolved rapidly with treatment and there about 7.4% cases that were life-threatening and resulted in some residual disability. At certain times kratom can also cause dependence which then leads to symptoms like insomnia, hostility, muscle pain, aggression, emotional changes, hypertension, and runny nose at the time of withdrawal.