For many years, there have been a variety of drugs that have been used. As awe talked about those drugs throughout this course we focused more on the opioids and those drugs that have similar effects and consequences. This paper will focus on a drug called “Kratom” which is not a common or well known drug in the United States however, has already been seen as addictive and an opioid like drug.
The opioid epidemic touches nearly every American. Some are prescribed opioids for pain relief, some are battling opioid and heroin dependency and addiction, while others have lost a loved one or friend to an overdose. Prescription drugs are given to patients around the world daily, but some come with deadly addictive cost. Some of the factors that have also facilitated the increase in the use of opioids in the management of chronic pain as Runyan states include the "introduction of high-dose, extended release oral tablet formulations of opioids with good bioavailability" (2017). Despite the growing number of treatment options for substance use disorders, which are chronic, relapse rates remain very high. One substance that has been used to combat this addiction is a drug called Kratom. This paper will outline what this drug exactly is and how it is used over the world.
Kratom, a 4–16-metre high tropical tree, coming from the Rubiaceae or coffee family is derived from the plant Mitragyna speciosa in Southeast Asia. In folk medicine in low doses it is used as a stimulant in high doses a sedative recreational drug and treatment for opiate addiction as well as arthritic pain. Kratom plants can be widely found in Thailand Malaysia Borneo Philippine New Guinea and Africa. Nearly 25 alkaloids have been isolated from M.speciosawith mitragynine and 7‐hydroxymitragyine being the active compounds. These alkaloids are reported to produce morphine‐like effects. Different classes of psychoactive substances share common behavioral and neurobiological patterns, despite their diverse pharmacological profiles and resultant adverse effects (Ismail, N. W., Jayabalan, N., Mansor, S. M., Müller, C. P., & Muzaimi, M. 2017). Thus, addiction potential and adverse health consequences are becoming an important issue for health authorities.
The dried leaves of kratom can be chewed fresh smoked or made into an extract (Hassan et al. 2013; Singh Müller & Vicknasingam 2014). It is regularly used for its energizing and pain relieving effects which are reported to have opiate-like effects depending on the dose consumed. Kratom has also been used to treat those with opioid addictions. In mid-twentieth century in SE Asia kratom was also increasingly used as a substitute for opioids for disorders including cough pain and depressed mood states and to ameliorate opioid withdrawal symptoms in chronic users (Eisenman 2015).
Users of kratom tend to be peasants, laborers and farmers who use the plant to overcome the burdens of their hard work. Heavy users may chew kratom between 3-10 times a day while new users may only need a few leaves to obtain the desired effects. Some users find with time they need to increase doses to 10-30 leaves or even more per day (Chopra, N., & Marasa, L. H. 2017). In knowing this information, one can assume that one of the original forms and purpose was to be sold as a street drug to help with pain an opioid would help relieve.
Imported to Western countries from Southeast Asia, in recent years kratom has become a popular enhancer. Beyond kratom, some of the most widely used psychoactive plants, largely not under international control, include Salvia divinorum, khat (Catha edulis), Hawaiian baby woodrose seeds (Argyreia nervosa), and “Genie” (a smoking mixture containing multiple plant materials and of dubious pharmacognostical identity) (United Nations Office on Drugs and Crime 2014). Previous studies on kratom use in Southeast Asia have described the demographic‐characteristics of kratom users, reasons for kratom use, and the spread of kratom from its original context of use to western countries where it is viewed as an herbal product capable of providing a “legal” high and is increasingly being sold through the internet and local tobacco shops.
Natural products often used as enhancers are exceptionally complex in terms of their chemistry. Kratom preparations contain varying amounts of several phytochemicals, making their pharmacological and toxicological evaluation unique and difficult. Mitragynine, Paynantheine, Hydroxymitragynine, Speciogynine, and Speciociliatine are just a few of the compounds found in these leaves. The level of complexity, variability, and the unknown nature of these leaves, coupled with the risks associated with taking psychoactive materials, could offer further risks of ill health by misadventure, with potentially life-threatening consequences.
With little information on the kratom impact on humans, there is evidence from experimental animal models. In humans, regular consumption may escalate, lead to tolerance and may yield aversive withdrawal effects. Altogether, available data currently suggest both, a therapeutic as well as an abuse potential. In order to understand the behavioral effects in rats and mice, mitragynine was isolated from the plant. During the experiment, scientist exposed these animals to the chemical and tracked their reactions. Severe withdrawal signs developed after 12 hours, and increased level of anxiety became evident after 24 hours of withdrawal (Eisenmann SW 2015). Acute mitragynine independently impaired passive avoidance learning, memory consolidation and retrieval, Chronic mitragynine administration led to impaired passive avoidance and object recognition learning. Altogether, these findings provide evidence for an addiction potential with cognitive impairments for mitragynine, which suggest its classification as a harmful drug.
Kratom is currently widely available in many Asian countries (e.g., in Malaysia) where it can be easily bought from kratom traders in the community Consumers can be classified into two main groups: the first includes those who solely use kratom to improve physical tolerance to laborious work and the second polydrug users who attempt to manage drug withdrawal symptoms or reduce the intake of other opiates like heroin (Vicknasingam B., Narayanan S., Beng G. T., Mansor S. M. 2010) A recent study showed that out-of-treatment opiate users in Malaysia often use kratom to reduce their dependence on illicit opiate as well as to ameliorate opiate withdrawal symptoms.
Currently, there is no information on the prevalence of kratom use in the native countries, but it seems to be in Malaysia and Thailand. A survey performed in 2007 investigating kratom use in Thailand (26,633 respondents aged 12–65 years) indicated that the lifetime, past year, and past 30 days prevalences for kratom were 2.32%, (Vicknasingam B., Narayanan S., Beng G. T., Mansor S. M. 2010). These figures, with the exception of lifetime use, were significantly higher than those for cannabis. Making kratom the most widely used illicit drug in Thailand which has been illegal in Thailand since 1943 (Eisenmann SW 2015). Kratom is also controlled in a few other countries in the region. To control its widespread abuse, The Malaysian government is in the midst of regulating ketum under the Dangerous Drugs Act 1952, which will consider the substances as harmful as opiates and amphetamines (Hassan Z et al. 2013)
...(download the rest of the essay above)