Review of the literature pertaining to the long and short term use and abuse of Kratom.

Physiological and behavioural effects related to use, abuse, and addiction to Kratom  (FULL ARTICLE)

This is just a review of the scientific literature and is merely a presentation (citations) of the existing knowledge up to 2012 when it was written.

The most interesting part of this article, besides the list of studied alkaloids and their effects, is how diverse the alkaloid profiles were in the study based on geography. The review indicates that there might actually be 3 strains. Thai, Malaysian, and possibly a third (presumably borneo), which appear to be dramatically different in alkaloid make up.

Differentiating the strains even further, very young leaves had only 4 of the alkaloids found in mature leaf. This could explain why "white vein" might be considered to have a different effect. Unfortunately, the differences in genetics were not documented, which means the differences in the alkaloid profiles may be caused by the genetic differences vs the differences in geographical agricultural conditions.

The known health benefits and historical medical uses of alkaloids (as cited by the review) are numerous and listed with citations in this article.

...Vicknasingam and colleagues performed a survey of current M. speciosa use in 136 active users in northern Malaysia. They found that M. speciosa (Ketum) users were relatively older (mean 38.7 years). About 77% of the users had previous drug use history. Long-term consumers with more than 2 years of use had higher odds of being married, of consuming more than the average three glasses of Ketum a day and reporting better appetite. Short-term users (<2 years of use) had higher odds of having ever used heroin, testing positive for heroin in a urine sample and of using Ketum to reduce addiction to other drugs. Both, short- and long-term consumers reported that they used Ketum in order to reduce their intake of more expensive opiates, to manage withdrawal symptoms and because it was cheaper than heroin. Only very few consumers (5.6–12.5%) report ‘euphoria induction’ as a reason to use Ketum. Drugs can be consumed in order to instrumentalize their psychoactive effects to better achieve other, non-drug related goals (Müller and Schumann, 2011). Ketum users report as major self-perceived benefits of their drug use that the drug ‘helps to work harder’ (76.6–87.5%), that it ‘makes more active’ (76.6–86.1%), it ‘increases sexual desire’ (73.4–84.7%), and an increase in appetite (57.8–77.8%). Interestingly, self-perceived use was higher in short-term than in long term users, thus suggesting a loss or reduction of the self-perceived instrumentalization. These findings differ from those in neighbouring Thailand where Ketum was used primarily to increase physical endurance. According to this study, the daily consumption of Ketum solution is 3 × 250 mL to ease opiate withdrawal symptoms, which contains app

There is a general effect of ‘cocaine-like’ stimulation in small doses, while at high doses ‘morphine-like’ sedation and nausea are reported (Babu et al., 2008). Several studies suggestthat M. speciosa preparations have analgesic, antipyretic, antidiarrheal, euphoric, anti-depressant, and anxiolytic effects. They may work as immune booster, lower blood pressure, and have anti-viral, diabetes- and appetite suppressing effects (Macko et al., 1972; Burkill, 1935). Besides this, they can also cause anorexia, dry-mouth, diuresis and constipation after long term use at high doses (Suwanlert, 1975; Perry, 1980).