Changing Trends in the Use of Kratom (Mitragyna speciosa) in Southeast Asia

Objective: Kratom (Mitragyna speciosa. Korth) is an indigenous medicinal plant of Southeast Asia. This review paper aims to describe the trends of kratom use in Southeast Asia, particularly, in Malaysia and Thailand, where its use has been extensively studied by social scientists. Design: A literature review search was conducted through the internet. Nineteen articles illustrating kratom use in humans in Southeast Asia were reviewed. Results: The kratom has long been used by rural folk in Southeast Asia as a remedy for common ailments, to fight fatigue from hard manual work, as a drink during social interaction among men and in village religious functions. Studies based on self-reports suggest that prolonged kratom use does not result in serious health risks or impair socialfunctioning. Two recent trends have emerged: kratom is reportedly being used to ease withdrawal from opioid dependence in rural settings, while in urban areas, adulterated kratom cocktails are being consumed by younger people to induce euphoria. Meanwhile, kratom use is no longer classified under the Dangerous Drug Act in Thailand and attempts to classify it under the Dangerous Drug Act in Malaysia have not been successful. Conclusions: Legal sanctions appear to have preceded serious scientific investigations into the claimed benefits of ketum. More objective controlled trials and experiments on humans need to be conducted to validate self-report claims by kratom users in the community.