Kratom herb use and abuse Mitragyna speciosa, mitragynine
November 17 2017

Mitragyna speciosa (kratom), a tropical tree used traditionally to combat fatigue and improve work productivity among farm populations in Southeast Asia, has become popular as a psychoactive substance in Western countries.

2017
The FDA reports it will confiscate shipments of kratom and says it is aware of reports of 36 deaths associated with the use of kratom-containing products. The FDA added that there have been reports of kratom being laced with other opioids like hydrocodone and its use is associated with serious side effects like seizures, liver damage and withdrawal symptoms.

2016
DEA Officially Backtracks On Move To Ban Kratom, An Herb Many Use As Medicine

My personal experience
In November of 2017 I was given a bag of small pieces of kratom by a friend who had been taking it. I boiled a couple of ounces in water and drank a couple of cups each day for a week. I can't say I noticed much. It did taste good, though. I did not notice much of an effect on mood or alertness. I suspect an extract in capsule form may be more potent but thus far my personal experience is quite limited.

From what has been published so far
I have read in studies the following but I am not sure yet how accurate this is: In small doses kratom could provide an energy boost and in larger doses it could have a mellow, sedating effect, perhaps acting on the opioid receptors. Frequent use can lead to dependence and adverse reactions, even ER visits. Long-term daily high dose intake could induce anxiety, insomnia, loss of sex drive, constipation and the darkening of skin. Withdrawal symptoms can occur after frequent use.

Review article
Brain Res Bull. 2016. Neurobiology of Kratom and its main alkaloid mitragynine. Kratom or its main alkaloid, mitragynine is derived from the plant Mitragyna speciosa Korth which is indigenous to Southeast Asian countries. This substance has become widely available in other countries like Europe and United States due to its opium- and coca-like effects. In this article, we have reviewed available reports on mitragynine and other M. speciosa extracts. M. speciosa has been proven to have a rewarding effect and is effective in alleviating the morphine and ethanol withdrawal effects. However, studies in human revealed that prolonged consumption of this plant led to dependence and tolerance while cessation caused a series of aversive withdrawal symptoms. Findings also showed that M. speciosa extracts possess antinociceptive, anti-inflammatory, anti-depressant, and muscle relaxant properties. Available evidence further supports the adverse effects of M. speciosa preparations, mitragynine on cognition. Pharmacological activities are mainly mediated via opioid receptors as well as neuronal Ca2+ channels, expression of cAMP and CREB protein and via descending monoaminergic system.

Mood lifter
Phytomedicine 2010.
Antidepressant-like effect of mitragynine isolated from Mitragyna speciosa Korth in mice model of depression. Farah Idayu N, Taufik Hidayat M, Moklas MA, Sharida F, Nurul Raudzah AR, Shamima AR, Apryani E.Human Anatomy Laboratory, Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400 Selangor, Malaysia.
Mitragyna speciosa Kotrth. leaves have been used for decades as a traditional medicine to treat diarrhea, diabetes and to improve blood circulation by natives of Malaysia, Thailand and other regions of Southeast Asia. Mitragynine is the major active alkaloid in the plant. To date, the role of mitragynine in psychological disorders such as depression is not scientifically evaluated. Hence, the present investigation evaluates the antidepressant effect of mitragynine in the mouse forced swim test (FST) and tail suspension test (TST), two models predictive of antidepressant activity and the effect of mitragynine towards neuroendocrine system of hypothalamic-pituitary-adrenal (HPA) axis by measuring the corticosterone concentration of mice exposed to FST and TST. An open-field test (OFT) was used to detect any association of immobility in the FST and TST with changes in motor activity of mice treated with mitragynine. In the present study, mitragynine at dose of 10mg/kg and 30mg/kg i.p. injected significantly reduced the immobility time of mice in both FST and TST without any significant effect on locomotor activity in OFT. Moreover, mitragynine significantly reduced the released of corticosterone in mice exposed to FST and TST at dose of 10mg/kg and 30mg/kg. Overall, the present study clearly demonstrated that mitragynine exerts an antidepressant effect in animal behavioral model of depression (FST and TST) and the effect appears to be mediated by an interaction with neuroendocrine HPA axis systems.

Research
Monitoring of kratom or Krypton intake in urine using GC-MS in clinical and forensic toxicology. Anal Bioanal Chem. 2010. Philipp AA, Meyer MR, Wissenbach DK, Zoerntlein SW, Zweipfenning PG, Maurer HH. Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Saarland University, Homburg, Saar, Germany. The Thai medicinal plant Mitragyna speciosa is misused as a herbal drug. Besides this, a new herbal blend has appeared on the drugs of abuse market, named Krypton, a mixture of O-demethyltramadol (ODT) and kratom. Therefore, urine drug screenings should include ODT and focus on the metabolites of the kratom alkaloids mitragynine (MG), paynantheine (PAY), speciogynine (SG), and speciociliatine (SC). The aim of this study was to develop a full-scan gas chromatography-mass spectrometry procedure for monitoring kratom or Krypton intake in urine after enzymatic cleavage of conjugates, solid-phase extraction, and trimethylsilylation. As mainly metabolites of the kratom alkaloids were detected in urine, the detectability of kratom was tested successfully using rat urine after administration of a common user's dose of MG. As the metabolism in humans was similar, this procedure should be suitable to prove an intake of kratom or Krypton.

J Diet Suppl. 2013. An evidence-based systematic review of kratom (Mitragyna speciosa) by the Natural Standard Research Collaboration. An evidence-based systematic review of kratom (Mitragyna speciosa) by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.

Forensic Sci Int. 2013. A simple HPLC-DAD method for the detection and quantification of psychotropic mitragynine in Mitragyna speciosa (ketum) and its products for the application in forensic investigation. Mitragyna speciosa, a native plant of Thailand and Malaysia known as 'ketum', is a plant of considerable interest. It exhibits strong antinociceptive effect and yet, acts like a psychostimulant. Due to the affordability and its ease of availability, the abuse of this plant as a substitute for other banned narcotics has become a major concern in many societies. In countries such as Thailand, Myanmar, Australia and Malaysia, the use of ketum is illegal. However, for a person to be charged for possessing or selling ketum, a reliable analytical method is needed in order to detect and identify the plant and its products. Mitragynine is the major alkaloid of ketum. This compound manifests its antinociceptive effects by acting on the opioid receptors. Since M. speciosa contain large quantity of mitragynine and it is exclusive to the species, the present analytical method is developed and validated for the purpose of screening ketum products based on this unique compound as the analytical marker. The method uses a HPLC-DAD system with Inertsil C8 as the column and a mixture of acetonitrile and formic acid as the mobile phase. This method not only detects mitragynine, it can also be used to quantify the amount of mitragynine in the sample. The limit of detection is 0.25 μg/ml, while the limit of quantification is 0.50 μg/ml. The method has been tested and found suitable for the identification and quantification of mitragynine in dried plants, a variety of ketum extracts, as well as ketum drink obtained from the market.

Questions, emails
I have been an ongoing customer of yours since the 1990s and receive your newsletter. I was hoping you could give me some insight into the herbal pain medication Kratom. I have only recently run across it, and unfortunately, much of the literature is about recreational use of this currently legal herb. Any time I discover a new "miracle herb" I check your sites to see what you have to say or what formulation you may have that I may want to try. I have had a spinal fusion in the last year, and have had difficulty returning to work. It was a work related injury, so the recommendation of my nurse case manager is that I should not increase my hours to more than 2hr/daily until I can significantly reduce my oxycodone. I am working with my doctor to find safe medications which will give me a pathway to reduce the oxycodone but provide pain relief without opiates until my body is sufficiently healed to not need medication for pain relief. I am currently beginning Lyrica, as the gabapentin I was using developed intolerable side effects associated with long-term use. The Lyrica is helpful, but also has side effects, so if Kratom is safe when used responsibly (and I could find a reliable, trustworthy vendor), it actually might be a better bridge for me. I am a very cautious person, and still feel I have a great deal to consider before a decision as to whether I might benefit from Kratom. You may tell me that it is safe, when taken correctly, but I would still do more research into whatever company from whom I might chose to purchase it for reliability, safety and general wisdom as to whether it is right for me. I have been purchasing supplements from your company since the 1990's and always pay attention to your process and recommendations, so I will not take any positive information about this herb as a carte blanche recommendation for me to use it. I am merely in the process of trying to understand it before even getting to the point of determining whether it holds enough promise for me to try finding a responsible vendor, and one serious about the potential health benefits, not mere recreational potential.
   A. As of 2017 I am not very familiar with the benefits and risks of this herb, but I will keep my eyes open for new research.

I was curious if you have any experience in the benefits of Kratom for anxiety, pain relief, and perhaps most popularly the relief of many withdrawal symptoms that a lot of people in our country experience when finally quitting opiates?
   A. I do not have personal experience taking this plant or much feedback from patients or people who have used it.