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World J Pharmacol. Nov 28, 2022; 11(3): 16-26
Published online Nov 28, 2022. doi: 10.5497/wjp.v11.i3.16
Controversial usages of kratom (Mitragyna speciosa): For good or for evil
Murtadha Basheer, Rana Khudhair Jasim, Gam Lay Harn
Murtadha Basheer, Rana Khudhair Jasim, Gam Lay Harn, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden 11800, Penang, Malaysia
Author contributions: Basheer M and Khudhair Jasim R prepared the content of the manuscript; Gam LH wrote and edited the manuscript.
Supported by Ministry of Higher Education Malaysia for the Fundamental Research Grant Scheme, No. FRGS/1/2020/STG02/USM/01/1.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gam Lay Harn, PhD, Professor, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 USM, Minden 11800, Penang, Malaysia. layharn@usm.my
Received: July 15, 2022
Peer-review started: July 15, 2022
First decision: September 26, 2022
Revised: October 4, 2022
Accepted: November 23, 2022
Article in press: November 23, 2022
Published online: November 28, 2022
Processing time: 136 Days and 7.9 Hours
Abstract

Kratom (Mitragyna speciosa) is a plant that grows well in tropical climates such as in Southeast Asia. Traditionally, people discovered it possessed a stimulating effect that relieved tiredness. Furthermore, it contains analgesic and medicinal properties for the treatment of pain, diarrhea, muscle discomfort, and blood pressure and to enhance stamina. Nevertheless, long term or regular consumption of kratom leads to addiction. This is because the main alkaloid of kratom, mitragynine, binds to opioid receptors and exerts a euphoric effect similar to that of morphine, which may lead to death. Due to this reason, kratom has been listed as a regulated substance in many countries including the United States, Thailand, Malaysia, Bhutan, Finland, Lithuania, Denmark, Poland, Sweden, Australia, and Myanmar. Usages of kratom carry two pharmacological effects depending on dosage. Low-dose kratom exerts a stimulating effect that refreshes the user. High-dose kratom exerts sedative effects that can lead to addiction similar to that of morphine. Despite the euphoric effect of kratom, the beneficial values of kratom to human health is indisputable. Therefore, a complete banning of kratom may cause a loss to pharmaceutical industry. Rather, a controlled or selective usage of kratom will be a better choice.

Keywords: Kratom; Opioid; Pharmacological actions; Toxicity; Addiction; Herbal plant

Core Tip: Traditionally, people discovered kratom (Mitragyna speciosa) possessed a stimulating effect that relieved tiredness. Long term or regular consumption of kratom leads to addiction because the main alkaloid of kratom binds to opioid receptors and exerts a euphoric effect. Due to this reason, kratom has been listed as a regulated substance in many countries. Despite the euphoric effect of kratom, the beneficial values of kratom to human health is indisputable. Therefore, a complete banning of kratom may cause a loss to pharmaceutical industry. Rather, a controlled or selective usage of kratom will be a better choice.