The Health Impact of Long-Term Kratom (Mitragyna Speciosa) Use in Southern Thailand

Abstract

Background

Mitragyna speciosa or Kratom has been used in Thailand traditionally for its medicinal value. Despite case reports of kratom consumption causing adverse effects, research on its long-term health impact is limited. This study examines the long-term health impact of kratom use among people in Southern Thailand.

Methods

Three community-based surveys were conducted from 2011 to 2015. In the first and second surveys (2011 and 2012) a total of 1,118 male respondents comprising 355 regular kratom users, 171 occasional kratom users, 66 ex-users, and 592 non-users aged 25 or above, were recruited from 40 villages. All respondents were followed up in this study. However, not all respondents were successfully followed up throughout the entire set of studies.

Results

Common health complaints were no more common among kratom users than ex- and non-users, but more regular than occasional users claimed kratom to be addictive. Those with high kratom dependence scores were more likely to experience intense withdrawal symptoms, which developed 1-12 h after the last kratom intake. Over half (57.9%) of regular users had experienced intoxication effects compared to only 29.3% of occasional users. Kratom users were less likely to have a history of chronic diseases such as diabetes, hypertension, dyslipidemia than ex- and non-users.

Conclusion

Regular long-term chewing of fresh kratom leaves was not related to an increase in common health complaints, but may pose a drug dependence risk. Severe kratom dependents were more likely to suffer from intense withdrawal symptoms. Medical records revealed no death due to traditional kratom use, but the high prevalence of tobacco or/and hand rolled cigarette smoking among kratom users should be of concern.

Keywords:

• Mitragyna speciosa
• kratom
• health status
• dependence
• withdrawal
• Thailand

Acknowledgments

This study was supported by the Research Chair Grant from the National Science and Technology Development Agency, Ministry of Science and Technology, Thailand. The Epidemiology Unit, Prince of Songkla University, is partially supported by the National Science and Technology Development Agency, Ministry of Science and Technology, Thailand, and the Thai Health Promotion Foundation. While DS was preparing this paper, she was in receipt of a postdoctoral scholarship supported by the NIDA, and worked with Dr. Carl Latkin at the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Many thanks to village health volunteers who acted as assistant researchers, the director and staff of Chian Yai Hospital, Pak Phanang Hospital, Mae Chao Yu Hua Health Center, Karaket Health Center, Tay Thalae Health Center, Ban Sri Raksa Health Center, Ban Yang Youn Health Center, and Suan Luang Health Center for their facilitating and coordinating support during data collection. Thanks are expressed to the villagers at the study site and all subjects for their participation in this research.

Disclosure statement

The author declares that there are no conflicts of interest.

Additional information

Funding

This work (Project P-10-10307) was partially supported by a Reseach Chair grant to the first author from the National Science and Technology Development Agency, Ministry of Science and Technology, Thailand.