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ABSTRACT
Krathom (Mitragyna speciosa Korth.) is an addictive and illicit substance used in Thailand and other Southeast Asian countries. It has become the most commonly used substance among villagers. The study aimed to explore the factor structure of the krathom withdrawal syndrome based on the findings of an earlier qualitative study. The current study was divided into two stages. Cross-sectional data collections were employed in both phases. The samples comprised, respectively, 196 and 330 krathom users aged over 25 years. The characteristics of krathom withdrawal symptoms and signs were identified and the factor structure examined using exploratory factor analysis (EFA). Confirmatory Factor Analysis (CFA) was used to examine the construct validity and multivariate linear regression was used to identify factors predicting the intensity of krathom withdrawal symptoms. The final scale comprised 20 items with four factors: craving-fatigue syndrome; musculoskeletal system and insomnia; mood symptoms; and autonomic nervous system/physical sickness. Symptoms and signs of krathom withdrawal similar to those of the withdrawal syndrome of opioid substances appear to be present in regular krathom users. The krathom withdrawal intensity is predicted by duration of krathom use, frequency, and daily amount of krathom use.
Acknowledgments
The authors wish to thank the village health volunteers who acted as assistant researchers, the Director of the Mae Chao Yu Hua Health Center, and all staff for help in coordinating the fieldwork. Ms. Walailuk Jitpiboon’s help with the data processing and analysis is highly appreciated. Appreciation is also expressed to the experts who have kindly reviewed the instruments, Professor John B. Saunders and Professor Manit Srisurapanont.
Funding
This study was supported by the Research Chair Grant to Dr. Sawitri Assanangkornchai from the National Science and Technology Development Agency, Ministry of Science and Technology, Thailand (P-10-10307). 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.