Kratom: Balancing the Therapeutic Aspects for the Safety of the Public in the Future
Abstract
Kratom (Mitragyna speciosa) in Thailand used to be classified as a category 5 narcotic drug under the Narcotics Act B.E. 2522, but has now been unlocked on August 24, 2021. Kratom is native to Southeast Asia, the leaves of the kratom are used by the people of this region to make a tea to relieve fatigue, relief pain and reduce symptoms associated with opioid withdrawal. Evidence indicates that people in the United States and Europe are increasingly turning to use Kratom. It is intended to be used to treat opioid withdrawal symptoms when quitting opioids and to treat pain. Recent studies have confirmed that the chemical constituents of Kratom have pharmaceutical and medical benefits. However, an increasing number of adverse reactions have been reported from the use of Kratom products. In August 2016, the US Drug Enforcement Administration announced a plan to classify Kratom and its constituents mitragynine as Schedule 1 controlled substances which has caused a lot of backlash and defense from many Kratom advocates. The debate on the risk ratio, the benefits and safety of Kratom are ongoing. The supporter said that Kratom is a safer and less addictive alternative to opioids for pain relief. Opponents of Kratom argued that Kratom is a drug and dangerous that should be banned. Since many countries have used Kratom widely, it is therefore important for physicians, scientists and policymakers must have the knowledge of such matters. The purpose of this article was written to provide up-to-date knowledge of the progression and controversy in these stories. The author has played a role in researching Kratom while studying in the US and intending to give an unbiased overview. It concluded that 1. In animals, Kratom and its parent alkaloid, mitragynine, may be useful for pain relief and control of opioid withdrawal symptoms, but clinical trials are still needed. 2. Although Kratom is not as toxic as opium, but there are still legal concerns about the safety and lack of quality control of marketed "Kratom" products 3. Issues regarding the safety and effectiveness of kratom and its active substance, mitragynine, can be addressed by doing more research. However, the classification of kratom alkaloids as a controlled substance, Category 1, presents a significant hurdle to kratom research
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