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Kratom is not currently approved as a drug or medical device in many countries. From our point of view, kratom should be classified as a narcotic from a purely technical point of view. However, according to information from Swissmedic, it is not legally a narcotic (as of 1/2015). In 2017, however, the ingredients mitragynine and 7-hydroxymitragynine were added to the list of narcotics.
Stem plant
The tree Korth. from the family Rubiaceae, which grows up to 15 m high, is native to Southeast Asia and is found, for example, in Thailand, Myanmar and Malaysia. It belongs to the same family as the coffee bush. Images at Google Images
Medicinal drug
The fresh or dried leaves are used as a medicinal drug. They are also processed into powders, extracts and capsules.
Ingredients
Relevant constituents include indole alkaloids such as mitragynine (Figure) and numerous related analogs such as 7-hydroxymitragynine. Mitragynine has structural similarities to yohimbine.
Effects
Kratom is stimulant like coca at low doses and analgesic, antinociceptive, antitussive, antidiarrheal, euphoric, and psychoactive like opium at higher doses. It binds to opioid receptors and can induce opioid-like effects. According to animal experiments, it is thought to stimulate alpha-2 receptors.
Indications for use
Kratom is primarily used as a stimulant, intoxicant, and opioid withdrawal. Kratom has also been used as a substitute for opioids and opium, and is used medicinally for chronic pain and digestive problems, among other conditions (without regulatory approval).
Dosage
The fresh or dried leaves and corresponding preparations are very bitter and are chewed, swallowed, smoked or prepared as tea. The effects appear after 5-10 minutes and last for a few hours.
Contraindications
We do not have sufficient information on precautions. In principle, similar precautions should be observed that apply to the use of opioids.
Adverse effects
Possible adverse effects include nausea, vomiting, constipation, dry mouth, fatigue, tremor, nystagmus, weight loss, hyperpigmentation of the skin, and the development of psychosis. Kratom can be addictive and lead to withdrawal symptoms such as anxiety, restlessness, sleep disturbances, sweating, and craving. In our view, the potential health risks are not well understood.
