Ketum: Medicinal Friend or Foe?

Use and Abuse of Ketum

The Ketum leaf contains over 40 alkaloids, with Mitragynine being the main constituent accounting for over 66% of the total alkaloids [2,3]. Mitragynine and 7-hydroxymitragynine (7-HMG) are psychoactive alkaloids exclusive to this plant. The effects of Mitragynine on humans are dose-dependent.[3] At low doses, the leaves of the Ketum tree are a known stimulant. [4] At higher doses, ingesting the Ketum leaf has an analgesic and anti-inflammatory benefit as well as aiding in opioid withdrawal syndrome which arises from its opioid-like properties. Higher doses also cause euphoria, sedation and mind-altering effects akin to opioids.[3,5] One study even found it to be more potent than morphine, another opioid drug![7]

Red Alert!

Several reports show that Kratom use can also lead to respiratory depression, anorexia, depression, psychosis, and seizures. Similarly, there have been concerns about overdose-related deaths, risks of addiction, abuse, and dependence on Ketum.[7] Due to the nature of Mitragynine as a psychoactive ingredient and its potential for abuse, it is subjected to control in Malaysia under the Poisons Act 1952 [Act 366][4]

Registration Status in Malaysia and its Associated Controversy

Mitragynine is listed as a psychotropic substance under the Poisons Act 1952. Import, export, manufacture, sale and possession of mitragynine is listed as a criminal offense under Section 30 of this act for which the punishment is a fine of not more than RM10,000, 4 years imprisonment or both.[4]

However, kratom trees themselves are not illegal plants! As it stands, the cultivation or presence of naturally growing kratom is not prohibited by any law in Malaysia. This loophole blunts the teeth of law enforcement as they are not able to attack the production of kratom leaves. The lack of any test kits sets law enforcement back even further as they are unable to arrest and prosecute kratom addicts. Thus, the focus of the law is largely placed on the transporting, processing and selling of kratom.[8]

As it can be easily cultivated in Malaysia, further research into the use of kratom may give Malaysia an economic and academic advantage of its untapped medicinal potential. While we hope to move in that direction, Caring Pharmacy does not encourage use or misuse of kratom.