Self-reported prevalence and severity of opioid and kratom (Mitragyna speciosa korth.) side effects

Saref A 1 , Suraya S 1 , Singh D 2 , Grundmann O 3 , Narayanan S 1 , Swogger MT 4 Show all authors , Prozialeck WC 5 , Boyer E 6 , Chear NJY 1 , Balasingam V 1

Affiliations 

  • 1 Centre for Drug Research, Universiti Sains Malaysia, 11800, Minden, Penang, Malaysia
  • 2 Centre for Drug Research, Universiti Sains Malaysia, 11800, Minden, Penang, Malaysia. Electronic address: darshan@usm.my
  • 3 Department of Medicinal Chemistry, College of Pharmacy, University of Florida, 1345 Center Drive, Room P6-20, Gainesville, FL, 32611, USA
  • 4 Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
  • 5 Department of Pharmacology, College of Graduate Studies, Midwestern University, Downers Grove, IL, USA, 60515
  • 6 Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
J Ethnopharmacol, 2019 Jun 28;238:111876.
PMID: 31014959 DOI: 10.1016/j.jep.2019.111876

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE: Mitragyna speciosa (Korth.) is a traditional medicinal plant widely used in Southeast Asia for its opioid-like effects. Although kratom produces analgesia through binding of mitragynine and other alkaloids at the mu-opioid receptor (MOR), the association of long-term kratom use with adverse opioid-like effects remains unknown.

AIM OF THE STUDY: To determine the self-reported prevalence and severity of opioid-related adverse effects after kratom initiation in a cohort of illicit opioid users.

MATERIALS AND METHODS: A total of 163 illicit opioid users with current kratom use history were recruited through convenience sampling from the northern states of Peninsular Malaysia. Face-to-face interviews were conducted using a semi-structured questionnaire.

RESULTS: Respondents were all males, majority Malays (94%, n = 154/163), with a mean age of 37.10 years (SD = 10.9). Most were single (65%, n = 106/163), had 11 years of education (52%, n = 85/163) and employed (88%, n = 144/163). Half reported using kratom for over >6 years (50%, n = 81/163), and 41% consumed >3 glasses of kratom daily (n = 67/163). Results from Chi-square analysis showed kratom initiation was associated with decreased prevalence of respiratory depression, constipation, physical pain, insomnia, depression, loss of appetite, craving, decreased sexual performance, weight loss and fatigue.

CONCLUSIONS: Our findings indicate that kratom initiation (approximately 214.29 mg of mitragynine) was associated with significant decreases in the prevalence and severity of opioid adverse effects.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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