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.
SCOPE: Extensive review of ecological literature and field observations shows Lepidosperma species to be important components of many ecosystems, often dominating understorey and sedge-rich communities. For the first time, a detailed ecological review of a Cyperaceae genus is presented.
CONCLUSIONS: Lepidosperma species are long-lived perennials with significant abundance and persistence in the landscape. Speciation patterns in the genus are of considerable interest due to complex biogeographical patterns and a high degree of habitat specificity. Potential benefits exist for medicinal products identified from several Lepidosperma species. Over 178 organisms, including 26 mammals, 42 birds, six reptiles, five amphibians, eight arachnids, 75 insects, three crustaceans and 13 fungi, are found to be dependent on, or making use of, Lepidosperma species. A significant relationship exists between Lepidosperma species and the moth genus Elachista. Implications for the conservation and ecology of both sedges and associated species are discussed.