rVOLUME Villi, NUMBER I SPRING / SUMMER 2000

ENCOUNTERS WITH KRATOMby PAULE. WOGG

While surfing the web a few years ago, I came across the de-scription of a plant called Mitragyna speciosa, or kratom. Theshort discussion mentioned its unusual combination of ef-fects as being both stimulant and depressant simultaneously,and having an indole chemical structure (something com-monly found in psychedelics). I asked a friend who lived inthe region where the plant was said to grow to check into itsavailability; after making a half-hearted effort to find thisplant, I was told that it was not very common, and I didn'tpursue it further. A year or so later I was at an ENTHEOBOTfu'lYconference in Mexico, where two of the speakers mentionedthis plant. Neither speaker knew of anyone who had actu-ally seen it, used it, or had any first-hand experience withthis plant. Since I was planning to be in South East Asia theweek following the conference, I decided to make more of aneffort to find this exotic species of ethnobotanical interest.Upon getting back to the States (having returned fromMexico and prior to leaving for Asia), I called my friend inSouth East Asia to help me find this plant.

After arriving in South East Asia, we met with some friendswho knew of a person that used this plant regularly. Theysaid that they could arrange for some leaf to be delivered.The following day, I went to a restaurant where the ownerknew the person who used the plant. They had a bag ofbranches with leaves and flowers waiting for me when I ar-rived that evening. That particular evening I was extraordi-narily fatigued from being 12 hours out-of-phase from mynormal time-zone; so much so that I couldn't really carry on

a conversation-which is somewhat unusual for me. I de-cided to try chewing some of the leaves-I started with two,then after about 15minutes, I chewed another two. The firstthing that I noticed when I started chewing the fresh leaf wasa numbing sensation in my mouth. About 10-15 minutesafter chewing the second two leaves, I felt alert, centered, andin a good mood-and was back to myoid talkative self. Theeffects were not overly stim ulating, in fact, I did not find it tobe a stimulant in the classical sense, but rather more of a"centering agent." I felt "put back together" and slightly eu-phoric. The effectswere pleasant; subtle, yet definitely there.

The following day, I arranged to meet with the man who hadcollected the plant material that had been left for me. Wemet back at the same restaurant. He was in his mid 40s andhad used the plant daily for several years. He was a good-natured and gentle man, and appeared to be quite healthy.He pulled from his pocket a stack of leaves that he keptwrapped in a plastic bag, removed the leaves from the bag,folded one up and put it in his mouth and began chewing.Her then offered me some. I eagerly accepted and we begandiscussing the plant. He felt very strongly about the plant,and told me about how it had changed his life. At one timehe had been a heavy whiskey drinker, and he gave up whis-key after he starting using kratom. He also discussed otherhealth benefits he has experienced since he started chewingthe leaf daily. Prior to his use of kratom, he suffered from whatsounded like clinical depression, chronic lower back pain,and he easily caught colds and influenza. He said that hewould need to go to the hospital at least once or twice eachyear due to severe colds and flu. Since starting using kratom,his lower-back pain has been eliminated, and he has not comedown with a single cold or flu in over 6 years. He now worksfull time doing moderate physical labor, and seems to befairly content with life in general. He also told me of somefriends that he gave kratom to; at least 10of them were heavydrinkers, and now none of them habitually use of alcoholsince they started chewing kratom.

Traditionally, kratom is used to treat diarrhea, cough, para-sites, and is used as an opium substitute. It is rumored to beused to treat opiate withdrawal in some areas, but nobodycould confirm this use, as none of the users that I spoke with

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considered kratom to be a drug, and they did not generallyassociate themselves with people who used opium or other"drugs." The leafis typically chewed, although I have heardof people smoking it or using some form of an extract (ap-parently this is not common, as neither this man nor severalother users that I discussed this plant with on subsequentvisits knew of anyone who smoked it or used an extract). It isusually chewed fresh, and dried leaves are used to make ahot water infusion or tea. Chewing fresh leaf is clearly thepreferred method of ingesting this plant by regular users.

In the months following my first exposure to kratom, throughextensive personal bioassays, as well as bioassays of friendsand colleagues, it was seen that the leafhas a substantial abil-ity to relieve pain. This pain-relieving effect, as well as its pro-nounced anxiolytic effects, are the most promising areaswhere I feel that future research efforts should be focused.Based on 6 months of moderate to heavy daily use, I did notfind kratom to be any more habit-forming than caffeine orcommonly prescribed SSRI anti-depressants.

Although traditionally only the fresh leafis chewed, I foundthat chewing the dried leaf (which takes a little getting usedto), was by far the best method to attain full effects from thisplant in its dried form. The dried leaf is typically preparedby gathering leaves that have fallen from the plants, dryingthem in the daytime heat, then grinding them to a finepowder using mortar and pestle, and storing this in sealedplastic bags or similar containers.

There appear to be at least two different strains of this plant.Subjectively, each strain has somewhat different effects. Onestrain has larger leaves with red veins, the other has green.I've found the green-veined leaves to be more potent, 'thoughI prefer the red-veined strain as it tends towards a more re-laxed alertness. I suspect that the two strains not only varyin alkaloid content, but also in the proportions of thevarious active constituents as well.

When chewing the fresh leaf, one typically starts off with 2-3 leaves and then chews additional leaves throughout the dayas needed to sustain the level of effects desired. I tend to useit like coffee, starting with about 1 gram dried or a couple offresh leaves, and then chew more as needed to reach the levelof effects desired. Typically with dried material, I'd say thatbetween 1 and 1.5 gm is what I'd call a "normal" amount formood elevation and pain relief. Over 3 gm tends to producea more opiate-like feeling and can lead to constipation. If thedose is increased much past the level of the mild opiate stage,

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the effects can become more pronounced and be accompa-nied by nausea. (One individual I know vomited after con-suming a tea made with about 10 gm of dried leaf.) I've onlyexperienced nausea when using a lot on an empty stomach.At high doses a type of psychological irritability may also oc-cur, similar to what some people may experience on opiates.

Some comments on the kratom s effects:

Psychedelic? The main component, mitragynine, is a 4-sub-stituted indole alkaloid, as are psilocybin/psilocin-withmitragynine having a methoxy group and psilocybin havinga hydroxy group at this location. There are not many natu-rally-occurring alkaloids that carry an oxygen at that posi-tion (SHULGIN1999; SHL'LGIN2000). Nevertheless, Iwould notdescribe the effects ofkratom as being psychedelic in any way.I do, however, find it to produce some level of closed-eyevisuals, and a few people have reported interesting experi-ences when chewing a small amount and subsequentlyusing Cannabis.

Aphrodisiac? Since mitragynine is structurally similar toyohimbine, it is not surprising that a few male colleaguesexperienced some enhancement of erectile function whileusing kratom.

Anxiolytic? Verymuch so; one person who tried it said it was"nearly impossible to get anxious while using this material."

Anti-depressant? It has generally been found it to produce asubtle and steady sense of well-being that lasts for severalhours, typically with no "hang-over."

Stimulant? Although it is referred to as a "stimulant" in muchof the literature, in my experience, and that of friends andcolleagues, it appears to be much more of a "centering agent"or "mental clarifier," than a stimulant per-se. The first time Iused this plant, I was very tired and jet-lagged. After chew-ing 4 kratom leaves, I was back-totally there and able tocontribute to conversation as ifi were at peak mental perfor-mance. Not over-stimulated, not really feeling stimulated atall (although some people have reported feeling stimulated).I just felt like all my parts were pulled back together (if thatmakes any sense). That's the best way I can describe it. Andwhile the effects of pure mitragynine administered to 5 hu-man volunteers in one study reportedly had a stimulant ef-fect described as being similar to cocaine (GREWAL 1932),another researcher found mitragynine alone to have no no-ticeable effect after taking an oral dose of 100 mg of the

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isolated compound. While I have not experienced puremitragynine, I feel that it would be quite a stretch to refer tothe effects produced by the whole leaves as "cocaine like" oreven" coca like." Though kratom may have some minor stimu-lant effects (described above), a mild numbing of the mouth,and perhaps produce a slight euphoria, these effects fall farfrom that of cocaine. In S.E. Asia its cultural use is markedlysimilar to that of coca leaf in South America, being used byagricultural workers to increase physical and mental stamina,allowing for long hours of manual labor (typically agricul-tural) in the sun. This is where the similarities between thetwo end. In my experience and that of several who have bio-assayed the leaves (both fresh and dried), the typical effectswere that offeeling a "calm alertness" and/or "centeredness"at low dosages, which took on a distinctive but relatively mildopiate character at higher dosages. Typically those who bio-assayed the leaf were also well acquainted with coca-mosthad used both cocaine and coca-leaf on several occasions.Aside from the initial numbing sensation, they found thesubjective experience to have little in common with that ofcoca or cocaine. The stimulant effects of kratom are quitesubtle, and most who have bioassayed it find that caffeine orEphedra/ephedrine possess stronger stimulant properties.Hence, the comparison of the stimulant properties of kratomto that of coca/cocaine is hardly a meaningful one, as theireffects are not of the same order of magnitude.

Attention enhancer? One person tried kratom when she ranout of her attention deficit medication Adderall" (a mixtureof amphetamine salts). She commented on how the leaf ma-terial substituted well for her ADHD medication, and that itwas "gentler" than her regular medication. It held her overquite sufficiently for a few days, allowing her to function atfull capacity in her professional career as an engineer, untilshe was able to get her prescription refilled.

Pain Reliever? One colleague with severe pain, for which heis prescribed high doses of opiate analgesics, tried using thedried leaf to help ease his withdrawal and reduce his currentdose of 1.4 gm morphine and 24 mg dilaudid per day (askratom is rumored to be affective in curbing opiate with-drawal). He said that he found it very useful, not necessarilyso much to curb the withdrawal (it is unclear ifit helped withthis aspect or not), but he found that it tended to relieve thepain-not just distract him from it, as his prescription opi-ates did). Another colleague who was sent a sample reportedthe anxiolytic affects, but with an unexpected beneficial side-effect of relieving his chronic lower-back pain. He said that asmall amount chewed in the afternoon or early evening (per-

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haps below threshold psychoactive levels) relieved his backpain for the rest of the day, with the pain returning the fol-lowing morning.

Curbing opiate withdrawal? One colleague said that it washighly effective in suppressing the withdrawal syndrome as-sociatedwith opiate withdrawal, although another subjectperforming a self-experiment leaves some question as to itseffectiveness for this purpose. Clinical studies might be help-ful to determine its value in this area.

Opiate-like effects? At low doses I would not consider theexperience to have any noticeable opiate-type effects, al-though people have mentioned it relieving pain at doses thatare threshold or subthreshold for noticeable psychologicaleffects. I've found this to be the case with my bioassays aswell-it seems to be a very effective pain-reliever, perhapseven more-so than opiates, with the advantage of having an-algesic activity at levels that don't significantly impair one'sability to function (i.e., operate a motor vehicle, etc.). Athigher doses, the experience takes on distinctly opiate-likeeffects, similar to codeine or hydrocodone. In recent years,research has found that the alkaloids mitragynine andmitragynine pseudoindoxyl from kratom bind to micro- anddelta-opioid receptor sites (yAMAMOTO et al. 1999), whichmight help to explain some of the pain-relieving action aswell as the high-dose codeine-like effects of this plant. It mayalso shed some light on its use to curb opiate withdrawal,and its use as an opium substitute when opium is not avail-able.

Kratom more addictive than opiates? This is a rumor I haveheard, and read about on the Internet. It is completely falsein my experience. I used this plant daily for about 6months-first going 3 days straight then stopping for a couple of days,then 7 then 14, 21, 90, etc. I found that upon stopping usage

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after about 6 months of moderately heavy daily use (at timesI was using more than 30 gm dried leaf per day), that I be-came rather emotionally sensitive, depressed, etc. for a fewdays upon quitting use. It is hard to separate how much ofitwas the situation I was dealing with (a difficult period), andhow much of it can be attributable to withdrawal. I also ex-perienced some tearing, which is common to opiate with-drawal. At any rate, if these effects could be considered "with-drawal," they were mild and very manageable, consideringthe duration of daily use. In later periods of use, I did notexperience any withdrawal. It is certainly not more addictivethan opiates-at least not in my personal bioassays-butrather far less addictive. South East Asian users report "yawn-ing" when stopping use--not being tired or fatigued, but justyawning a lot.

Is there an antidote to overdose? At higher doses, the effectsare not necessarily very pleasant, and may include constipa-tion, itchy nose, mild agitation, and nausea. I have been toldby several people that the effects can be aborted; every na-tive kratom user I queried related that you can eliminate itseffects almost immediately by drinking lemon or tamarindjuice (without sugar-I was told that sugar would make the

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effects worse). It is said to take 5 minutes or less to stop theeffects completely. Since I have not tried this, I cannot con-firm or negate its effectiveness as an antidote.

Finding some rather unexpected effects (analgesic proper-ties, anxiolytic properties, etc.) has lead me to realize thatthere are very real therapeutic uses for this plant. One pos-sible issue with it being accepted into Western medicine isthat rnitragynine, the primary alkaloid does not seem to re-produce the same effect as the whole herb, which contains21 or so additional "minor" alkaloids GANSEN & PRAST 1988).A tea made from the herb tends to be "less full bodied" thanchewing the leaf directly; I suspect some of the minor alka-loids are non-water soluble and/or destroyed by the diges-tion process. If chewed, perhaps these constituents are ab-sorbed sublingually and bypass the digestive enzymes/chemicals that might otherwise break them down. Typicallywhole herbs are less attractive to Western medicine than areisolated compounds. For this reason, I fear that Westernmedicine might not use this herb effectively; they may findthat the isolated compounds alone don't provide the thera-peutic effects that they seek, rendering the herb useless fromtheir viewpoint. ¥

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