It looks like some people have given a very negative impression of growing kratom in the United States. This tree is in the same genus and family as kratom wholesale (Mitragyna speciosa, in the coffee or Rubiaceae family) and the leaf is even known on the street as kra thum khok." The leaves are green with light-greenish white veins, and while they are somewhat smaller than kratom leaves, they have a similar structural appearance.

The 4 × 100 concoction is usually made of brewed kratom tea, cough syrup (e.g., diphenhydramine), and Coca‐Cola, whereas an assortment of substances such as anxiolytics, antidepressants, and analgesics are also added based on consumers preferences (Tungtananuwat & Lawanprasert, 2010 ). The 4 × 100 concoction is reported to provide better euphoria (Tanguay, 2011 ; Tungtananuwat & Lawanprasert, 2010 ). In fact, there is rising concern about the rapid diffusion of 4 × 100 particularly among young people in the community (Tanguay, 2011 ). The use of 4 × 100 with poly drugs (anxiolytic or antidepressant) can be fatal due to its multidrug toxicity (Tungtananuwat & Lawanprasert, 2010 ).

Although the phenomenon has only been marginally studied, an exponential number of kratom's subjective experiences have been posted online on drug fora by users in the EU and US and elsewhere. Takayama, H. (2004), ‘Chemistry and pharmacology of analgesic indole alkaloids from the rubiaceous plant, Mitragyna speciosa', Chemical and Pharmaceutical Bulletin, Volume 52, pp. 916-928.

This is the case of Mitragyna speciosa (kratom), a tropical tree used to improve work performance and to withstand great heat. Kumarnsit, E., Vongvatcharanon, U., Keawpradub, N. and Intasaro, P. (2007), ‘Fos-like immunoreactivity in rat dorsal raphe nuclei induced by alkaloid extract of Mitragyna speciosa', Neuroscience Letters, Volume 416, pp. 128-132.

Background: Mitragyna speciosa leaves have been abused by drug addicts as some of the alkaloids (mainly mitragynine) from the plant possess opiate and cocaine-like effects. Mitragyna speciosa grows naturally in Thailand, Malaysia, Indonesia, and Papua New Guinea and has been used for many years in Southeast Asia as an opium substitute.

Parthasarathy, S., Ramanathan, S., Ismail, S. et al. (2010), ‘Determination of mitragynine in plasma with solid-phase extraction and rapid HPLC-UV analysis, and its application to a pharmacokinetic study in rat', Analytical and Bioanalytical Chemistry, Volume 397, pp. 2023-2030.

Although the cultivation of ketum trees is considered to be nonillegal, those caught for distributing ketum or in possession of processed ketum leaves can be fined up to a maximum of RM10,000 or sentence to a 4‐year jail term, or both (Vicknasingam et al., 2010 ). More recently, the Malaysian government has proposed a new bill in parliament to reschedule ketum from the Poisons Act 1952, to the Dangerous Drugs Act, 1952.
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