Mitragyna speciosa (Kratom) is a plant indigenous to some parts of Asia. According to GC-MS analysis of freshly made Malaysian ‘ketum' drinks, prepared by extended boiling of fresh leaves in water, one 250 ml glass of ‘ketum' contained 22.5-25 mg mitragynine. Instead, this herb contains an alkaloid called mitraphylline that binds to the same mu-opioid receptors in the brain as mitragynine and is also present in kratom seeds (Mitragyna speciosa) and cat's claw (Uncaria tomentosa).

In the evenings, men use kratom as a drink when they relax and socialise (Saingam et al., 2012 ). In villages, kratom is also served as a drink to male guests during social gatherings (Saingam et al., 2012 ; Tanguay, 2011 ). It serves as a substitute for alcohol among Muslims in Malaysia and South Thailand because alcohol consumption is against Islamic teachings (Tanguay, 2011 ; Tungtananuwat & Lawanprasert, 2010 ). Because kratom users are not considered to be alcohol users, they are free from the social stigma attached to those consuming alcohol (Saingam et al., 2012 ). Kratom has also earned a place in some village religious ceremonies where it is offered to a god or spirit as a precious gift for fulfilling their desires or vows (Saingam et al., 2012 ).

It might also be worth adding that kratom use is not detected by conventional drug screening tests as advanced tests, like liquid chromatography-tandem or ion-mass spectrometry, are required 7 We also reiterate here the importance of focusing and asking direct questions on the nature and patterns of drug intake, including medical products diversion and consumption of NPS, during clinical assessments 94 Given that nowadays polydrug use represents the norm rather than the exception, especially in emergency settings 90 , the simultaneous use of drugs should also be promptly identified, investigated, and well discriminated.

A 47-year-old man developed drug-induced liver injury following concomitant administration of escitalopram for major depressive disorder and Mitragyna speciosa for low back pain not all duration of treatments to reaction onset stated. Since the use of M. speciosa has been forbidden in Thailand, the leaves of M. diversifolia or others are frequently used as substitutes but are not considered as effective.

Kratom taken in large, sedating doses corresponding to 10-25 g of dried leaves may initially produce sweating, dizziness, nausea and dysphoria but these effects are shortly superseded with calmness, euphoria and a dreamlike state that last for up to six hours.
이 게시물을..