Kratom in medicine
Kratom, as well as the isolated alkaloids derived from it, are of great interest to official medicine. As early as 1897, Ridley, describing the traditional use of Kratom, mentioned that the leaves of the plant were an effective treatment for opium addiction. More recent reports indicate the successful use of mitragynine to treat methadone dependence in New Zealand. According to these reports, a patient smoked dried Kratom leaves when experiencing withdrawal symptoms daily for six weeks. The patient also reported vivid hypnagogic dreams while using Kratom. In the United States, as part of the initial experimental studies on ibogaine as an effective treatment for drug addiction, Dana Beal, an American activist of the "Treatment, not War" movement, proposed using mitragynine – the dominant active alkaloid in Kratom – in comparative experiments. However, the acting deputy director of NIDA, Charles Grudzinskas, rejected this proposal, justifying it on the grounds that there is even less reliable scientific information about mitragynine than about ibogaine.
Although ibogaine and mitragynine are chemically similar to each other (both are indole derivatives) and interact with opioid receptors, their pharmacological effects have significant differences. If ibogaine is typically used for a single dose, aiming to achieve a kind of "shock effect," Kratom can be used for a long time as a form of "replacement therapy," similar to methadone.
The advantage of Kratom is that it has legal status in most countries of the world, and is currently one of the safest means capable of eliminating the acute manifestations of withdrawal symptoms in patients. It is a much cheaper and safer alternative to methadone. At present, there are many reports of the successful use of Kratom for detoxification, even in severe cases of opiate addiction. However, people who place high hopes on the use of Kratom for self-treatment of drug addiction should clearly understand that Kratom, although potentially safe and effective, is unlikely to be beneficial if used uncontrollably and for an extended period. To date, despite all the potential of Kratom in the treatment of drug addiction, no clinic officially uses it in treating its patients.
There is also great interest in using Kratom in the therapy of acute and chronic pain syndrome against the background of using "classical" opioid analgesics, as it may reduce their dosage while maintaining a high level and quality of analgesia. In addition, in such cases, it is possible to slow down the development of tolerance to morphine-like substances and, therefore, slow down the development of physical dependence on them.
In addition to its psychotropic activity, kratom has a whole range of other medicinal properties, which are due to the presence of a large number of other biologically active substances in its leaves. Among these substances are those with pronounced antioxidant and immunostimulatory properties, as well as those with antibacterial and antiviral activity, and substances that affect the cardiovascular system. Some sources even report the plant's anticarcinogenic properties.
Kratom seems to be quite effective as an alternative to codeine in various cough suppressants. Unlike codeine and other opiates, kratom has a significant advantage - it does not suppress respiration and promotes the expectoration of mucus, rather than inhibiting it. Also, its antibacterial and immunostimulatory properties should not be forgotten when treating infectious diseases of the upper respiratory tract. These properties of kratom are also very appropriate in cases of treating pain syndromes after some surgical interventions, as this would reduce the risk of developing infectious complications in such cases. In terms of analgesic effectiveness, kratom is approximately comparable to codeine and some of its derivatives. However, individual alkaloids from leaves, often positioned as "opioid analgesics tens of times superior to morphine," have shown some rather unexpected results. In the early 1970s, the pharmaceutical company Kline and a French pharmacological laboratory conducted experiments on mitragynine by administering the isolated alkaloid to a human. In a personal letter to Karl Jansen in 1986, Raffauf reported that the study was discontinued due to unacceptable acute side effects. He wrote, "It is likely that the possible reason for this phenomenon is the pharmacological differences between isolated mitragynine and natural kratom leaves, which contain many other active alkaloids." Pure mitragynine administration causes nausea, vomiting, double vision, muscle disorders, and adverse cardiovascular effects. Therefore, it cannot be used as an analog of a series of street opioid drugs in its pure form. This is another important feature of kratom and its alkaloids in particular.
In 1999, Pennapa Sapcharoen, director of the National Institute of Thai Traditional Medicine in Bangkok, stated that kratom could be prescribed to patients suffering from depression but emphasized that this would require a lot of additional research. Furthermore, any potential use of kratom in the treatment of drug addiction should be considered exclusively within the framework of comprehensive therapy.
Thus, while in the ethnic medicine of many countries where the plant Mitragyna speciosa grows in the wild, various preparations from its leaves have been successfully used by folk healers for various pathologies and symptoms for a long time, Western official medicine is essentially just beginning to get acquainted with this amazing plant.