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Coming up easy

With epithets such as ‘the legal heroin’ and ‘the heroin-like leaf’, and often sold alongside ‘legal highs’ such as synthetic cannabis and the hallucinogenic plant salvia, a certain Southeast Asian herb has propelled the media into a sensationalist tailspin.

“Heroin-like drug sold over the counter locally” ran the main story on an Ohio-based TV news channel in the US last year. A newspaper in the UK splashed the headline “Herbal remedy killed my son” over its front page, despite the fact anabolic steroids were said to have caused the individual’s death.

When nine youths in Sweden overdosed in 2010 after consuming pills called Krypton, a concoction containing the herb, newspapers were quick to point the finger. That was until coroners returned with the verdict that the overdoses were caused by O-Desmethyltramadol, a derivative of the legally prescribed anti-depressant tramadol. 

Despite the media frenzy, buyers expecting a serious buzz from kratom might be disappointed. Many consumers and health professionals agree that the herb’s effects are minimal – somewhere between knocking back a few espressos and popping too many prescription sleeping pills. 

Kratom, the leaf of the Mitragyna speciosa tree, which comes from the same botanical family as coffee, has been consumed in Southeast Asia for centuries. Typically chewed or drunk by rural labourers as a tonic, kratom acts on the central nervous system as either a stimulant or depressant depending on the quantities and strains consumed. In Southeast Asia its legal status varies, but in most Western countries it is legal, readily available and growing in popularity. 

“The UK market is growing steadily,” said Chris, the manager of an online legal high store based in the UK, who asked to have his full name withheld. “In the past six months we’ve taken on a couple of part-time staff [to deal with the orders].”

In the US, as early as 2005, the Drug Enforcement Administration (DEA) noted that “the wide availability of kratom on the internet suggests that demand is extensive”. Kratomonline.org is one store that backs up this hypothesis. It offers eight different strains of kratom powder, resin, capsules and tincture, as well as live plants and informative how-to guides. One ounce of maeng da – which translates as ‘pimp grade’ and is described as the “strongest strain available today” – costs just under $20. Less powerful strains are cheaper, and the standard delivery charge is $3. A few dollars more gets you next-day delivery. 

“It’s so easy to buy kratom online,” said John Hart, 30, of Iowa, who has been consuming the herb for several years to help with chronic back pain he developed after an accident at work.

Some people say it’s a drug, but it doesn’t feel like a drug – it’s delivered to my mailbox. And it’s been a miracle for me.

John Hart

But not everyone sees kratom as a harmless herbal remedy. In June the US Food and Drug Administration (FDA) authorised customs officials to detain products containing the herb, citing health warnings. The herb is currently banned in the states of Indiana, Louisiana, Vermont and Tennessee; other states are considering prohibitory laws. 

Despite these bans, the quantities of kratom leaving Southeast Asia are on the rise, according to an Indonesian supplier who asked to remain anonymous. “In recent years, our exports have increased enormously,” he said.

Kratom trees grow wild across Southeast Asia – predominantly in Thailand, Malaysia and Indonesia – and its leaves have been used medicinally or ceremonially for centuries. In Malaysia, most villages had a kratom teahouse. In southern Thailand, the herb was an important part of cultural ceremonies and an alternative to alcohol for Muslims in the region. 

However, kratom has been criminalised in Thailand since 1943, and it was made a controlled substance in Malaysia and Myanmar in 2003 and 1993 respectively. In Indonesia there are no bans, although exports are regulated. “Certificates needed to ship by air with DHL, Fedex or UPS are no longer provided, [although] EMS still accepts shipments labelled Mitragyna speciosa,” explained the Indonesian supplier.  

Despite kratom’s illegality for almost 70 years, it is only of late that officials in Thailand have clamped down. In 2005, 1,251 arrests were made relating to production, possession and export. Four years later this number had leapt to 7,388. More than three-quarters of these took place in Thailand’s restive southern provinces. 

Fancy a cuppa? drinking kratom tea has been said to ease withdrawal symptoms experienced by heroin and meth addicts. Photo: Amaralak Khamhong

According to Pascal Tanguay, project director of the global health organisation Population Services International (PSI) Thailand, who has studied kratom use for many years, this surge in arrests had much to do with the Thai media’s reporting of ‘4×100’. 

A concoction of kratom tea, cough syrup, Coca-Cola and ice-cubes, 4×100 is typically used by youngsters and is said to have a euphoric effect similar to morphine, although the high is short-lived. Thailand’s media frequently presents 4×100 as a recreational drug, listing it along with heroin and methamphetamines as among the main dangers in society.

Staggering kratom drunk kid kills parents horrifically. 

Kom Chad Luek daily newspaper (headline)

Newspapers have also reported other chemicals being added to 4×100, including road paint, powdered mosquito coils and even ashes from dead bodies. They have also spuriously linked 4×100 to gangs, murder and Islamic fundamentalism.

“[These media reports] have not been substantiated in any way by the research I’ve done or through my experience of managing Thailand’s largest project targeting people who use drugs,” said Tanguay. “The propaganda around 4×100 widely exaggerates public perception of the risks related to kratom use. The pharmaceutical products [such as cough syrup] in 4×100 can have much more negative health impacts than kratom.”

Despite the media panic, over the past few years there has been a fightback by those who support the herb’s use. In August 2013, Thailand’s minister of justice, Chaikasem Nitisiri, announced that the government would be looking into decriminalising kratom. He cited the herb’s historic place in Thai culture as rationale, as well as its use in treating the withdrawal symptoms of heroin and methamphetamine addicts. 

Cocktail hour: Kratom tea, cough syrup, Coca-Cola and ice-cubes, are combined to create ‘4×100’. Photo: Amaralak Khamhong

The self-prescription of kratom by opiate users has been widely documented in Southeast Asia. But it is only in the past decade that health professionals and scientists have started to investigate this positive use of the herb. 

In 2013 the University of Mississippi tested the effects of kratom on heroin withdrawal. “Mitragynine (an alkaloid in kratom) completely blocked all withdrawal symptoms and could provide a remarkable step-down-like treatment for people addicted to hardcore narcotics such as morphine, oxycodone and heroin,” said Christopher McCurdy, one of the faculty members responsible for the tests. Other studies carried out in the US and Southeast Asia have come to similar conclusions.

“A miracle. A fucking miracle,” said Thomas MacFadden, a recovering heroin addict who lives in Brighton, UK. “I use it alongside methadone, or sometimes instead of it. Last month my methadone prescription was reduced, so I started drinking kratom [in tea]. I recommend it to all my mates.” 

However, there is concern that kratom will become stigmatised before adequate research can be carried out. In the US, kratom would need to go through a ‘new drug application’ (NDA) and be approved by the FDA before it can be used by health professionals to treat addiction and other ailments. However, the FDA has already declared that kratom can have adverse health effects on its users – a position it is unlikely to revise until further clinical tests are completed.

In Thailand there was optimism that after 70 years the herb would be decriminalised and more funding would be given to researchers, but recent political changes in the country have dampened such hopes. According to Tanguay, the military junta now has “bigger fish to fry” and a decision over kratom will be delayed.

While critics of the herb call for criminalisation and supporters fight to keep it legal and readily available, it should be scientists who have the final word on kratom. A sensationalist media and reactionary politicians seem to be winning the battle for the time being – a situation that might prove costly to thousands around the world who could benefit immensely from this small, green Southeast Asian leaf.

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