Boonsiri Junsirimongkol
Junsirimongkol, Boonsiri, Virginia Commonwealth University, United States/Suansaranrom Psychiatric Hospital, Thailand; Jittarom, Chinanaj, Suansaranrom Psychiatric Hospital, Thailand
Background: Kratom, a Southeast Asian native plant also known as Mitragyna speciosa Korth (Rubiaceae), has been reported to have weak opioid agonist activity, mostly based on 7-hydroxymitragynine. Kratom abuse in southern Thailand often occurs in persons with mental illness, including schizophrenia.
Objective: The purpose of the study was to examine the characteristics and clinical presentation of kratom abusers seen in a psychiatric service.
Methods: The sample consisted of 87 outpatients, age 18–60, who had histories of kratom abuse and were treated at the Suansaranrom Psychiatric Hospital between August–December 2004. Data collection was performed using a semistructured interview that included opioid and stimulant abuse questionnaires.
Results: The majority of the subjects were male, age 18–35 (39.1%), and agricultural field laborers (65.5%). Kratom was commonly used by chewing (49.6%), together with drinking coffee (69.0%). The common clinical effects reported from the use of 1–20 leaves included psychoactivity (69%), decreased muscle pain (63%), and sunburn sensitivity (59%). Stimulant effects were more prevalent at low doses, while opiate-like effects were more common at higher levels of use. Withdrawal symptoms were reported, including muscle aches (68%), insomnia (60%), and irritable mood (59%). However, taking more than 20 leaves per day for 3 to 5 years resulted in reports of hallucination (31%) and paranoid symptoms (17.2%). Continuing abusers for more than 5 years often had small-sized feces similar to goats', and some reported decreased euphoria and impaired cognitive abilities.
Conclusion: Kratom abuse in southern Thailand has received little scientific attention, although cases are associated with serious psychiatric illness that require treatment in a psychiatric hospital.
Report preparation was supported by the Humphrey Fellowship Program.