Darshan Singh et al. (2021). The Use Of Kratom (Mitragyna Speciosa Korth.) Among People Who Co-Use Heroin And Methamphetamine In Malaysia. *Journal Of Addiction Medicine*, 16, 223 - 228. https://doi.org/10.1097/ADM.0000000000000876.

Title: The Use of Kratom Among Adults with a History of Heroin and Methamphetamine Use in Malaysia

Study Overview

Kratom (Mitragyna speciosa Korth.) is an indigenous plant widely regarded in Southeast Asia for its traditional medicinal properties. A recent study conducted in Malaysia sheds light on the use of kratom among adults undergoing drug rehabilitation, specifically those with a history of heroin and methamphetamine co-use. This exploratory research, involving 332 patients from various rehabilitation centers, reveals fascinating insights into the motivations and impact of kratom use among those battling addiction.

Findings on Withdrawal Management

The research focused on a predominantly male population (95%) and comprised mostly ethnic Malays (98%). The average age of respondents was found to be 32.3 years, with a significant portion (64%) falling between 18 and 35 years. Many had experienced multiple encounters with the law due to drug-related offenses, emphasizing the severity of substance use challenges in this demographic. Notably, the mean age of first kratom use was recorded at 23.5 years, indicating that a substantial number of individuals turn to this plant at a relatively young age in their drug-using trajectory.

Kratom as a Tool for Withdrawal Management

The study uncovered that over two-thirds of participants utilized kratom primarily to alleviate withdrawal symptoms associated with heroin and to manage their methamphetamine intake. Alarmingly, 59% reported using kratom as a substitute for both heroin and methamphetamine, while specific motivations included reducing heroin intake (58%) and decreasing methamphetamine consumption (71%). This suggests that many users perceive kratom as a viable alternative during their recovery journey, serving both as a means of self-medication and as a potential harm reduction strategy. ### Patterns of Kratom Use Interestingly, the participants demonstrated varying patterns of kratom consumption, with 58% indicating they consumed three glasses or less daily, while 42% reported higher intake levels. The average daily consumption was approximately 3.6 glasses, yet due to the geographical diversity of respondents, the specific mitragynine content, the active alkaloid in kratom, could not be standardized across the sample.

Implications for Future Research

The findings from this study suggest several key implications for future research. First, the perceived benefits of kratom in managing withdrawal symptoms highlight a critical area that warrants further investigation. While kratom is often seen as a safer alternative to opiates due to its traditional use and availability, scientific validation of its efficacy and safety profile remains sparse. Research that systematically examines the pharmacological properties of kratom, particularly its impact on reducing both opioid and methamphetamine dependence, is essential in addressing these concerns. Moreover, the study indicates that those with previous rehabilitation experience were less likely to use kratom as a substitute for heroin. This observation may highlight the importance of integrating comprehensive harm reduction strategies, including education on alternative treatment options such as methadone therapy, into rehabilitation programs.

The Path Forward

In conclusion, the study illustrates kratom’s potential role as a harm-reduction tool for individuals grappling with complex substance use disorders, particularly in populations where conventional therapeutic options may be limited or stigmatized. As the opioid crisis and polydrug use continue to escalate, understanding the nuances of kratom use in these communities becomes increasingly vital. Given the self-reported benefits highlighted by the respondents, it is incumbent upon the scientific community to delve deeper into kratom's therapeutic potential to ensure those struggling with addiction have access to the best possible care and treatment options. Further studies are not only warranted but crucial in elucidating kratom's position within the broader context of substance use treatment.