title: Traditional and non-traditional uses of Mitragynine (Kratom): A survey of the literature.
abstract: The objective of the paper was to highlight the differences in the traditional and non-traditional users of kratom in the South East Asian and Western contexts.
  
  
  
  A literature survey of published kratom studies among humans was conducted. Forty published studies relevant to the objective were reviewed.
  
  
  
  Apart from the differences in the sources of supply, patterns of use and social acceptability of kratom within these two regions, the most interesting finding is its evolution to a recreational drug in both settings and the severity of the adverse effects of kratom use reported in the West. While several cases of toxicity and death have emerged in the West, such reports have been non-existent in South East Asia where kratom has had a longer history of use. We highlight the possible reasons for this as discussed in the literature. More importantly, it should be borne in mind that the individual clinical case-reports emerging from the West that link kratom use to adverse reactions or fatalities frequently pertained to kratom used together with other substances. Therefore, there is a danger of these reports being used to strengthen the case for legal sanction against kratom. This would be unfortunate since the experiences from South East Asia suggest considerable potential for therapeutic use among people who use drugs.
  
  
  
  Despite its addictive properties, reported side-effects and its tendency to be used a recreational drug, more scientific clinical human studies are necessary to determine its potential therapeutic value.
authors.affiliation: Centre for Drug Research, Universiti Sains Malaysia, 11800 Gelugor, Penang, Malaysia.
authors.forename: Darshan
authors.initials: D
authors.lastname: Singh
authors.affiliation: School of Social Sciences, Universiti Sains Malaysia, 11800 Gelugor, Penang, Malaysia.
authors.forename: Suresh
authors.initials: S
authors.lastname: Narayanan
authors.affiliation: Centre for Drug Research, Universiti Sains Malaysia, 11800 Gelugor, Penang, Malaysia. Electronic address: vickna@usm.my.
authors.forename: Balasingam
authors.initials: B
authors.lastname: Vicknasingam
mesh_terms: D000818:Animals; D001210:Asia, Southeastern; D003431:Cross-Cultural Comparison; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects; D032065:Mitragyna / Q000737:chemistry; D046948:Secologanin Tryptamine Alkaloids / Q000009:adverse effects* / Q000627:therapeutic use*; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology / Q000209:etiology
chemical_list: D013287:Illicit Drugs; D046948:Secologanin Tryptamine Alkaloids; C001801:mitragynine
keywords: Drug; Fatality; Ketum; Kratom; Mitragynine; Recreational; Toxicity