Self-reported prevalence and severity of opioid and kratom (Mitragyna speciosa korth.) side effects.

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE\nMitragyna speciosa (Korth.) is a traditional medicinal plant widely used in Southeast Asia for its opioid-like effects. Although kratom produces analgesia through binding of mitragynine and other alkaloids at the mu-opioid receptor (MOR), the association of long-term kratom use with adverse opioid-like effects remains unknown.\n\n\nAIM OF THE STUDY\nTo determine the self-reported prevalence and severity of opioid-related adverse effects after kratom initiation in a cohort of illicit opioid users.\n\n\nMATERIALS AND METHODS\nA total of 163 illicit opioid users with current kratom use history were recruited through convenience sampling from the northern states of Peninsular Malaysia. Face-to-face interviews were conducted using a semi-structured questionnaire.\n\n\nRESULTS\nRespondents were all males, majority Malays (94%, n\u202f=\u202f154/163), with a mean age of 37.10 years (SD\u202f=\u202f10.9). Most were single (65%, n\u202f=\u202f106/163), had 11 years of education (52%, n\u202f=\u202f85/163) and employed (88%, n\u202f=\u202f144/163). Half reported using kratom for over >6 years (50%, n\u202f=\u202f81/163), and 41% consumed >3 glasses of kratom daily (n\u202f=\u202f67/163). Results from Chi-square analysis showed kratom initiation was associated with decreased prevalence of respiratory depression, constipation, physical pain, insomnia, depression, loss of appetite, craving, decreased sexual performance, weight loss and fatigue.\n\n\nCONCLUSIONS\nOur findings indicate that kratom initiation (approximately 214.29\u202fmg of mitragynine) was associated with significant decreases in the prevalence and severity of opioid adverse effects.