Description

Mitragyna Speciosa Kratom

Mitragyna speciosa as a Potential Substitute Therapy in Opioid
Dependence: A Case Report
Karniza Khalid1*, Jason S.K. Wong2
, Ruzita Jamaluddin3
1
Clinical Research Centre, Hospital Tuanku Fauziah, Perlis, Ministry of Health Malaysia
2
Department of Pharmacy, Hospital Tuanku Fauziah, Perlis, Ministry of Health Malaysia
3
Department of Psychiatry and Mental Health, Hospital Tuanku Fauziah, Perlis, Ministry of Health Malaysia
ABSTRACT
Preclinical data have consistently suggested the pharmaceutical potential of kratom (Mitragyna
speciosa), including as a substitute therapy in opioid dependence. In this case report, we present
a case of a man with a long history of kratom use to help him cope with his opiate withdrawals
while abstaining from illicit drug use. This is the first published detailed case report highlighting
the potential use of kratom to aid opioid dependence encountered in the clinical setting. Our article
is also supported by literature review with regards to kratom’s safety profile and pharmacological
potential.
Keywords: Mitragyna; opiate alkaloids; opioid-related disorders; illicit drugs; personal narrative

INTRODUCTION

Polysubstance abuse and opioid dependence are
burgeoning issues stereotypically affecting the youths.
They are closely linked to social ill with spurring juvenile
crimes, hence risk public security due to the violent and
erratic behavior derived from the psychostimulants’
effects (Salas-Wright et al., 2017).
Clinical management of individuals with polysubstance
abuse, addiction and dependence is intricately
challenging as the program success highly depends on
the degree of self-awareness, their personal drive and
willingness to quit (Castine et al., 2019; Kennedy &
Gregoire, 2009). Pharmacological therapy may help to
an extent and to date, methadone is the most feasible and
the cheapest mode of substitution therapy adopted by
the Malaysian government as part of the harm reduction
policy to curb opioid dependence in the community
(Frank, 2020). Methadone is a synthetic opioid agonist
with affinity towards the endogenous mu-opioid
receptor with the preferential activation of β-arrestin
over the G-proteins, hence relieving opioid withdrawal
symptoms (Kapoor et al., 2020). The side effects, even
were mild and somatic, might be intolerable to some,
and this include excessive sweating, constipation and
dry mouth (Haber et al., 2017). In such cases, therapy
with other substitute therapy may be prescribed, such as
suboxone or buprenorphine, often at a much higher cost.
Kratom or Mitragyna speciosa is a plant homogenous to
the Southeast Asia with average range of the tree height
is between 13-52 feet (Khalid et al., 2021) (Figure 1). It
has dark green leaves and can grow up to 7 inches long
and 4 inches wide (Figure 2).
Figure 1. Kratom (Mitragyna speciosa) tree.
Figure 2. Kratom (Mitragyna speciosa) leaves.