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27 Dec 2024 15:28
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  •   Home > News > International

    Traditional Thai medicine kratom hailed as wonder drug in US, but comes with risks

    Kratom has been used for centuries as a traditional medicine in South-East Asia, but as its popularity has soared in the United States, so too has the controversy around it.


    Precariously perched on a polystyrene raft floating between rows of lush green trees, farmer Sherbs Saravarsi shows off his kratom plantation.

    He started it three years ago when the plant was decriminalised in Thailand, hoping to cash in on this new industry.

    "There's a lot of potential," he told the ABC.

    "It's just starting because in Thailand people don't see much value yet, but it's coming."

    Kratom is a tree in the coffee family and it can produce a stimulant-like effect in small doses. Others who ingest it in larger doses sometimes report a sedative-like effect.

    It has been used across South-East Asia for centuries as a traditional medicine and natural pick-me-up.

    The use of the drug has exploded in the United States, aided by influencers and podcasters such as Joe Rogan — a self-proclaimed kratom user.

    In America, kratom is largely sold in highly concentrated energy drinks and capsules, and it's become a billion-dollar industry.

    Proponents use it to self-treat everything from "pain [to] coughing, diarrhoea, anxiety and depression, opioid use disorder, and opioid withdrawal", according to the Federal Drug Administration.

    But while fans of kratom hail it as a natural antidote to drug dependence and pain, critics say it's nothing more than snake oil with the potential to do real harm if taken in high doses.

    The bad publicity threatens to shut down Thailand's blossoming kratom industry before it's even begun.

    How a humble herb became a controversial supplement

    Traditionally, kratom has been used by labourers and farmers in Thailand to combat fatigue, muscle pain and make it more bearable to work in the sun.

    But while they tend to chew on the leaves or dry them to make tea, some of the commercially available kratom products in the US are highly concentrated.

    In September, the US Food and Drug Administration (FDA) did a pilot study on kratom, which has not yet undergone peer review, and found the leaf was well tolerated by humans.

    "The data suggest that at the doses tested, using the specific botanical kratom sourced for the study, and under carefully controlled clinical conditions … kratom was well tolerated," they wrote.

    However, as noted by Bloomberg, the study excluded the highly concentrated popular kratom drinks sold at gas stations throughout the country which most users consume.

    Kratom use "can lead to psychotic symptoms, and psychological and physiological dependence" and "in the US, the abuse of kratom has increased markedly in recent years," according to America's Drug Enforcement Administration (DEA).

    "Kratom's effects on the body include nausea, itching, sweating, dry mouth, constipation, increased urination, tachycardia, vomiting, drowsiness, and loss of appetite," the DEA said.

    "Users of kratom have also experienced anorexia, weight loss, insomnia, hepatotoxicity, seizure, and hallucinations."

    It's now been banned in six American states, is the subject of multiple wrongful death lawsuits, and the DEA has listed it as a drug of concern.

    Kratom was listed as contributing to or causing at least 4,100 deaths in 44 states between 2020 and 2022, according to The Washington Post.

    The vast majority of cases involved other drugs in addition to kratom.

    Kratom was criminalised in Australia in 2005 and possessing, supplying or producing it can carry jail terms of up to two years.

    In August this year, the Australian Border Force intercepted a shipment of more than 6 kilograms of the substance and warned Australians against attempting to import it.

    'It gives kratom a bad image'

    In a country such as Thailand, where kratom has been used for centuries, the controversy overseas has come as a surprise.

    Ekasit Kumarasith has been studying the herb for over 20 years. He believes concerns about kratom are overblown.

    "In some case of death in the US, there are some misunderstandings or misconceptions because in those cases, mostly they are multiple drug users," he said.

    "Given the beneficial effect and [the fact that] toxicity is quite low, I have confidence that soon kratom will be used worldwide."

    Jake Coyner makes and sells kratom products such as soft drinks in Bangkok.

    He's worried about the impact of the stories emerging from the US.

    "It gives kratom a bad image. And kratom, if it's used naturally and responsibly, I don't think there's any harm. No-one's ever died in Thailand from using it," he told the ABC.

    "I think it might have to do with American culture. I feel like Americans like to take something that's natural and just concentrate it and synthesise it to like a really strong, potent thing, where it's something just different, and there's a lot of greed."

    Sittichai Daengprasert is the head of the Federation of Thai Herbal Industry group and also owns a pharmaceutical company.

    He says the drug should be used responsibly and moderately.

    "I think every product, whether herbal or pharmaceutical, they have side effects," he said.

    "Let's say paracetamol is good for headaches, but can have problems for the kidney or the liver.

    "Even water, if you drink water a lot, it can be harmful. Kratom is the same."


    ABC




    © 2024 ABC Australian Broadcasting Corporation. All rights reserved

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