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

  • Saref, Azlin1
  • Suraya, Sharifah1
  • Singh, Darshan2
  • Grundmann, Oliver3
  • Narayanan, Suresh1
  • Swogger, Marc T4
  • Prozialeck, Walter C5
  • Boyer, Edward6
  • Chear, Nelson Jeng Yeou1
  • Balasingam, Vicknasingam1
  • 1 Centre for Drug Research, Universiti Sains Malaysia, 11800, Minden, Penang, Malaysia. , (Malaysia)
  • 2 Centre for Drug Research, Universiti Sains Malaysia, 11800, Minden, Penang, Malaysia. Electronic address: [email protected] , (Malaysia)
  • 3 Department of Medicinal Chemistry, College of Pharmacy, University of Florida, 1345 Center Drive, Room P6-20, Gainesville, FL, 32611, USA.
  • 4 Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.
  • 5 Department of Pharmacology, College of Graduate Studies, Midwestern University, Downers Grove, IL, USA, 60515.
  • 6 Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Published Article
Journal of ethnopharmacology
Publication Date
Jun 28, 2019
DOI: 10.1016/j.jep.2019.111876
PMID: 31014959


Mitragyna 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. To determine the self-reported prevalence and severity of opioid-related adverse effects after kratom initiation in a cohort of illicit opioid users. A 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. Respondents were all males, majority Malays (94%, n = 154/163), with a mean age of 37.10 years (SD = 10.9). Most were single (65%, n = 106/163), had 11 years of education (52%, n = 85/163) and employed (88%, n = 144/163). Half reported using kratom for over >6 years (50%, n = 81/163), and 41% consumed >3 glasses of kratom daily (n = 67/163). 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. Our findings indicate that kratom initiation (approximately 214.29 mg of mitragynine) was associated with significant decreases in the prevalence and severity of opioid adverse effects. Copyright © 2019 Elsevier B.V. All rights reserved.

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