Native to Southeast Asia, kratom is a plant and herbal medicine with mild opioid and stimulant-like properties. It was held in high esteem as a traditional remedy for health ailments in Thailand, until its criminalization in 1943—the result of increased use following skyrocketing opium prices in the region and a scramble by the Thai government to control the opium market.
In May, the Thai government voted to remove kratom from the nation’s list of “narcotics,” making an unambiguous statement after 80 years of speculation on the plant’s role.
In a recently released report published in the International Journal of Drug Policy, researchers surveyed over 1,000 Thai citizens about their views on the plant’s decriminalization. The results showed a majority in favour of the removal of kratom’s criminalized status.
This rising acceptance of kratom stems from its history of being interwoven with Thai culture; past research has shown kratom’s consistent use amongst people in rural Thailand for centuries. Praised for its properties in herbal medicine, kratom has also been used to manage or end use of potent opioids. The result has been kratom advocates fighting for the plant’s place in Thai culture and across the globe.
“It was mistaken by policymakers in the past … we should accept this was a wrong law and should be corrected.”
“This [positive] perception has been passed down from generation to generation. In fact, the persons who changed the paradigm include policymakers, government officers and politicians,” Dr. Darika Saingam, a researcher at Prince of Songkla University in Thailand, told Filter. “For nearly 80 years, kratom was classified as an illegal substance. It was mistaken by policymakers in the past, and we should look back to the original point and accept this was a wrong law and should be corrected.”
Saingam is a renowned investigator of kratom’s effects. Her insight stems from years researching various kinds of kratom use among the majority-Muslim, mostly rural population of southern Thailand—including as a recreational drug, as a medicinal remedy and as a substitute for more potent intoxicants. Her findings have been reported in the International Journal of Drug Policy.
“I studied kratom use as a substitute among heroin users and the result was that the user was still healthy and had no serious health problems despite prolonged use,” she said. “Kratom is a psychoactive drug but we haven’t found its traditional use to have any adverse impact on mental health or to cause social problems.”
“Kratom has been used as a ‘traditional medicine’ for centuries by local people,” she continued. “The qualification of the traditional healers and knowledge of the regimens and methods was passed from ancestors to their descendants.”
According to Saingam’s research, cough symptoms, diarrhea, stomach ache, the common cold and even greater ailments such as diabetes and hypertension can be mitigated by kratom.
A holistic attitude to kratom is not limited to rural Thailand; researchers and other Thai citizens have shared it for decades. This has all resulted in positive public views around its legal regulation—beyond the decriminalization adopted by the government this year.
“In terms of legalization and in terms of people’s attitude, deep down people understand and believe in its beneficial effects because they have used it for such a long time,” Ekkasit Kumarnsit, associate professor with the faculty of science at Prince of Songkla University in Thailand,” told Filter. However, “even though something can be useful, there’s always a hidden agenda or more complex reason and that’s why it takes time.”
The discussion of Kratom’s legalization in Thailand is sometimes viewed as a double-edged sword, as Kumarnsit hinted. Even as its cultural significance as a remedy has ushered in an era of medicinal research, it has also gained prominence in the form of an altered recreational cocktail, known to the local population as “4×100.”
“It has had a very negative influence in terms of how the debate has been framed.“
“It is more harmful to its users than traditional kratom,” Saingam said, referencing the combination of other ingredients. “The kratom 4×100 cocktail is a mixture of boiled kratom leaves with other addictive substances such as codeine cough suppressant syrup, and illegal substances, with cola soft drinks. The users of this new kratom are predominantly teenagers or young adults who use it socially for fun or relaxation after work.”
Increasing use of 4×100 may be linked to sensationalized media coverage in Thailand, which has spread awareness of the formula and how to make it, resulting in a major uptick of 4×100 consumers, according to Saingam—and in turn inspiring more coverage.
The rising prominence of this cocktail has not halted the discussion of kratom’s legalization, experts say—but the speed of the debate did suffer as a result.
“It has had a very negative influence in terms of how the debate has been framed,“ Martin Jelsma, director of the Drugs and Democracy program at the Transnational Institute in Amsterdam, who is currently operating out of Thailand, told Filter. “I think that the distinction between recreational, medical, cultural and traditional has been very blurred.”
The complex debate has still made its way to the forefront of regulatory discussion amongst Thai officials.
This paradigm shift has also furthered a new branch of discourse: export.
“The House of Representatives here in Thailand voted in favour of taking kratom out of the narcotics act and to reschedule it [in May],” Jelsma said. “The Senate also adopted a change in the Narcotics Act, so it is not yet in force but it is fully adopted, so by August kratom will no longer be listed under the Narcotics Act.”
This paradigm shift has opened up conversations surrounding medicinal and non-medicinal regulation and has also furthered a new branch of discourse: export.
“This is a move to fully regulate kratom markets, which includes the possibility of the ONCB [Office of the Narcotics Control Board], the drug control agency here in Thailand, to give licenses for kratom plantations, which include crops for non-traditional, non-medical and export use,” Jelsma said.
While this may spell economic potential for Thailand, the plant’s global status is still in limbo. It is only legal in certain states in the US, where authorities have attacked its use and marketing. It has a “grey market” classification in Canada and is fully illegal in Australia.
As for the impending possibility for export from Thailand, Saingam calls for vigilance. Even though her research has shown that kratom has minimal harmful impact in its multiple applications, she still stresses that its regulation would not indicate that it is a cure-all.
“A clear warning message should be given to the public that, despite some benefits … its use has disadvantages and side effects, especially when co-used with other substances,” she said.
According to Jelsma, Thailand’s decriminalization could not have been achieved without researchers like Saingam and Kumarnsit.
“It was good for the whole debate in Thailand for it to go through this stage, researchers have done a really amazing job,” he said. “There’s now a wealth of knowledge surrounding the multiple uses of kratom, whether it is its medical applications or its history—it’s an unprecedented achievement anywhere.”
Photograph of Phuket City by Myinternationalwikipedia via Wikimedia Commons/Public Domain