The consumption of kratom can quickly become a habit, and individuals, who take it regularly over a longer period, can develop withdrawal symptoms after breaking off. There are no long term studies on kratom consumption with people, so that long term effects have to be extrapolated from animal experiments and a few reports of anthropologists. Although seldom, kratom addicted individuals can develop strong psychoses. One of two studies was done 1975 by Suwanlert on 30 longterm consumers in Thailand. In his report one found though the statement, which is contrary to the relevant literature, that kratom in high dosages acts stimulating and in low dosages sedative. Amongst the 30 individuals of his study were 5 patients who had developed psychoses after a longterm consumption and received medical treatment. These are 5 examples of psychoses after the development of a kratom dependency.
Case 1. A 55 year old man (Thai) had with 20 years started to use kratom. In the last few weeks he complained about cramps and mental confusion. He was thin, had dark discoloration on both cheeks and also showed consciousness disturbances, delusions, and hallucinations.
Case 2. A 32 year old Thai, who was employed as a worker, started with 22 years to consume kratom daily. In the last two years he has used in addition alcohol. He suffered from paranoia and states of confusion. After two weeks of treatment, the result was satisfactory.
Case 3. A 31 year old married Thai, who was employed as a worker, consumed kratom since 14 years of age. He complained about nausea and headaches. He suffered among others from hallucinations, paranoia, and states of confusion.
Case 4 and 5. These two patients developed likewise psychoses. They suffered from several dependencies: kratom, alcohol, amphetamines, and heroin. Within ten years after withdrawal, they had no relapse.
The Malaysian “Ministry of Health” had 1994 a second study over 54 consumers prepared, who had used kratom for 1 to 20 years. Almost all investigated individuals (94.3 %) related to have taken opioids and marijuana before they switched to kratom. The patients indicated to have suffered from withdrawal symptoms when trying to break the kratom consumption. But they also indicated that the withdrawal symptoms were milder and shorter than with opioids. There were also health tests and biochemical tests done, which confirmed that the consumers were in good health and showed no deviations to relevant values.
The scientists now have a multitude of reports on hand through the increasing spreading of kratom outside of Asia. This way it is possible to collect information which was not influenced by faith and tradition. This new source of information makes it possible to understand and research the manifold effects of kratom as well as to clarify and correct some mistakes and contradictory reports from scientific articles. Many testimonies of Western consumers though confirm the previous research data and reports.
GUIDELINES FOR CONSUMPTION
To avoid a possible dependency and habit formation, kratom should not be used more than about once per week.
Kratom should also not be combined with other stimulants (cocaine, yohimbine, amphetamine – also called speed -, as well as caffeine) and drugs which suppress the nervous system (opiates, alcohol, or benzodiazepine), because of the danger of overstimulation or too strong a sedation that can cause breathing difficulties or standstill.
Kratom should in addition not be combined with MAO inhibitors – MAOIs – (Peganum harmala, passionflowers, or antidepressants), since the combination of MAOIs with monoamines can evoke fatale reactions, although this has not been scientifically researched yet for kratom. MAO inhibitors have the effect of balancing certain brain transmitter substances. In this process they inhibit the so-called monoamine oxidase (MAO) and thus influence the reduction of certain brain transmitters. If one consumes body-foreign monoamines, they will not be broken down normally which can lead to a dangerous increase in blood pressure.
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