Singh Darshan, Narayanan Suresh, Vicknasingam Balasingam
Centre for Drug Research, Universiti Sains Malaysia, 11800 Gelugor, Penang, Malaysia.
School of Social Sciences, Universiti Sains Malaysia, 11800 Gelugor, Penang, Malaysia.
Brain Res Bull. 2016 Sep;126(Pt 1):41-46. doi: 10.1016/j.brainresbull.2016.05.004. Epub 2016 May 10.
The objective of the paper was to highlight the differences in the traditional and non-traditional users of kratom in the South East Asian and Western contexts.
A literature survey of published kratom studies among humans was conducted. Forty published studies relevant to the objective were reviewed.
Apart from the differences in the sources of supply, patterns of use and social acceptability of kratom within these two regions, the most interesting finding is its evolution to a recreational drug in both settings and the severity of the adverse effects of kratom use reported in the West. While several cases of toxicity and death have emerged in the West, such reports have been non-existent in South East Asia where kratom has had a longer history of use. We highlight the possible reasons for this as discussed in the literature. More importantly, it should be borne in mind that the individual clinical case-reports emerging from the West that link kratom use to adverse reactions or fatalities frequently pertained to kratom used together with other substances. Therefore, there is a danger of these reports being used to strengthen the case for legal sanction against kratom. This would be unfortunate since the experiences from South East Asia suggest considerable potential for therapeutic use among people who use drugs.
Despite its addictive properties, reported side-effects and its tendency to be used a recreational drug, more scientific clinical human studies are necessary to determine its potential therapeutic value.
本文的目的是突出东南亚和西方背景下传统和非传统 kratom 用户的差异。
对已发表的关于人类使用 kratom 的研究进行文献调查。对 40 篇与该目的相关的已发表研究进行了综述。
除了这两个地区在 kratom 的供应来源、使用模式和社会可接受性方面存在差异外,最有趣的发现是它在这两种环境中都演变成了一种消遣性药物,以及西方报道的使用 kratom 的不良反应的严重程度。虽然西方出现了几例中毒和死亡病例,但在使用 kratom 历史更长的东南亚却没有此类报道。我们强调了文献中讨论的造成这种情况的可能原因。更重要的是,应该记住,西方出现的将使用 kratom 与不良反应或死亡联系起来的个别临床病例报告,往往涉及与其他物质一起使用的 kratom。因此,存在这些报告被用来加强对 kratom 进行法律制裁的理由的风险。这将是不幸的,因为东南亚的经验表明,在吸毒人群中 kratom 有相当大的治疗用途潜力。
尽管 kratom 具有成瘾性、报告的副作用以及被用作消遣性药物的倾向,但仍需要进行更多科学的临床人体研究来确定其潜在的治疗价值。