Mitragyna speciosa (Korth.) Havil., otherwise known as kratom. Image credit: Uomo vitruviano

Efforts to control the trade and usage of recreational drugs* struggle against human ingenuity, driven by our boundless determination to get loaded. The search for new legal highs has led in two directions. One is the generation of new synthetic drugs which are sufficiently chemically distinct to avoid the regulations but which remain pharmacologically effective. These are often more dangerous than the illegal drugs they replace. The other is to mine the accumulated cultural and medical repositories of herbal lore from around the world to find psychoactive plants which haven’t yet been banned. Species are suddenly raised from obscurity to become the latest rush.

Over recent years a variety of plants have gone through a process of initial global popularity followed by a clamp-down, usually once a death has been associated with their use or abuse (even indirectly). A wave of media attention, hysteria and misinformation typically leads to regulatory action long before the formal medical evidence begins to emerge. One of the most recent episodes was over Salvia divinorum which enjoyed brief popularity as the legal hallucinogen of choice among students, despite being inconsistent in its effects and often quite unpleasant. Wherever you’re reading this, it’s probably already been banned.

Most of these plants have a long history of safe and moderate intake by indigenous populations in the regions where they grow naturally, either for ritual or medical purposes. The same can be said of many of the more common drugs we all know of: opium, coca and cannabis have many traditional uses stretching back for thousands of years. The problems arise when they are taken out of their cultural contexts and used for purely recreational purposes. This is often combined with plant breeding to increase the content of their psychoactive ingredients or chemical treatments that enhance their potency or synthesise their active components (such as in the production of heroin). A relatively benign drug is transformed from its original form into something much more problematic.

The latest plant to emerge as a potential drug in Europe, though already banned in many places, is Mitragyna speciosa, more commonly known as kratom, and native to several countries in Southeast Asia. Here in Ireland its active ingredient has been designated a Schedule 1 drug** since 2017. Pre-emptive legislation in other countries is quickly catching up.

I will confess to not having heard of kratom before it became a Western health concern. This is probably true of most people outside Asia, but more surprising to me given a long-standing interest in ethnobotany in Southeast Asia and having lived in Malaysia. I had previously subscribed to the view expressed in most textbooks that natural painkillers were absent from the regional flora, an opinion confirmed through my own discussions with orang asal shamen***. This may be because kratom grows in drier areas than I’ve worked in; I’ve certainly never come across it in any surveys of traditional agricultural systems in Malaysia. Pain relief is one of the scarcest and most sought-after forms of medicine, so if kratom is effective then I’m now puzzled that it isn’t more widespread.

In its normal range kratom is used as a mild painkiller, stimulant and appetite suppressant in the same way as coca leaves have been used for thousands of years in South America. The dosage obtained from chewing leaves, or even from extracts prepared by traditional methods, is likely to be low. This is very different from its recent use in Western countries where higher dosages and combinations with other drugs (including alcohol and caffeine) are likely to both enhance its effects and increase its toxicity. It is also more commonly sold over the internet as a powder.

Nevertheless, a parallel increase in recreational use within its native range has also been reported, although as of 2016 with no deaths associated. Recreational use also has a long history in Thailand, and habitual use in Malaysia has been known of since at least 1836. It is now thought to be the most popular illegal drug in south Thailand, though arguments continue over whether it ought to be regulated, despite the acknowledged risk of addiction. In this it mirrors the discussion over khat, a botanical stimulant widely used across Arabia and East Africa****. Where cultural associations are long-standing it is seen as less threatening than drugs from overseas.

Along with its long use as a drug in its own right, kratom has also been used as a substitute for opium (when unavailable) or treatment for addiction. It also has a folk usage in treating hypertension. This points towards the potential for beneficial medical uses which would be delayed or unrealised if knee-jerk regulation prevents the necessary research from being conducted. Compare the situation with cannabis: its medical use in China goes back thousands of years, but the stigma associated with its use in the West (which we can partly blame on Marco Polo) delayed its decriminalisation. Cannabis remains illegal in many countries despite steadily accumulating evidence of its medical value.

I’m a firm believer that we should recognise, respect and learn from the botanical knowledge of other cultures. Banning traditional medicines (and even socially important recreational drugs) in their home countries on the basis of their abuse by people in the Global North is morally wrong. Excessive regulation also deprives us of many of the potential benefits which might come from a better understanding of these plants.

All this is not to diminish the real physical and mental damage caused by addiction, and the need to protect people from abuse and the associated social costs. But the urge to get high is nothing new, and the cultures that have formed alongside psychoactive plant chemicals, from morphine to mescaline, usually incorporated ways of controlling their use and appreciating them in safe moderation. In Tibetan regions where I’ve worked cannabis is a frequent garden plant, and teenagers enjoy a quiet rebellious smoke with little stigma attached, while adults eventually grow out of the phase. Our own immature explorations of ethnobotany need to learn that there’s much more to a plant than the titillation provided by its active ingredients.

UPDATE: after posting, @liana_chua pointed out this fascinating blog post by @PaulThung about the market-driven boom in kratom production in West Kalimantan, where it is known as puri. It’s a great reminder that what’s seen as a growing problem in the Global North can simultaneously be a development opportunity for people in deprived regions.

* I dislike the term ‘war on drugs’ because I don’t like the tendency to militarise the vocabulary surrounding complex and nuanced issues (see also ‘terror’). Also, as others have pointed out, war is dangerous enough without being on drugs as well.

** Schedule 1 covers drugs which have no accepted medicinal or scientific value. The classification in Ireland is therefore based on uses rather than the potential for harm or addiction. This can become a bit circular. For example, nicotine isn’t on the list, but its only medical usage is in treating nicotine addiction. Cannabis, however, is on the list.

*** Of course I hadn’t considered before now that this is something they might not want to talk about, given that kratom is regulated in Malaysia, where it is known as ketum,  although attempts to ban it outright have not yet come to fruition. Still I would have expected to spot a large shrub in the Rubiaceae if they were growing it deliberately.

**** I’ve often chewed khat in countries where its use is tolerated, and it’s a great way to boost your mood and energy level during fieldwork. It is also addictive, of course.