Technically illegal in Thailand, krathom is now growing in popularity in the West where it is viewed as both a herbal wonder treatment and a potential new drug scourge.
CONTROVERSIAL PLANT: Krathom grows prolifically at a wildlife sanctuary in Satun province.
Sold in "head shops" and online as "herbal incense", the US is not sure how to deal with the new phenomenon. The Drug Enforcement Administration (DEA) has been issuing warnings about krathom for several years claiming some users had exhibited symptoms of psychosis, hallucinations and confusion.
Several US media reports in recent months have warned of doctors' concerns about the herb, with one claiming six krathom emergency cases in Phoenix, Arizona, although the cases were patients presenting with mild withdrawal symptoms. The media reports often highlight the fact that the drug is legally available in North America and some European countries despite being illicit in Thailand.
A Louisiana state senator is backing a bill that would add krathom to the list of schedule-one drugs in the US, along with other banned substances such as heroin, LSD and marihuana. Other American politicians have called for its immediate ban.
However groups such as the Kratom Association (sic), which actively support the use and sale of the herb, argue that it is a safe substance when used on its own and has medicinal value as a pain reliever, an aid for overcoming addiction, and a treatment for anxiety and depression.
The association says on its website that krathom has never been responsible for a "police call, poison control centre call, traffic accident, death or any other societal disruption. Krathom users, are in fact, mainly middle-aged and well-educated folks who mostly use it as an alternative to deal with depression, anxiety, pain, addiction and other ailments."
Academic literature on krathom use for medical purposes is scarce, but a 2010 study by Universiti Sains Malaysia's Centre for Drug Research looked at its informal use as a treatment to manage withdrawal symptoms from opioid addiction among 136 users in the northern states of Kedah and Penang.
It concluded that krathom (or ketum as it is known in Malaysia) was affordable, easily available and had no serious side affects.
"If prolonged use is safe, the potential for widening the scope and reach of substitution therapy and lowering its costs are tremendous, particularly in developing countries," it said.
There are no documented deaths from krathom use on its own, however, a 2010 report "Fatal 4X100; Home-made Kratom Juice Cocktail" by Wichian Tungtananuwat and Somsong Lawanprasert highlights the dangers of the plant when mixed with other ingredients.
The report, which acknowledges the family declined a full autopsy, investigates the death of a 21-year-old Muslim man in 2007 who may have died from the cocktail, although multiple drugs were found in his blood and urine after analysis.
4X100 is believed to get its name from the four ingredients used in the drink: boiled krathom leaves, cola soft drink, cough syrup and tranquilizers or mosquito coils. It is popular with Muslim youths in the South and Bangkok whose religion prohibits them from drinking alcohol, the report says.
From 2007 to 2008 the seizure of 4X100 increased almost sixfold from 290 litres to 1,700.
Krathom (Mitragyna speciosa) also has an interesting chemical structure. The 25 mitragynine alkaloids can act as both a stimulant and depressant while possessing a chemcial structure of a psychedelic.
In layman's terms, chewing krathom leaves, a low dose, has a stimulating effect, while a high dose, such as from boiling, has a sedative and euphoric-like action similar to opiates, the report says.
Krathom was first made illegal in Thailand in 1943, but for centuries before that it was a widely accepted opiate in Southeast Asia. According to the Kratom Association, the reason it was outlawed was simply tax.
As the government levied duties and taxes on opium shops and users, krathom grew in popularity, robbing the state treasury of income.
"Taxes for opium are high while krathom is currently not being taxed," Police Major General Pin Amornwisaisoradej, a member of the House of Representatives, said in January, 1943.
"With the increase of those taxes, people are starting to use krathom instead and this has a had a visible impact on our government's income."
But the Krathom Act was not enforced with much vigour after World War II and people openly grew krathom trees and chewed the leaves. Im 1979, krathom was included under schedule 5 of the Narcotics Act, the least restrictive and punitive level.