Kratom (Mitragyna speciosa Korth.) Use Among Poly-Drug Users in Southeast Asia: A Systematic Review.

Kratom (Mitragyna speciosa) is a medicinal plant in Southeast Asia. While studies continue to highlight kratom's utility among poly-drug users, its context of use and therapeutic relevance appears opaque. This review evaluated studies reporting the therapeutic benefits of kratom use among poly-drug users in Southeast Asia, as perceived by the users. A literature search was conducted and only articles that narrated kratom use in poly-drug users in Southeast Asia were selected. A total of nine articles were reviewed. All the surveys were designed as cross-sectional studies and most (n = 7/9) originated from Malaysia. There were no significant differences in the context and motives of kratom use among poly-drug users in Southeast Asia. Kratom was reportedly ingested for a variety of purposes, but largely as an affordable substitute to opiates and amphetamine-type stimulants. Poly-drug users commonly use kratom to self-manage substance use disorder or drug dependence, decrease drug intake, alleviate withdrawal, and for its rejuvenating effects. Co-consumption was not associated with health issues. While these preliminary studies provided important empirical insights, the limitations in their design, sample selection, and focus underscore the need for further studies, including clinical studies, to establish the safety and claimed therapeutic value of kratom in poly-drug users.