WHILE Malaysia plans to table a bill at the Dewan Rakyat next year to ban ketum, an estimated US$100 million (RM408.4 million) of products made from the plant’s extracts are sold annually in the United States, a Universiti Sains Malaysia professor said.

Professor Sharif Mahsufi Mansor said in the US, ketum, or kratom, is used as a painkiller for chronic pain, anti-depressant, mood enhancer and energy booster.

Studies showed the users were mostly Caucasians aged 31 to 50, who consumed at least 5g of ketum for chronic pain relief and to fight depression.

Sharif said ketum in the US was sold at prices ranging from US$12 (RM49) to US$180 (RM735), and in forms like capsules and powder, while spotting nice packaging with names like Red Malay, Green Malay, Green Malaysian.

“The US market is different. We don’t sell it like that here. We sell the juice in plastic bags,” said the newly minted professor in a lecture on ketum at the university today.

Sharif said ketum was also used to treat addiction to other drugs, like morphine, and as an alternative to methadone, an opioid used to treat pain.

The half life of ketum is 23.2 hours, almost as long as methodone’s 23 hours.

“Ketum is called the Methadone of the East. It has potential,” the professor said.

No scientific data

However, Sharif stressed that he was not saying that ketum was safe.

“The old folk in Malay villages have been using ketum for a very long time but there is no scientific study to show that ketum is truly safe. 

“We don’t have enough data,” he said.

“It takes a long time to study drugs. They go through many development phases. Such studies are usually done by big pharmaceutical firms or multinationals.”

Ketum – an indigenous medicinal plant that grows in wet and muddy land in the northern Malay peninsular and southern Thailand – has been used traditionally to treat various ailments.

Apart from a painkiller, ketum which is also called “biak-biak” has been used to treat diarrhoea, coughs, skin infection, high blood pressure, diabetes, fatigue, opium addiction syndrome, and for de-worming.

These days, ketum in Malaysia, where it is largely used by the Malay community, is consumed as an energy booster and to kick addiction.

More studies needed

Sharif said ketum studies were ongoing, and clinical tests on people had not been conducted.

“We need long-term studies to determine if ketum is safe, and clinical tests to verify that ketum can be used as a new painkiller and to help treat drug addiction,” he said.

So far, studies on lab animals, like rats, reveal that ketum (mitragyna speciosa) did not act like other drugs.

The ketum leaf contains an alkaloid called mitragynine (MGN) that has psychoactive properties, which has led it to be used as an anti-depressant.

But in Straub Tail tests, lab rats given morphine or other opioid drugs had erect tails but those given ketum did not.

This has help researchers conclude that ketum is not an opiate, and MGN is not like morphine.

“Although it has effects like morphine, its chemical structure is different. 

“People who consume ketum and expect to enjoy euphoria like when taking heroine will also be disappointed,” he said.

No deaths, but potential for abuse

Sharif also said there had been no records of deaths due to ketum in Southeast Asia.

Deaths related to ketum, according to previous studies, were due to consumption of opiate drugs, alcohol, benzodiazepina and other drugs along with ketum, he said.

He also said surveys with 58 frequent ketum users and 19 healthy subjects, who consumed an average of 1.3 to 1.6mg of ketum juice a day for over six years, showed that they did not experience any haematology and biochemical changes. 

Sharif admitted that there were potential abuses in the use of ketum.

He said ketum users had reported that they felt happy, strong, better focused and energetic five to ten minutes after taking ketum.

“But the data shows that ketum causes dependence, not addiction,” he said.

Previous studies had shown that long-term ketum users of 16 to 30 years suffered anorexia, weight loss, insomnia, skin pigmentation on the cheeks, dry mouth, constipation and frequent urination.

Meanwhile, cutting off chronic intake of ketum juice can cause aggression, excessive tearing of the eyes, loss of desire to work, and muscle aches.

Sharif said ketum users could handle the symptoms without treatment, unlike those caused by addiction to opiate drugs.

“The discomfort like trouble sleeping often lasts two or three days,” he said.

Decision on ketum must have basis

Asked whether it was the right move to ban ketum while studies were underway to better understand the plant and its effects, Sharif said the decisions should be based on data and reasonable basis.

Ketum has been controlled under the Poison Act since 2003. In Thailand, Myanmar and Australia, it is regulated under the countries’ respective Narcotics Acts.

The Malaysian Health Ministry is now seeking a total ban on the sale, possession, use and planting of ketum. Drinking the juice and keeping the leaves will also be an offence.

The bill to amend the Poison Act for the ketum ban is expected to be tabled in the Dewan Rakyat sitting next year. – December 14, 2017.