The distressing withdrawal symptoms of Kratom dependent patients in the psychiatric clinic of Takuapa hospital, Phang-nga province, Thailand

Main Article Content

Amornrut Bangphichet, M.D.


Objectives: This study aims to explore the characteristic of distressing withdrawal symptoms and related factors from Kratom dependent patients.

Methods: This was a retrospective descriptive study on Kratom dependent patients who had been treated at the psychiatric clinic of Takuapa hospital from January 2012 to December 2018. The relationship between characteristics of patient and Kratom use and the most distressing withdrawal symptoms were analysed using Fisher’s exact test.

Results: Of 137 patients whose data were analysed, 135 were male with the average 30.5 years of age, 54.0% were single, 94.9% had less than secondary education, and about half (50.3%) earned less than 5,000 baht per month. Labors (general employees, agriculturists and fishermen) were the most common population (70.1%). The most frequent reasons for receiving treatment were having physical illnesses (39.4%) and willing to quit Kratom (33.6%). The most frequent duration of Kratom use was 1 year-less than 5 years (35.8%).             The majority of the respondents (68.6%) preferred taking Kratom by drinking its boiled leaves to chewing the fresh leaves. The most common concurrently used drugs were amphetamine and ices (35.0%). Most of the respondents (63.5%) had any of comorbid psychiatric conditions, including substance-induced psychosis (19.0%). The most reported distressing withdrawal symptoms were muscle, bone and joint pains (91.2%), followed by insomnia (59.1%). The younger users tended to drink the boiled leaves while the older users tended to chew the fresh leaves. Duration of Kratom use was significantly associated with the characteristic of the withdrawal symptoms. Insomnia as the most distressing symptom was more frequent among those who had been using Kratom for more than 10 years.

Conclusion: Muscle, bone and joint pains and insomnia were the most commonly reported distressing withdrawal symptoms among the Kratom dependent patients. The symptoms reliefs should be considered in Kratom dependence treatment.


Download data is not yet available.

Article Details

Original article


1. สาวิตรี อัษณางค์กรชัย, ดาริกา ใสงาม, สมสมร ชิตตระการ, อาภา ศิริวงศ์ ณ อยุธยา, จุไรทิพย์ หวังสนิทวีกุล. บทสรุปของพืชกระท่อม [The Conclusion of Kratom]. กรุงเทพฯ: จรัลสนิทวงศ์การพิมพ์; 2558.

2. Cinosi E, Martinotti G, Simonato P, Singh D, Demetrovics Z, Roman-Urrestarazu A, et al. Following (the Roots) of Kratom (Mitragyna speciosa): The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries.
Biomed Res Int. 2015;2015:968786. doi:10.1155/2015/968786.

3. สาวิตรี อัษณางค์กรชัย, ดาริกา ใสงาม, จุไรทิพย์ หวังสินทวีกุล, เอกสิทธิ์ กุมารสิทธิ์, ดาร์เนีย เจ๊ะหะ, สุพัตรา ลิ่มสุวรรณโชติ และคณะ. การวิจัยพืชกระท่อม: ผลกระทบต่อสุขภาพและสังคม [Research on Kratom: Effects to Health and Societies]. [อินเตอร์เน็ต]. สำนักวิจัยและพัฒนา มหาวิทยาลัยสงขลานครินทร์. [สืบค้นเมื่อวันที่ 23 มี.ค. 2562] จาก:

4. Singha D, Narayananb S, Vicknasingama B. Traditional and non-traditional uses of Mitragynine (Kratom): A survey of the literature. Brain Res Bull. 2016;126:41-6.

5. Saingam D, Assanangkornchai S, Geater AF, Lerkiatbundit S. Factor Analytic Investigation of Krathom (Mitragyna speciosa Korth.) Withdrawal Syndrome in Thailand. J Psychoactive Drugs. 2016;48(2):76-85. doi:10.1080/02791072.2016. 1156791.

6. Saingam D, Assanangkornchaia S, Geatera AF, Balthip Q. Pattern and consequences of krathom (Mitragyna speciosa Korth.) use among male villagers in southern Thailand: A qualitative study. Int J Drug Policy. 2013;24:351-8.

7. สมฤดี เอี่ยมฉลวย. ผลกระทบด้านร่างกาย จิตใจและพฤติกรรมของผู้ใช้ใบกระท่อมที่เข้ารับการบำบัดรักษาในสถานบำบัดรักษาสารเสพติด [Physical, Psychological and Behavior outcomes of Kratom users at a substance abuse treatment center] [วิทยานิพนธ์ปริญญามหาบัณฑิต]. กรุงเทพฯ: จุฬาลงกรณ์มหาวิทยาลัย; 2560.

8. Singh D, Muller CP. Vicknasingam BK. Kratom (Mitragyna speciosa) dependence, withdrawal symptoms and craving in regular users. Drug Alcohol Depend. 2014;139:132-7. doi:10.1016/j.drugalcdep.2014.03.017.

9. Assanangkornchai S, Muekthong A, Sam-Angsri N, Pattanasattayawong U. The Use of Mitragynine speciosa (“Krathom”), an Addictive Plant, in Thailand. Subst Use Misuse. 2006;42:2145–57.

10. Hassan Z, Muzaimi M, Navaratnam V, Yusoff NH, Suhaimi FW, Vadivelu R, et al. From Kratom to mitragynine and its derivatives: Physiological and behavioural effects related to use, abuse, and addiction. Neurosci Biobehav Rev. 2013;37:138-51.

11. Chittrakarn S, Keawpradub N, Sawangjaroen K, Kansenalak S, Janchawee B. The neuromuscular blockade produced by pure alkaloid, mitragynine and methanol extract from Kratom leaves (Mitragyna speciosa Korth.).
J Ethnopharmacol. 2010;129:344-9.