In our interview with Martin Kuchař, a member of the Early Warning System working party of the National Monitoring Center for Drugs and Addiction and associate professor at UCT Prague, we essentially picked up where we left off a year ago – the safe use of kratom and the associated topics of quality control, sale to minors, and legislative regulation.
You recently traveled to Thailand because of kratom. What was the goal of your trip?
An interesting situation happened in Thailand. Kratom is legal there, but they also have certain issues with regulating it. They set legal limits for alkaloid content, but they have no accredited laboratories to run the necessary testing. That has led to them not being able to export kratom to places such as Europe. We promised the Thais that we would help them harmonize their analytical methods, but we were also interested in learning more about the community of users and the way it's being used. Our mission was supported by the government; the Czech embassy in Bangkok was a partner, which was a clear statement by the Czech side that it is choosing to control rather than ban when it comes to kratom. Control in general, which involves the determination of not only alkaloid content but also that of heavy metals and molds, and microbial contamination, is beneficial primarily for the end user. Quality control needs to be performed at the manufacturing site as well as the point of import, for two simple reasons – there is no point in exporting batches that don't meet the quality standards, but they can also be contaminated by things such as mold during transport.
But quality control is not mandatory for distributors in Czechia...
Yes, the decision whether to analyze samples of the batches they receive is fully voluntary for distributors at the moment. However, the suggestion is enshrined in the Czechoslovak Kratom Association's code of ethics, which is an organization we have a long-standing cooperation with and whose members we provide with discounted rates for testing. By doing so, we want to support its ethical sale and minimize the amount of "unverified" kratom, which doesn't get tested, making its way to the user. We are very much against that, the same as we are against the sale of kratom to minors. Spreading awareness is essential because it could help eliminate any negative impact that the inappropriate use of kratom can have.
Could inappropriate use lead to addiction?
Kratom addiction really can happen and we need to warn people about it. Similar to coffee and tobacco, everyday use leads to the consumer requiring increasing doses to achieve the same result. I must point out that we are prone to addiction based on genetics and evolution – even the consumption of food rich in sugar floods the system with dopamine, which is a part of the body's reward system. Any compound associated with dopamine gives the body a signal that it can repeat the experience, keep doing it, which eventually leads to addiction. From a social standpoint, I would add that kratom addiction is much less dangerous than opioid addiction, for instance, which can easily lead to overdose and death.
How does kratom work in combination with other compounds or medicines?
That is one thing that I pointed out in the risk assessment. Certain compounds and medicines could have different effects in combination with kratom, be it in the sense of potentiation or suppression of effect, or differences in the effective duration. Combining kratom with other suppressants, such as opioids, benzodiazepines, alcohol, and so on, potentiates the effect, which can lead to nausea and even loss of consciousness. Such a person's life is then in danger primarily because of the potential to aspirate vomit. Therefore, advising against combining kratom with other compounds is pertinent. But if somebody takes kratom and has a small beer, nothing major is going to happen. If somebody uses kratom sporadically, responsibly, the benefits it can have are prevalent.
What are the main benefits in your opinion?
Kratom initially creates arousal, which later leads to sedation, relaxation. If there's a person who needs to undergo periods of intense learning and therefore drinks a lot of coffee and has sleep issues, making them agitated, kratom could help them concentrate, provide stores of energy, but also allow them to rest in the sedation phase. That is a lot of positives. At the same time, I must add that it should be used sensibly and absolutely not on a daily basis. Kratom can also help during physical exertion. I have experienced such a situation myself during a difficult trek in the mountains, and I know dozens of people close to me who have had similar experiences. I must point out once again that these are people who do not use kratom every day, but often even less than once a week.
How should we stop kratom from being sold to minors?
The same as alcohol, kratom should only be sold in specialized shops and only based on an ID check. Given the option, I would move the legal limit for kratom sale to 21 years of age, and for the oft-discussed cannabinoids, I would go even higher, to 26 years. Let me give a simple explanation as to why. The brain is developing at a breakneck pace when we're young, it's very pliable, which can lead to the formation of neural pathways that facilitate addiction.
Speaking of children, did you notice the news about a young man who overdosed on kratom?
Certain types of media are entirely based on sensation. It's no wonder, then, that you might come across stories of a mother crying about her son overdosing on kratom. Extremely emotional stories are not at all representative of what kratom actually is, however. The subsequent mediated discussion was much more sober – the benefits and risks of kratom use based on facts were presented. Any and all discussions should revolve around evidence-based facts, after all. That's not to say that the media should publish stories of people saying just how much better kratom made their lives. That simply doesn't belong in the technical discussion we should be having about psychoactive compounds. I believe that it should involve various professional associations, such as the aforementioned Czechoslovak Kratom Association, as well as patient groups and medical associations focused on pain because some of the user base comes from there. Then some people prefer making tea from a natural compound rather than using strong opioids and injecting morphine.
What is the argument used by people opposed to kratom who would rather see it banned altogether alongside other compounds?
Ethnobotanical compounds, which include kratom, kanna, and kava, are compounds that have been used in a specific social context abroad. The context is different in our country. Those opposed to kratom use the deeply-rooted traditional use of alcohol as an argument. However, the risks of kratom use cannot compare to the risks of alcohol consumption. Just look at the number of cases of heavy and even fatal intoxication, or the number of people addicted to alcohol. Regular users of kratom in Czechia are often people who have experience with the use of ethnobotanicals abroad and who have read about the topic. The majority are definitely not experimenters who decided to try something new. People who "discovered" kratom in publicly accessible vending machines are an exception. Kratom has been in our market for about fifteen years, and it flew under the radar for a long time. Naturally, that led to risks not being discussed overmuch, which meant that issues with excessive use could occur. This brings us to a key topic, which is primary prevention and awareness of the risks associated with kratom use.
What kind of research associated with kratom are you currently working on?
There are many kinds of kratom, and I don't mean just the different colors, but also the types of plants – Mitragyna speciosa, Mitragyna hirsuta, javanica, and about another ten species that grow in various parts of the world. We assume that different plants of the Mitragyna genus have different ratios of the dozens of alkaloids they contain. That might be the reason why one person says they get a boost after taking kratom while another might feel sedated. That's why we're interested in the alkaloid content of various species, which is the focus of our current research. We don't have the results right now, but as soon as our research is finalized, we will certainly publish them.
CV BOX
Martin Kuchař, M.Sc., Ph.D. (born September 17, 1980) is the head of the Forensic Laboratory of Biologically Active Substances at UCT Prague's Faculty of Food and Biochemical Technology, which focuses primarily on the analysis of psychoactive substances and ethnobotanical products and the synthesis of new substances for the treatment of mental disorders.
He graduated in Organic Chemistry from UCT Prague, earning his Ph.D. at the Institute of Organic Chemistry and Biochemistry of the Czech Academy of Sciences.
As an expert consultant on psychoactive substances for the Police of the Czech Republic and a member of the Early Warning System working party of the National Monitoring Center for Drugs and Addiction, Kuchař plays a role in shaping the legislation on addictive compounds and anabolic and hormonal products. He represents Czechia in The International Association of Forensic Toxicologists (TIAFT).
His research activities are focused on new psychoactive substances, using molecular biology to find relations between their structure and effect, and their use in healthcare.
He lives in Prague.
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