The Mitragyna speciosa Kratom tree grows naturally throughout Southeast Asia, yet little is known of its traditional consumption outside of Thailand, Malaysia, Myanmar/Burma, countries which have mentioned Kratom use in official documents and studies.
This is mainly due to the fact that Kratom use, though common in large cities, is still most often linked to rural, sometimes remote ethnobotanical traditions, which still have not been studied. Mitragyna speciosa Kratom grows across Indonesia, Papua New Guinea, Vietnam, Laos and Cambodia for instance, yet little documentation on its use exists- though it is unlikely that Kratom’s properties are not known in such contexts, where little data has been gathered on tribal ethnobotanical pharmacopoeia. Most reports and documents on traditional Kratom use come from Thailand and Malaysia.

Mitragyna speciosa Kratom, and Kratom leaf preparations are traditionally used as medicine, with a wide array of applications, notably as an analgesic pain killer, immune system booster, treatment for diarrhea, sexual stimulant (and to prolong sexual intercourse) as well as to moderate / help addiction to opiates. Mitragyna speciosa Kratom was also used in topical ointments or as a poultice spread on wounds and as a cure for fevers. Traditional Malay healers also use Mitragyna speciosa Kratom in de-worming preparations, to improve blood circulation, as a cough suppressant and to treat symptoms related to diabetes, and Kratom is also seen as a general energizing tonic.

As a psychoactive drug, Mitragyna speciosa Kratom has the rather unusual quality of being used both as a stimulant (in low doses), and as a depressant sedative, for relaxation (in higher doses).

In the traditional Southeast Asian context, the most popular way of using Mitragyna speciosa Kratom is by chewing fresh leaves, which highlights Kratom’s stimulant effect.

Fresh Mitragyna speciosa Kratomleaves are usually chewed throughout the day, often continuously, by workers or manual labourers seeking a stimulating effect, an increase of endurance and stamina and a diminution of hunger. When preparing fresh Mitragyna speciosa Kratom leaves, the central vein is removed (as this part of the leaf is thought to induce nausea) and salt is sometimes added, as this is though to prevent constipation. A hot drink such as warm water, tea or coffee often follows the chewing of Mitragyna speciosa Kratom leaves. Other ways Mitragyna speciosa Kratom leaves are used directly taken involve grinding up and eating fresh, dried, or reconstituted dried leaves.

Dry Mitragyna speciosa Kratom leaves are not usually chewed, but most often brewed into a tea or extracted into water, which is then boiled down, evaporated so that a resinous tar remains. This crude Mitragyna speciosa Kratom extract is then shaped it into small balls that are traditionally rolled in a material such as flour for preservation, then stored until use. This resinous Kratom extract is then swallowed directly or diluted into a hot drink. Such a traditional preparation method is quite popular as it makes Mitragyna speciosa Kratom use quite convenient.

Kratom is also very commonly brewed as tea, or concentrated infusions, and sold as a drink. In Malaysia, Mitragyna speciosa Kratom is sold in roadside booths, where it is known as air ketum, which translates as Kratom water. Reports indicate that such Kratom drinks were sold for the relatively cheap price of 1 ringgit per cup when it was legal, price which has gone up to 2 ringgit since the recent official prohibition.

Mitragyna speciosa
Kratom is not often smoked, although this method does exist and does provide some moderate effects, especially with vaporisation of concentrated extracts – but this is not a common traditional mode of use.
Some villagers also use the Mitragyna speciosa Kratom leaves in cooking, both for Kratom’s psychoactive qualities as for its specific taste, as a form of aromatic spice.

In addition to its use as a stimulant, and also relaxant and narcotic drug in its own right, Mitragyna speciosa Kratom is often used as an opium or opiate substitute, absorbed orally at higher dosages.

In its traditional South-East Asia setting, Mitragyna speciosa Kratom use is particularly popular with older workers in rural/suburban areas, who often chew Kratom leaves throughout the day to help with physical labour. To some extent, this practice might be compared to the more widespread Asian tradition of Betel (Areca catechu) chewing or even to the South-American Coca (Erythroxylum coca) leaf tradition, both plant based stimulants commonly used to alleviate physical labour induced fatigue and to suppress hunger. Yet the dual nature of Mitragyna speciosa Kratom’s effects means that chewing Kratom leaves not only helps workers get through a long day of physical labour, but that Kratom is also used, in higher doses, as an “after work” relaxant which is said to "calm the mind”, whereas the former two plants are most exclusively used as stimulants or medicine.

Mitragyna speciosa
Kratom was, and to an extent still is, a relatively inexpensive working man’s drug, the Kratom leaves growing on the native Mitragyna speciosa tree are often picked by the users themselves in the countryside, or sold and bought on local market places, or sold per cup as Kratom tea. Mitragyna speciosa Kratom users tend to be male, and quite poor, usually peasants, labourers, and farmers or workers, who use Kratom as a stimulant to help with the difficulties of intense physical work and frugal existences, rubber tappers for instance, were and still are common Kratom users.

Female Mitragyna speciosa Kratom users are apparently quite rare, and the age of usage onset seems to be higher than for other drugs- a specificities which shows that Kratom is still most often used as a mild stimulant, which helps compensate the physical issues linked with aging. This is particularly true in the traditional rural village communities. In more urban and suburban settings, to which the rural depopulation brings former peasants seeking different economic and social dynamics, the situation is different, and this is were Mitragyna speciosa Kratom is most often used as a sedative narcotic, in combination or as a substitute to other drugs, especially opiates.

The association of Mitragyna speciosa Kratom and work, especially physical labour, is particularly widespread: it has been reported that in some parts of Thailand parents are said to prefer giving their daughters in marriage to men who used Mitragyna speciosa Kratom rather than men who used cannabis, an inclination which was based on the belief that Kratom users tend to be “hard working”, while cannabis users are more likely to be “lazy”.
This belief is also backed by many Mitragyna speciosa Kratom users themselves, who, according to some studies, report having started to use Kratom because of a desire to work more efficiently, linking Kratom use with increased endurance and motivation to work.
It might seem strange that a plant which also has sedative narcotic qualities and sometimes used as an opiate substitute could be used as a stimulant on a regular, daily basis, yet this particularity of Kratom is probably explained by the most popular mode of traditional endemic use, which is the chewing of Mitragyna speciosa Kratom leaves.
Given that Mitragyna speciosa leaves are actually wet-weight of the plant, doses taken are actually lower than tea or whole dry leaf doses. The method itself implies a slow delivery of a daily Kratom dose, and is thought to probably enhances the stimulating effects and to decrease the Kratom dosage needed. This particular balance mechanism of Kratom use indicates that Kratom’s stimulant effects predominate once a tolerance to the sedative/opiate like effects develops, and that the unpleasant effects of overdosing on the stimulant component actually keeps users from overindulging in the opiate habit.

If traditional use of Mitragyna speciosa Kratom is associated with the rural and/or lower classes of South-East Asian society and their hard physical labour, Kratom use also bears cultural and social stigmas somewhat similar to Betel and Coca chewing- or other practices which the dominant urban society might choose to consider as “backwards” or uncivilized. This is something to keep in mind when it comes to the results and conclusions drawn by some existing studies on Mitragyna speciosa Kratom use and its consequences.
Such studies on Kratom, as with the two other traditions of chewed stimulants, to which one might to a certain extent add a third, the Yemeni and East African Qat / Khat (Catha edulis) chewing tradition, (with the main difference that Qat use is not just used by workers, but also socially integrated to Yemeni middle and upper middle class social ceremonies, and strongly linked to the arts of music and poetry), rarely speak in the favour of Mitragyna speciosa Kratom.
Yet in such Kratom studies, it is also often hard to distinguish between the physical and mental degradations linked to the subject’s impoverished living conditions, intense physical labour from an early age, and the actual eventual consequence caused by the lifetime daily use of the stimulant, Kratom…
It is important to keep this traditional social context in mind when reading such material. The researcher’s potential bias is another factor to consider in government funded studies, which too often combine
disdain/misunderstanding of rural/working class practices and other “uncivilised” customs, along with tangible governmental pressure to find something to blame and/or on which to push social and economic reforms – a purpose Mitragyna speciosa Kratom use might fill conveniently.
Mitragyna speciosa Kratom was first made illegal in Thailand, then in Malaysia, but traditional use remains widespread, since Mitragyna speciosa Kratom trees grow natively in these regions and have not yet been eradicated. Despite Mitragyna speciosa Kratom’s ancient history of human use and popularity- a popularity which is growing outside its traditional South-East Asian cultural context since the recent “discovery” of its benefits by western users- there are still many unknown elements about Kratom, and really little serious and long-term research on which to draw firm conclusions.

Some Kratom studies have found no real addiction problems in villagers using Kratom, while others apparently have… but unfortunately few of such studies were based on more than reports of hearsay collected by anthropologists, studies of poly-drug users which also used Kratom, or even animal studies based on extracted alkaloids rather than Mitragyna speciosa Kratom leaf products. Such variations between existing studies of traditional Mitragyna speciosa Kratom use are likely either related to the researcher’s bias and motivations or to actual differences in patterns of use and doses.

It seems possible that when Mitragyna speciosa Kratom doses used are high enough, a mechanism of μ receptor crossover comes into play, and Kratom’s action becomes similar to that of opiates, and some form of addiction becomes a strong possibility, especially when Kratom is used regularly.

Heavy traditional users have been said to chew Mitragyna speciosa Kratom between 3 and 10 times a day- or continuously throughout the work period. With time, a tolerance to Mitragyna speciosa Kratom does build, implying that if new users may only need a few Kratom leaves to obtain positive effects, after a period of regular use the mechanisms of tolerance might mean a need to increase Kratom doses to 10-30 chewed leaves or more per day. With Kratom whatever tolerance is present is apparently kept in check as daily doses are stationary, and eventual differences in dosage patterns correspond to longer periods of use (work periods) rather than a desire to have stronger effects. Physical tolerance to a drug can also exist without necessarily implying an addiction mechanism.

Outside the traditional context, most of the information, especially what is available online, tends to come or be based on the same limited pool of studies and research- with the fore-mentioned inconclusive or questionable results, that would often call for further studies in order to confirm them…
Most of these studies’ conclusions are more and more often questioned by the rigorous observations of non-traditional Kratom users and researchers. In such a context, what is clear is that the tradition of South-East Asian
Mitragyna speciosa Kratom use calls for renewed, more objective investigation and scientific research, especially when it comes to assessing the eventual consequences of regular and continued use of Kratom. Yet this will surely not be facilitated by countries having to chosen to ban the leaves of the Mitragyna speciosa Kratom tree.