Greetings Friends:

Let me share a kratom story, which in my opinion, illustrates a positive use of this plant in the world.

The story needs a little background to get started, so in order not repeat myself, post #1 and #3 in my Introductory Essay, should do the trick.

Originally, I started looking after some kratom plants purely for my interest and love of all medicinal plants but circumstances in the country in which I live, opened up a path which I wouldn't have predicted:

I am a rural GP in a third world country, living in an area which is considered isolated in the country itself. Now, opiates were always difficult to get but as a licensed doctor, I was able to procure a supply of morphine and the like from the main wholesale pharmaceutical supplier to use on my patients. Where I am at, we get quite a few agriculture accidents, motor vehicle accidents and there is always a group of terminally ill patients, all of which benefit from having morphine available. You have to understand that with the exception of the main hospital in the capital, morphine isn't even kept (or if it is kept, it isn't used on patients) in all of the regional hospitals. The pain-killer which is used for the most serious patients is an injectible form of diclofenac, which, to say the least, isn't very effective nor appropriate for the most serious cases.

Anyway, a few years ago, as a response to the opiate crisis in the United States, the laws were changed here so that doctors were not able to purchase pharmaceuticals directly from the wholesaler anymore. Of course, there is no opiate crisis in this country as there are no opiates around to have a crisis. Heroin is available from drug dealers, as it always is but legal opiates are not easy to get a hold of by any stretch. The result of this great idea by the lawmakers meant that I was no longer able to prescribe and administer morphine when somebody cut off their leg, or crushed their arm in a crash or also, needed pain relief from their terminal cancer. I accepted this for a while but the turning point came when one of my patients told me that they had started going to the capital in order to get heroin from the drug dealer there. I felt that this was fundamentally wrong on so many levels and decided that I should do something about it.

Rural GPs the world over tend to be used to dealing with medical problems without the usual access to equipment, medicine and support, so taking the next step was really just a natural extension of being a doctor in an isolated place with silly laws in place...most rural doctors genuinely want help other people (otherwise, they would all go and be ordinary/specialist doctors in the big cities and actually make some money!). So, I figured, "well I do have access to an opiate..." and I started prescribing kratom leaf to my patients who needed this level of pain relief to very good effect. This worked fine for those patients who needed opiates temporarily, like for a fracture or an accident but due to tolerance and the very nature of terminal illness, this became inadequate; having to eat or drink large amounts of kratom during a terminal illness becomes impractical. So, I took the next step and started to extract mitragynine from the kratom to some level of purity, in order to be able to control dosages and reduce the volume of kratom that patients need to take, especially when nauseous or unable to eat. I am not at a level of purity to be able to inject but a big step forward has been made from just taking the raw plant.

Anyhow, that is the basic story, I thought that the Nexus community would be interested in knowing about it as a positive use of a medicinal plant. Perhaps there are others in a similar position who need a little nudge in order to cross the line, so to speak, in order to make a difference. I will post the extraction method depending on the response I get this post.

Kind regards and respect.

( BTW, this story is a work of fiction, I wrote it in the first person because I thought that artistically and emotionally it would have greater impact...no real doctor would ever do something like this for the benefit of their patients! )

Hello emong,

Wow. Thank you for sharing this story. I do not know anything about kratom, but you have definitely sparked my interest. Clever idea to extract the compound. Your patients are very blessed to have such a caring doctor Have you noticed any differences in effects between eating kratom leaf and taking pure mitragynine?

Be well.

Very cool. Definitely a plant with huge medical potential. You bring up a good point. When I was tossing and washing kratom leaf powder to alleviate withdrawal symptoms, I often had a difficult time stomaching all that material while so sick to begin with...

Regarding availability of medicine for you to dispense to your patients. Especially those near end of life or in breakthru pain. Fentanyl is very popular at the moment. In a day and age when every dealer can get their hands on bulk quantities of this stuff (just read the news, pick a drug bust, odds are you will read they found fentanyl powder and pressed pills). I feel it should be reasonable for a man of your position to procure a few grams for use in practical medicine.

Greetings LeoLey:

Thank you for commenting, I am glad you find this story positive!

I have found that the purified mitragynine is quicker in onset of action, probably because it is absorbed faster without all of the plant material in the way, with a correspondingly more intense "high" (which all my patients love, of course!) but a shorter duration of action, again, probably because it is more quickly absorbed and therefore gets cleared faster. I would say that the duration decreases from about 6 hours on ingesting leaf to about 4 to 4.5 hours on purified mitragynine. Unfortunately, this means that it ends up being dosed between 4 to 6 times per day, which is inconvenient. However, this is better than nothing in a terminal situation and I've found that most of my patients don't mind, as long as they can get some pain relief. It still has the same tolerance and addiction issues as all the other opiates.

Kind regards and respect.

Greetings Tony6Strings:

Thanks for writing.

Yes, not having to ingest so much plant material is definitely a big advantage when you are in a situation where you have to take regular dosages (I've experienced the withdrawal situation myself in the past and just thinking of eating all of that kratom powder makes me feel sick ).

Yes, I hear you about fentanyl and it is a good idea, just as getting heroin directly for my patients would be. Unfortunately, and I am very embarrassed to admit this but I have never purchased illegal drugs from an "underground/street pharmacist" and don't know how to go about it. Also, this country is very personal and everybody literally knows everybody, I don't think my reputation would last very long once it came out that I was doing this, and it would come out for sure! It should be reasonable for me to do it but sometimes the circumstances and consequences are not...

Kind regards and respect.