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Poison Control:Ketum by Professor Dzulkifli Abdul Razak

DAUN ketum, scientific name Mitragyna speciosa, is back in the news.

This time with an official pronouncement: "It's illegal now to sell, possess ketum leaves" screamed one headline (NST, Aug 11). This is nothing new, except that this time those caught with it face a maximum fine of RM10,000 or a jail term of up to four years, or both, upon conviction.

The offence and punishment, as provided for under Section 30 (5) of the Poisons Act 1952, were recently gazetted. This is in view of the fact that the use of ketum leaves has been associated with addiction, and reportedly a growing number of youths are now hooked to it. Called kratom in Thailand, the leaf is generally regarded as a "substitute" for other types of drug abuse, especially ganja (cannabis). Locally better known as daun biak, the leaf is used as a "supplementary" drug during opium or heroin withdrawal treatment. According to some sources, the leaf helps addicts during withdrawal because of its morphine-like qualities. Others say it is the hallucinogenic and/or depressive properties that do the trick. Whatever, the leaves when chewed give a "high" and supposedly assist the withdrawal process, which otherwise would be agonising. Some even claim that its juice acts as a general tonic. The active substance of ketum is the alkaloid mitrigynine.

The plant is indigenous to Malaysia, growing mostly wild in the northern part of the peninsula, from Kedah to as far as Thailand.

In these areas, there are even ketum farms which provide a regular income. It has various uses, including as a cheap alternative medicine.

One of the farmers reportedly said traditional healers use ketum for deworming, improving blood circulation, and even to treat diabetes. Although better scientific documentation is still needed to verify these claims, the popularity of ketum is undeniably related to its medicinal virtues.

The law against ketum not only deprives Malaysians of their "natural pharmacy", but the nation's biodiversity could be threatened if all plants are destroyed.

While these actions are justified in the attempt to curb widespread addiction, it smacks of hypocrisy and double standards. This is especially true when comparing ketum with another dangerous leaf, tobacco. To understand the stark contradictions, let us examine the issue at hand which we reviewed in these columns on June 3, 2001 (see recommended site).

First, while both ketum and tobacco are well documented to cause addiction, the degree and severity of addiction associated with ketam is in no way near that of tobacco, which contains the addictive substance nicotine. Its addictive liability is often equated to that of heroin. Secondly, in terms of fatalities and harm, tobacco is way ahead of ketum. Tobacco has been implicated in the premature death of millions of users and many more are suffering from a variety of diseases, ranging from cancer to stroke, impotency to asthma.

This is further evident from the multi-billion dollar lawsuits pending against tobacco companies.

Death due to ketum is relatively rare, and so too disease. Thirdly, despite such wide disparities, tobacco is systematically cultivated as an official revenue generating crop by many governments. As though this were not enough, there are subsidy schemes to encourage the growing of this killer plant. In some cases, training and other special assistance are provided. There is no such support or help for ketum, though it is indigenous and less widely available. Still, quite certainly all ketum plants will be destroyed over time, while hundreds of tobacco plantations continue to flourish Fourthly, tobacco, though heavily regulated, is recognised as a "legitimate" product to be sold throughout Malaysia. It is tolerated as an income-generating crop for the country at the expense of the lives of millions of Malaysians, especially youths. Ketum, on the other hand, is classified as an illicit substance.

Last but not least, ketum is now officially banned, with fines and jail sentences as deterrents. Not so for tobacco. It is available anywhere, to almost anyone except perhaps those below 18 years, at least on paper.

These glaring contradictions are hard to understand. Could it be ignorance or a severely flawed decision-making process, or are the decision-makers working at cross- purposes, as happens sometimes? Measured by the standards of ketum, tobacco cannot continue to enjoy the various "niceties", especially if ketum is to be forever condemned. But judging from the no-nonsense speech by the Minister of Health during the Asean Consultation on the Impact of Afta on Tobacco Trade and Health this week, there is still hope that the contradictions and double standards will be ironed out, and hopefully soon. There should be only one broad standard when dealing with addictive substances if the country is serious about getting rid of the entrenched menace anytime in the near future. If ketum is deemed undesirable, tobacco should be so classified as well, many times over. And this must be reflected consistently in any of the decisions relating to all forms of substance abuse.

This article was published on Saturday 04 September, 2004.
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