The Ministry of Public Health has recently announced the removal of cannabis and kratom from category 5 narcotics, as stated in the Controlled Herbs (Cannabis) B.E. 2022 and the Narcotics Act (No. 8) B.E. 2021. According to the Department of Corrections Situation Monitoring Report for 2023, drug cases are a prevalent issue in Thailand compared to other types of cases. In light of this information, a research team consisting of Pharmacist Teerathorn Sangrai, Assistant Professor Pharmacist Maleerak Utsintong, and Dr. Preecha Nootim recognized the importance of addressing drug addiction and helping patients successfully reintegrate into society while preventing relapse. This requires a comprehensive rehabilitation process that addresses both physical and mental aspects. In their search for potential treatments, the team came across Khun Sophit Bannalak's Traditional Thai Medicine Recipe, Volume 3, which includes a recipe for opium deprivation. The recipe suggests using a combination of junkie (a type of herb), derris scandens, cannabis, and kratom leaves to be boiled and consumed in place of smoking opium. The Ministry of Public Health later updated this recipe to the Amphetamine Antidote Recipe, reflecting the current era where opium use is not as widespread as in the past.
The research team has used the AutoDock4.2 program to predict key substances that bind to the kappa-opioid receptor target molecule. They considered factors such as binding energy, %member in cluster, and H-bond. Their findings show that mitragynine has a superior ability to bind to the receptor compared to cannabidiol (CBD), tetrahydrocannabinol (THC), and genistein-7-O-[?-rhamnopyranosyl-(1?6)]-?-glucopyranoside (GTG). Based on this, the team has developed a drug preparation formula in the form of an effervescent tablet to reduce drug addiction. The formula consists of 83.32 grams of cannabis, 56.68 grams of derris scandens, 170 grams of kratom leaves, and 5 liters of water. The mixture is boiled for 4-6 hours, filtered, and then undergoes a freeze-drying process until it becomes a brownish-black solid. This extract is then used to make effervescent tablets by mixing it with lactose, sodium bicarbonate, tartaric acid, and citric acid. The resulting powder has an angle of repose of 19.79. The tablets have a hardness of 10.042 kilograms, a thickness of 4.573 millimeters, a diameter of 12.738 millimeters, a weight of 0.9883 grams, an erosion rate of 0.04 percent, and disintegrate within 5 minutes after being popped with an automatic rotary tablet press. Each tablet contains 0.0413 milligrams of mitragynine as the main active substance. The tablets were also tested for heavy metal contamination and were found to have acceptable levels of arsenic, lead, and mercury. No cadmium, pesticides, or alpha-toxin fungi were found, and there was no presence of harmful microorganisms such as Staphylococcus aureus, Salmonella spp., Clostridium spp., and Escherichia coli.
References:
Assistant Professor Pharmacist Maleerak Utsintong
Professor in Pharmaceutical Care
School of Pharmaceutical Sciences, University of Phayao