Kratom, scientifically named Mitragyna speciosa Korth., belongs to the Rubiaceae family, continues to spark debates over its legal standing, particularly in Indonesia [1], [2]. This plant species is indigenous to Southeast Asia, specifically found in Thailand, Malaysia, the Philippines, Myanmar, Indonesia, and Papua New Guinea [3]. Within Kalimantan, it holds cultural significance and is known by diverse regional names such as ketum, purik, kedamba, and sepat wood [4]. West Kalimantan, Indonesia, is a central hub for the cultivation and production of the highly sought-after kratom on a global scale. Since 2010, communities in this area, notably in regions like Kapuas Hulu, Melawi, Ketapang, Sekadau, and Tayan, have actively engaged in extensive kratom cultivation. The Kapuas Hulu Regency, with places such as Putussibau, notably emerges as a pivotal center for both the cultivation and commerce of kratom [5]. Over time, many locals in Putussibau shifted from rubber farming to cultivating and trading kratom due to higher financial returns. For generations, the community has utilized kratom for various purposes, including boosting energy, healing wounds, managing several conditions like cholesterol, fatigue, diabetes, rheumatism, pain, and insomnia. These practices have been integrated into social activities, with kratom being consumed in various forms such as fresh leaves, powdered variants, or concentrated preparations like syrup, taken through methods including chewing, brewing, or steeping.

Kratom is notable for its rich alkaloid content, comprising 54 alkaloids [6]. Among these compounds, the primary one is mitragynine, accompanied by diastereomers like speciogynine, speciocilliatine, and mitraciliatine, which have been subject to extensive investigation for their pharmacological attributes [6], [7]. Mitragynine has been shown to interacts with opioid receptors (µ (MOR), γ (DOR), and κ (KOR)), and purportedly causing milder withdrawal symptoms [8], [9], [10]. Despite such reports, numerous studies have highlighted promising anti-nociceptive effects, emphasizing their potential as natural pain-relieving agents [11], [12]. Additional studies have reported that kratom attenuates chemotherapy-induced peripheral neuropathy (CIPN) [13] and inhibits the proliferation of nasopharyngeal carcinoma cell lines [14]. Despite extensive research into kratom's compounds, further investigation is essential. This exploration is crucial to fully understand the effects, mechanisms, and potential applications of these compounds, which could lead to innovative therapeutic approaches and pharmaceutical developments.

Concerns about the safety of kratom usage engage a wide range of stakeholders, encompassing health professionals, economists, academics, the general public, and government officials. Countries like Myanmar, Singapore, Malaysia, and Vietnam have imposed bans on kratom due to safety concerns [15]. In Indonesia, the government, particularly through the Indonesian Food and Drug Authority (BPOM), has regulated its use by prohibiting inclusion in traditional medicine or dietary supplements [1], [16]. Recently, the Indonesian National Narcotics Agency (BNN) has been in coordination with Singapore and Malaysia to propose a ban on kratom [17]. Nonetheless, comprehensive study elucidating the health and biochemical effects of kratom use in Indonesia remains scarce. Therefore, there is an urgent call for studies that thoroughly analyze and provide scientific evidence concerning the effects of kratom consumption on the health of local communities, particularly in regions like Putussibau, West Kalimantan. This study holds immense significance, potentially playing a pivotal role in shaping policies and establishing crucial regulations governing kratom use in Indonesia. By offering robust scientific evidence on the health effects of kratom consumption within local communities, this study could serve as a cornerstone for informed decision-making. Moreover, it has the potential to guide the development of well-tailored regulations, balancing the protection of public health while respecting kratom's cultural and social importance. The insights from this study would not solely benefit local communities but also contribute to broader discussions and initiatives regarding the responsible use and management of kratom in similar contexts globally.