Kratom (Mitragyna speciosa): User demographics, use patterns, and implications for the opioid epidemic

• Published in: Drug and alcohol dependence 2020-03, Vol.208, p.107849-107849, Article 107849
• Main Authors: Garcia-Romeu, Albert, Cox, David J., Smith, Kirsten E., Dunn, Kelly E., Griffiths, Roland R.
• Format: Article
• Language: English
• Subjects: Adult; Analgesics, Non-Narcotic - isolation & purification; Analgesics, Non-Narcotic - therapeutic use; Analgesics, Opioid - adverse effects; Analgesics, Opioid - therapeutic use; Anxiety; Anxiety - drug therapy; Anxiety - epidemiology; Anxiety - psychology; Craving; Cross-Sectional Studies; Demographics; Demography; Dosage; Drug abuse; Drug addiction; Drug withdrawal; Epidemics; Epidemiology; Female; Harm reduction; Herbal medicine; Humans; Kratom; Male; Mental depression; Middle age; Middle Aged; Mitragyna; Mitragyna speciosa; Mitragynine; Narcotics; Opioid Epidemic - prevention & control; Opioid receptors; Opioid use disorder; Opioid-Related Disorders - drug therapy; Opioid-Related Disorders - epidemiology; Opioid-Related Disorders - psychology; Opioids; Pain; Pain - drug therapy; Pain - epidemiology; Pain - psychology; Pharmacology; Plant Extracts - isolation & purification; Plant Extracts - therapeutic use; Polls & surveys; Privacy; Side effects; Sociodemographics; Substance abuse treatment; Substance use; Substance use disorder; Surveys and Questionnaires; Young Adult
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2020.107849

•Kratom is a Southeast Asian plant with opioid-receptor mediated effects.•Kratom has recently emerged as a substance of abuse, with limited available data.•Kratom is being used by White, middle-aged Americans for pain, anxiety, depression.•Users also report using kratom to decrease opioid use, withdrawal, and craving.•Additional research on kratom epidemiology and pharmacology is necessary. Kratom, a Southeast Asian plant with opioid-receptor mediated effects, has emerged as a potential substance of abuse, with limited data on its use and effects. This study characterized kratom user demographics, use patterns, and perceived drug effects. A cross-sectional, anonymous online survey was conducted between January and December 2017. 2,798 kratom users – mean age 40 (SD = 12); predominantly White (90 %), female (61 %), and located in the US (97 %) – completed the survey. Kratom was primarily taken orally in doses of 1−3 g (49 %), with daily use (59 %) being most common. Kratom was used for pain (91 %), anxiety (67 %), and depression (65 %), with high ratings of effectiveness. 1,144 (41 %) used kratom to stop or reduce prescription or illicit opioid use, citing decreased opioid withdrawal and craving related to kratom use, with 411 reporting >1-year continuous abstinence from opioids attributed to kratom use. Roughly one-third of respondents reported adverse effects of kratom, largely rated as mild in severity and lasting ≤24 h. Seventeen participants (0.6 %) sought treatment for adverse effects. Fifty-six individuals (2 %) met DSM-5 criteria for a past-year moderate or severe kratom-related substance use disorder (SUD). When asked how troubled they felt regarding their kratom use, the mean (SD) rating was 3.2 (9.8) on a scale from 0 to 100. Kratom is used among White, middle-aged Americans for symptoms of pain, anxiety, depression, and opioid withdrawal. Although regular use was typical, kratom-related SUD and serious adverse effects were uncommon. Additional research on kratom epidemiology and pharmacology is imperative in light of the present opioid epidemic.