Prevalence and Correlates of Past-year Kratom Use Among US Adults: Findings From the 2021-2023 National Survey on Drug Use and Health.

Prevalence and Correlates of Past-year Kratom Use Among US Adults: Findings From the 2021-2023 National Survey on Drug Use and Health.

CED Clinical Relevance  #50Monitored Relevance  Early-stage or contextual signal requiring further evidence before action.
🔬 Evidence Watch  |  CED Clinic
KratomEpidemiologyMental HealthSurvey ResearchSelf-Medication
Journal Journal of addiction medicine
Study Type Clinical Study
Population Human participants
Why This Matters

This is the first robust national epidemiological data on kratom use in the US, establishing baseline prevalence rates as regulatory discussions intensify. Understanding who uses kratom and why helps clinicians recognize patterns and potential interactions in their patient populations.

Clinical Summary

This cross-sectional analysis of 139,524 adults from the 2021-2023 National Survey on Drug Use and Health found 0.68% past-year kratom prevalence, stable across survey years. Use was higher among males, adults 26-49, and non-Hispanic white or multiracial populations. Notably, prevalence exceeded 2% in adults with serious psychological distress or major depression, and over 5% in certain subgroups, suggesting potential self-medication patterns. The study provides population-level prevalence data but cannot establish causation or clinical outcomes.

Dr. Caplan’s Take

“These data confirm what I observe clinically – kratom use clusters among patients with untreated mood disorders and pain conditions. The 5%+ prevalence in certain distressed populations suggests we’re missing opportunities for evidence-based interventions.”

Clinical Perspective
🧠 Clinicians should routinely screen for kratom use, particularly in patients with depression, anxiety, or chronic pain. Given the regulatory uncertainty and limited safety data, these conversations should focus on understanding patient motivations and exploring evidence-based alternatives while maintaining therapeutic rapport.

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FAQ

How common is kratom use among US adults?

According to the 2021-2023 National Survey on Drug Use and Health, approximately 0.68% of US adults reported past-year kratom use. This prevalence remained stable across the survey years, indicating consistent but relatively low usage rates in the general population.

Which patient populations are most likely to use kratom?

Kratom use is more prevalent among males, adults aged 26-49, and non-Hispanic white or multiracial individuals. Clinicians should be particularly aware that usage rates exceed 2% among patients with serious psychological distress or major depressive episodes, and exceed 5% in certain high-risk groups.

Should I be concerned about kratom use in patients with mental health conditions?

Yes, the study shows significantly higher kratom usage rates among patients with serious psychological distress and major depressive episodes. This suggests potential self-medication behaviors that warrant clinical attention and monitoring for both therapeutic effects and potential risks.

Is kratom use increasing in the United States?

Based on this national survey data, kratom use prevalence remained stable between 2021-2023, showing no significant increase over this period. However, the widespread availability of kratom products suggests continued monitoring of usage patterns is warranted.

What should clinicians know about kratom’s clinical relevance?

While kratom use affects less than 1% of the general population, its higher prevalence among patients with mental health conditions makes it clinically relevant. Clinicians should consider screening for kratom use in vulnerable populations and stay informed about emerging evidence regarding its safety and efficacy profile.






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