A national study examining kratom use in the United States has found that the substance is becoming increasingly popular, particularly among young adults, while also being strongly associated with addiction and mental health problems. The research, conducted by investigators at the University of Michigan and Texas State University, is believed to be the first nationwide analysis to explore both patterns of kratom use and its links to substance use disorders and psychological distress. The findings were published in the Journal of Addiction Medicine.
Kratom is a plant native to Southeast Asia that is sold in the United States in a variety of forms, including powders, capsules, teas and concentrated liquid shots. Supporters often describe it as a natural remedy that may help manage pain, anxiety or opioid withdrawal symptoms. At the same time, critics warn that it can be addictive and is too easily accessible, including to minors. Researchers said the rapidly shifting legal and regulatory landscape surrounding kratom in the U.S. made it especially important to conduct a large-scale national study using recent data. Sean Esteban McCabe, Carol J. Boyd Collegiate Professor in the University of Michigan School of Nursing and the study’s principal investigator, said policymakers and health professionals urgently need clearer information about who is using kratom and the potential risks associated with it.
The study estimated that more than five million people in the United States have used kratom at least once in their lifetime. That figure includes more than 100,000 children between the ages of 12 and 17. Researchers also found that kratom use has reached its highest recorded level in the country, despite the fact that roughly half of U.S. states either ban the substance outright or regulate its sale and distribution. Adults aged 21 to 34 reported the highest rates of use, with approximately 3.4% saying they had tried kratom at least once and about 1% reporting use within the previous year. According to the study, the proportion of Americans aged 12 and older who reported ever using kratom rose from 1.6% in 2021 to 1.9% in 2024.
The research also identified strong associations between kratom use and other health concerns. Most individuals who currently use or have previously used kratom met the criteria for a substance use disorder, and many also reported cannabis use, major depression or serious psychological distress. The findings, researchers said, highlight the need for improved addiction treatment and mental health services, while also reinforcing calls for stronger measures to restrict youth access to kratom products. McCabe argued that if policymakers are serious about protecting children, more consistent regulations governing kratom and related products are needed across all states.
Federal agencies in the United States have repeatedly expressed concern about the safety of kratom. The U.S. Food and Drug Administration has not approved kratom for any medical use and has warned consumers about risks that may include addiction and serious side effects. Meanwhile, the U.S. Drug Enforcement Administration has listed kratom as a drug or chemical of concern. Researchers also pointed to the growing popularity of products containing 7-hydroxymitragynine, often called 7-OH, a synthetic derivative associated with the kratom plant. These products, sold in gas stations, smoke shops and online retailers, are sometimes marketed as “legal morphine” and can reportedly be five to 50 times more potent than traditional kratom.
Despite the concerning findings, the researchers stressed that the study does not prove that kratom directly causes addiction or mental health disorders. Because the data were collected at a single point in time, the study cannot determine whether kratom use preceded psychological symptoms or whether people experiencing mental health difficulties were more likely to use kratom. McCabe also noted that kratom use may be underreported in medical and clinical settings because it does not appear on standard drug screening tests and instead requires specialised testing. Combined with the patchwork of regulations across the United States, this lack of consistent monitoring continues to complicate public health responses and policy decisions surrounding the increasingly popular substance.
More information: Sean Esteban McCabe et al, Kratom Use and Associations With Mental Health in the United States, Journal of Addiction Medicine. DOI: 10.1097/ADM.0000000000001701
Journal information: Journal of Addiction Medicine Provided by University of Michigan
