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

Albert Garcia-Romeu, David J. Cox, Kirsten E. Smith, Kelly E. Dunn, Roland Griffiths

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Background: 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. Methods: A cross-sectional, anonymous online survey was conducted between January and December 2017. Results: 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. Conclusion: 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.

Original languageEnglish (US)
Article number107849
JournalDrug and alcohol dependence
StatePublished - Mar 1 2020


  • Harm reduction
  • Kratom
  • Mitragyna speciosa
  • Mitragynine
  • Opioid use disorder
  • Opioids

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)
  • Toxicology
  • Pharmacology


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