Rising Kratom Use in the US Linked to Mental Health and Addiction

A national study has found that kratom use is increasing across the United States, with a notable rise in popularity among young adults and a documented link to addiction and mental health challenges.

The research, published in the Journal of Addiction Medicine, represents the first known national effort to analyze the use patterns of kratom and its association with substance use disorder and mental health.

Kratom is a plant native to southeast Asia. It is commercially available in various forms, including teas, pills, liquid shots, and powders, and is frequently sold through online retailers and some physical stores.

Usage Trends and Demographics

According to the study, more than 5 million people in the United States reported having used kratom at some point in their lives. This total includes more than 100,000 children between the ages of 12 and 17.

The data indicates that kratom use is at an all-time high in the U.S. Analysis of the National Survey on Drug Use and Health, which collected data from households between 2021 and 2024, shows that the share of Americans aged 12 and older who have ever used the substance rose from 1.6% in 2021 to 1.9% in 2024.

The highest rates of use were reported among adults between the ages of 21 and 34. Within this demographic, approximately 3.4% reported having used kratom at least once, while about 1% reported using it within the past year.

Mental Health and Addiction Associations

Researchers found that the majority of individuals who currently use or have used kratom also report cannabis use and have a substance use disorder. Many of these individuals report experiencing major depression and serious psychological distress.

Sean Esteban McCabe, a professor in the University of Michigan School of Nursing and the principal investigator of the study, noted that these findings suggest a need for improved mental health and addiction treatment.

However, the researchers emphasized that the study does not prove that kratom causes addiction or mental health problems. Because the survey provided a snapshot in time, it cannot determine whether kratom use preceded the onset of mental health symptoms or vice versa.

Potency and Public Health Risks

The study highlighted the emergence of high-potency products such as 7-OH, or 7-hydroxymitragynine. This synthetic derivative of the kratom plant is often sold in drinks, gummies, and tablets at smoke shops, gas stations, and online.

These 7-OH products can be five to 50 times more potent than standard kratom and are sometimes marketed as legal morphine.

The U.S. Food and Drug Administration has not approved kratom for any medical use. Federal agencies have issued warnings regarding potential risks, including serious side effects and addiction. The U.S. Drug Enforcement Administration has also identified kratom as a chemical or drug of concern.

Regulatory and Clinical Challenges

Public health and policy decisions are complicated by a fragmented regulatory landscape. Approximately half of the U.S. States currently regulate or ban kratom, while other states have no regulations in place.

McCabe, who also serves as the director of the Center for the Study of Drugs, Alcohol, Smoking and Health (DASH), stated that kratom use is likely under-reported in clinical settings. This is because the substance does not appear on standard drug tests and requires specialized testing to detect.

“Policy changes regarding kratom and 7-OH products are needed in all states if we are serious about protecting our children,” McCabe said. “Five million people is more than the entire population of the six smallest states in the US combined—Wyoming, Vermont, Alaska, South Dakota, North Dakota, and Delaware.”

The study was supported by the National Institute on Drug Abuse of the National Institutes of Health, with contributions from coauthors at DASH, the University of Michigan Medical School, Texas State University, and Rush University.