Objectives: Kratom is now widely available in the United States, yet epidemiological data remain sparse. This study examined the prevalence and correlates of kratom use among adults in the civilian noninstitutionalized US population using the most recent National Survey on Drug Use and Health (NSDUH) data. Methods: Data from the 2021–2023 NSDUH were limited to adults aged 18+ years (n = 139,524). Weighted prevalence estimates were calculated overall, by year, and by demographic and clinical characteristics. Logistic regression models were used to examine correlates of past-year kratom use. Results: The combined (2021–2023) weighted prevalence of past-year kratom use among US adults was 0.68% (95% CI, 0.60%–0.77%), remaining stable across survey years. Kratom use was more common among males, adults aged 26–49, and non-Hispanic white or multiracial adults. Prevalence exceeded 2% among adults reporting serious psychological distress or a major depressive episode, and exceeded 5% among those reporting certain types of substance use or prescription medication misuse. In covariate-adjusted analyses, higher odds of kratom use were observed among men, adults aged 35–49 years, and those reporting prescription pain reliever use or misuse, as well as cigarette, cannabis, and ketamine use, whereas lower odds were observed among black and Hispanic adults compared with white adults. Conclusions: Kratom use among adults in the United States was relatively stable between years 2021 and 2023 and concentrated among individuals with reported psychological distress and substance use. Future studies should include more comprehensive assessments of kratom use, and screening for kratom use in high-risk clinical populations may be warranted.
Mun et al. (Mon,) studied this question.