Citation

Schimmel J, Amioka E, Rockhill K, Haynes CM, Black JC, Dart RC, Iwanicki JL. Addiction 2020; ePub(ePub): ePub.

Affiliation

Rocky Mountain Poison & Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA.

Copyright

(Copyright © 2020, John Wiley and Sons)

DOI

10.1111/add.15082

PMID

32285981

Abstract

BACKGROUND AND AIMS: Mitragyna speciosa ("kratom") contains mu opioid partial agonists. It is widely available, and occasionally used as a home remedy for opioid use disorder. The Drug Enforcement Agency considers kratom a Drug of Concern; however, prevalence of use and role in drug misuse are unknown. This study aimed to characterize kratom use in the United States (U.S.).

DESIGN: Cross-sectional Survey of Non-Medical Use of Prescription Drugs (NMURx) Program, 2018 3rd quarter and 2019 1st quarter. SETTING: A validated non-probability online survey in the U.S. PARTICIPANTS: A total of 59,714 respondents 18 years or older, weighted to represent the adult U.S. population (N=252,063,800). MEASUREMENTS: In addition to prevalence of past-year kratom and other drug use, behavior proportions were estimated. The Drug Abuse Screening Test (DAST-10) estimated consequences of drug abuse.

FINDINGS: Estimated prevalence of past-year kratom use in the adult U.S. population was 0.8% (95% CI 0.7-0.9), representing 2,031,803 adults. Lifetime prevalence was 1.3% (95% CI 1.2-1.4), representing 3,353,624 adults. Kratom users were younger (mean 35 years, p<0.001), with higher proportions of males (61.0 vs. 48.6%, p<0.001), students (14.1 vs. 7.5%, p<0.001), and healthcare professionals (9.7 vs. 4.5%, p<0.001), and fewer bachelor's/advanced degree graduates (33.4 vs. 42.6%, p<0.001), compared with non-users.

RESULTS were inconclusive on whether there was a difference in kratom use by race, household income, or employment status. Among those with past-year kratom use, 36.7% (95% CI 32.1-41.3) non-medically used prescription opioids, 21.7% (95% CI 18.0-25.5) used illicit opioids, 54.4% (95% CI 49.5-59.3) used another illicit drug, and 67.1% (95% CI 62.5-71.8) used cannabis. The DAST-10 profile was more often substantial/severe in kratom users (21 vs. 1%, p<0.001) compared with non-users.

CONCLUSIONS: Estimated United States past-year prevalence of kratom use is 0.8%, and kratom users tend to have more serious substance abuse profiles than non-users or users of cannabis, alcohol, or cigarettes. This is the first description of kratom use at the national level.

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Language: en