Kratom and White Middle Class Men in the US

"In our online convenience sample, we observed significantly greater odds of lifetime kratom use among White men, and greater odds of past-year kratom use among men only. When examining combined factor(s) through which we operationalized “White and middle-class,” we found that men in the White, middle-class group were nearly twice as likely to report lifetime kratom use as other men. Further, we observed much stronger and consistent associations between this indicator and both lifetime and past-year kratom use in NSDUH data. Lifetime kratom use was 3.10 times more likely to be reported by White, middle-class men and 1.86 times as likely to be reported by White, middle-class women. With respect to past-year kratom use, White, middle-class men and women were 2.30 times and 2.05 times as likely to report use, respectively. We suspect that these kratom users are not only of people with SUD histories, but also people who represent far more socially normative substance-use sub-groups who are using kratom for wellness purposes or enhancement (e.g., to boost cognitive and physical performance), as these motivations have been expressed by kratom-using people in prior investigations (Smith et al., 2021a; Smith et al., 2021b). Given the cross-sectional nature of these data and that these analyses are the first to use a “White, middle-class” indicator variable to represent a specific demographic of kratom users, we cannot claim that kratom use is increasing among this demographic. Rather, we can only assert that kratom use prevalence is significantly higher with this demographic intersection, seemingly among those with suburban residence, when compared with the rest of the US population (using NSDUH data), or when compared to other survey respondents with normative and illicit substance use (in our crowdsourced convenience sample). That kratom use has been associated with similar “middle class” attributes in kratom-specific online surveys in the US suggests that at least a sizeable proportion of people using kratom can be characterized in this way, even though we do not dismiss the heterogeneity that likely exists within this group. For instance, there are people who use kratom to address anxiety, chronic pain, fatigue, or SUD who are also among such a demographic group, but this does not suggest that there are no other motivations within this demographic groups, or other demographic groups for whom kratom use will become more prevalent for these or other reasons. With respect to the former, the lack of greater understanding of heterogeneity of kratom-using people may be an artifact of the questions that have been typically asked in surveys."