Prevalence of Kratom Use in the United States

"In the United States, anecdotal reports suggest that kratom commerce and use began in the last quarter of the 20th century but was largely limited to Southeast Asia immigrants and returning United States veterans with no published estimates of kratom use prevalence until the 21st century. In 2015, the Botanical Education Alliance (BEA) survey of kratom vendors estimated three to five million kratom consumers in the United States (BEA, 2016). The major United States surveillance systems tracking trends in recreational substance use and treatment-seeking for 'addiction' or substance use disorder (SUD) did not include kratom on their annual reports until 2020 3 . The National Survey on Drug Use and Health (NSDUH) prevalence data suggested approximately 1.7–1.8 million past-year kratom consumers from 2019–2021 (Palamar, 2021; SAMHSA, 2022; 2023a; b;c), while the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) system estimated 2.03 million, with lifetime prevalence at 3.4 million based on 2018–2019 data (Schimmel and Dart, 2020). Covvey et al. estimated lifetime prevalence of kratom use at 6.1% based on a 2019 survey (Covvey et al., 2020). Other approaches to estimating kratom use prevalence based on kratom import volume and market data projected more than 10 million current users in 2019 (American Kratom Association, 2019). Together, evidence suggests that the NSDUH and RADARS systems likely underestimate kratom use prevalence, indicating that better methods for estimation of novel product use are needed (Henningfield et al., 2022b; Palamar, 2022)."