The questionnaire and methodology for this study was approved by the Institutional Review Board of the University of Florida (IRB #2019-01121). ConsentInformed consent was obtained from all individual participants included in the study before the survey started.

Kratom (Mitragyna speciosa Korth.) use has increased substantially over the past decade outside of its indigenous regions, especially for the self-treatment of psychiatric conditions. An anonymous, cross-sectional, online survey was completed by 4,945 people who use kratom (PWUK) between July 2019 and July 2020. A total of 2,296 respondents completed an extended survey utilizing clinical scales for attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), depressive and anxiety disorders.PWUK and met criteria for ADHD, PTSD, depressive or anxiety disorders were primarily middle-aged (31-50 years), employed, more likely to have college-level education (81.3% vs. 80.0%), and reported increased concurrent or prior use of kratom with cannabis products, cannabidiol, and benzodiazepines. In all psychiatric conditions, PWUK reported less depressive and anxious moods. Self-reported quality of life was worse in psychiatric conditions whereas current pain was more severe. Based on this observational study, further clinical studies are warranted for kratom.