Kratom use categories and their associations with co-occurring substance use and mental health disorder symptoms during the COVID-19 pandemic

Adzrago, David; Obekpa, Elizabeth O.; Suragh, Tiffany; John, Evit Rajan; Yeh, Paul; Gallardo, Kathryn R.; Wilkerson, J. Michael

doi:10.1016/j.drugalcdep.2022.109605

Cited by 10 publications

(14 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Questions on kratom use were included for the first time in 2019 NSDUH survey. Two studies used 2019 NSDUH data [60 ▪▪ ,61] and two used 2020 NSDUH data [59,62]. Although the NSDUH survey population consists of noninstitutionalized US residents, aged 12 years and older, Sharma et al [60 ▪▪ ] analyzed data on kratom use among adolescents aged 12–17 years, whereas Smith et al [61] analyzed only responses from people who also reported lifetime nonmedical opioid (NMO) use.…”

Section: Resultsmentioning

confidence: 99%

“…The authors also reported a significant positive association between e-cigarettes use and kratom use among US adults [62]. Among NSDUH-surveyed noninstitutionalized US residents, aged 12 years and older, surveyed in 2020, overall lifetime prevalence of kratom use was 1.8%, and 0.41% responders reported their most recent kratom use within the past 30 days of being surveyed, whereas 1.40% responders reported their most recent kratom use more than 30 days prior to the survey date [59].…”

Section: Andandmentioning

confidence: 89%

“…During the reviewed period, there were eight original research studies published that are based on largescale national surveys or data from national health systems [59][60][61][62]63 && ,64 && ,65 && ,66]. They included four studies based on data from the US National Survey on Drug Use and Health (NSDUH), two nationwide surveys conducted in Malaysia, and two publications based on data pertaining to kratom-related or mitragynine-related public health concerns or adverse health events identified in national health systems.…”

Section: National Surveys Of Kratom Use Prevalence and National Healt...mentioning

confidence: 99%

See 2 more Smart Citations

Research and publication gaps on kratom and kratom products: a scoping review of current literature

Vicknasingam,

Karunakaran,

Chawarski

2024

Current Opinion in Psychiatry

View full text Add to dashboard Cite

Purpose of review Kratom plant, products derived from the plant, and plant phytochemicals are of great interest among researchers, clinicians, and consumers. However, there is a paucity of rigorously collected scientific data on their risk/safety profile and public health impact. This scoping review discusses original research articles published between 2022 and 2023. It focuses on identifying publication gaps on topics related to epidemiology, public health, and risk/safety profiles comparing evidence collected by researchers from Southeast Asia and the West. Recent findings Our review of the Scopus database identified a total of 55 publications, including clinical case reports and case series reports, surveys, studies enrolling human participants, and publications based on large-scale national surveys or large-scale national or international health system database records. Summary Overall, there is dearth of reliable data on key epidemiological factors, including the prevalence rates, and on objective and reliable indices of the risk/safety profiles. Rigorous and systematic studies including improved epidemiological surveillance, human laboratory, and controlled clinical studies are urgently needed to advance our understanding of public health consequences of consuming kratom and kratom-derived products and to improve our understanding of their risk/safety profile and additional analytical studies to better inform development of needed regulatory oversight.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Andandmentioning

confidence: 89%

Section: National Surveys Of Kratom Use Prevalence and National Healt...mentioning

confidence: 99%

See 1 more Smart Citation

Research and publication gaps on kratom and kratom products: a scoping review of current literature

Vicknasingam,

Karunakaran,

Chawarski

2024

Current Opinion in Psychiatry

View full text Add to dashboard Cite

show abstract

“…Adzrago et al analyzed the 2020 NSDUH data and concluded that kratom use was more frequently associated with individuals who had cannabis, opioid, and alcohol use disorders, as well as those with major depressive disorder ( 12 , 13 ). Kratom use appears to be on the rise in the United States, with data from the 2019 National Survey on Drug Use and Health (NSDUH) estimating 11.1% lifetime and 6.7% past-year kratom use ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological report

Torrico,

Patel,

Nikolov

et al. 2024

Front. Psychiatry

View full text Add to dashboard Cite

BackgroundKratom (Mitragyna speciosa) use in the United States is becoming increasingly popular and its legal status varies widely from state to state. Multiple reports of adverse events associated with kratom use have ranged from liver injury, seizures, psychiatric disturbance, and rarely death.MethodsThis study investigated coroner autopsy reports from Kern County in California for the year 2020 which included qualitative data on substances from blood toxicological reports. Of the 214 opioid-associated accidental overdoses reported, 4 subjects (1.9%) had mitragynine (kratom) exposure on the autopsy report and were included in the study. We reported available demographic information and comorbid substance findings from the associated autopsy reports.ResultsAll 4 individuals with mitragynine (kratom) toxicology had accidental opioid overdose deaths noted in autopsy reports. Each subject also had toxicology positive for at least one other substance. Fentanyl was found in 3 (75%) of the cases and suspected to be the primary contributor to opioid-related deaths in those cases. However, one fatality was without fentanyl, but instead had tested positive for benzodiazepines, cannabis, and other psychiatric medications.DiscussionThe findings of this brief report provide insight into the role that mitragynine (kratom) may have in modulating risk of opioid-related deaths. The combined use of kratom with opioids such as fentanyl appears most likely to increase the risk of a fatal overdose, but it may also occur with other medications such as benzodiazepines and psychiatric medications. It is a serious concern that in the midst of the opioid overdose epidemic there is a growing presence of kratom use in the U.S. population with a largely unregulated status.

show abstract

“…Data from the 2020 National Survey on Drug Use and Health (NSDUH) indicate that among people who used stimulant drugs (i.e., cocaine, methamphetamine, MDMA, and prescription stimulants) in the past year, past-year kratom use was overrepresented relative to the US population (20.8% vs. 6.6%, F(1, 50) = 10.62, p = 0.002) [58]. Indeed, data from both surveys and case reports document lifetime, past-year, or past 30-day use of kratom and contemporaneous use of alcohol, opioids, and/ or stimulants, but no causal or otherwise explanatory associations can be made with respect to polydrug use broadly or drug substitution or nonmedical management of SUD symptoms specifically [59][60][61][62][63]. These findings have not been detected among US adolescents (there, nicotine and cannabis displayed the strongest relationship) [64].…”

Section: Drug Substitution and Nonmedical "Self-treatment" In The Con...mentioning

confidence: 99%

Kratom’s Emergence and Persistence Within the US Polydrug Epidemic

2023

View full text Add to dashboard Cite

Purpose of Review Use of “kratom” products, derived from the bioactive botanical Mitragyna speciosa have increased amidst US polydrug use epidemics. Kratom alkaloids interact with opioid, serotonergic, adrenergic, and other receptors and regular users have described experiencing a wide range of effects. Some with polydrug use histories have reported using kratom as a substitute for other drugs or to nonmedically self-manage substance use disorder (SUD) symptoms. Data describing this remain scare and come from self-report. We review this literature describing kratom use as a drug substitute, or as a nonmedical “self-treatment” for attenuating dependence or SUD symptoms. Recent Findings Kratom products have been documented as being used as a licit and illicit opioid substitute. Use to reduce alcohol or stimulant consumption is less well documented. Although prior and current polydrug use appear common among a some kratom users, it is unclear if co-use is contemporaneous or concomitant. Temporal order of use initiation is typically undocumented. Use for energy and recreation are also increasingly reported. Summary Data on kratom consumption come primarily from self-report with significant limitations. Until controlled human laboratory studies have been conducted, we can presently only describe what is known about human kratom use based on self-report. Such data describe real-world kratom use, leaving unaddressed human abuse liability or therapeutic potential of kratom alkaloids. Clinicians should be mindful of use motivations among people with SUD histories, sensitively assessing use. The paucity of data highlights the urgent need to increase funding and research for understanding kratom’s effects in humans.

show abstract

Kratom use categories and their associations with co-occurring substance use and mental health disorder symptoms during the COVID-19 pandemic

Cited by 10 publications

References 49 publications

Research and publication gaps on kratom and kratom products: a scoping review of current literature

Research and publication gaps on kratom and kratom products: a scoping review of current literature

Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological report

Kratom’s Emergence and Persistence Within the US Polydrug Epidemic

Contact Info

Product

Resources

About