Rising Kratom Use in the U.S. Linked to Mental Health and Addiction Risks
A new national study has revealed that kratom use is on the rise in the United States, with increasing prevalence among young adults and significant associations with mental health challenges and substance use disorders. The research, which represents the first known national study to examine these specific use patterns and their links to addiction, highlights a growing public health concern as the substance becomes more widely available.
Kratom, a plant native to Southeast Asia, is sold in various forms—including powders, liquid shots, pills, and teas—through online retailers and certain brick-and-mortar stores. While some proponents view it as a natural alternative for managing various ailments, researchers are raising alarms regarding its impact on vulnerable populations, particularly children and young adults.
A Growing Population of Users
According to the study published in the Journal of Addiction Medicine, more than 5 million people in the United States report having used kratom in their lifetime. This includes a notable number of minors; researchers estimate that more than 100,000 children between the ages of 12 and 17 have used the substance.
The data indicates that kratom use is reaching an all-time high. The share of Americans aged 12 and older who reported ever using kratom rose from 1.6% in 2021 to 1.9% in 2024. The highest rates of use were observed among adults aged 21 to 34, with approximately 3.4% reporting lifetime use and about 1% reporting use within the past year.
Sean Esteban McCabe, a professor at the University of Michigan School of Nursing and the study’s principal investigator, noted the scale of this trend, stating that the 5 million users represent a population larger than the combined populations of the six smallest U.S. States: Wyoming, Vermont, Alaska, South Dakota, North Dakota, and Delaware.
Associations with Mental Health and Substance Use
While the researchers emphasized that the study does not prove that kratom usage causes mental health issues or addiction, they identified striking correlations. Most individuals who have used or currently use kratom also report having a substance use disorder or frequent cannabis use. Many users reported experiencing major depression and serious psychological distress.
These findings suggest a complex relationship between kratom and existing health struggles. Because the study utilized a snapshot in time, it remains unclear whether kratom use precedes mental health symptoms or if individuals with existing mental health or addiction issues are more likely to turn to kratom.
The Emergence of High-Potency 7-OH Products
A significant development in the kratom landscape is the rise of 7-hydroxymitragynine (7-OH). This synthetic derivative of the kratom plant is often sold in gas stations, smoke shops, and online in the form of gummies, tablets, and drinks.
The potency of these 7-OH products is a major concern for health officials. These products can be anywhere from five to 50 times more potent than regular kratom. In some instances, 7-OH is even marketed as “legal morphine,” highlighting the potential for misuse and the risks associated with its high potency.
Clinical and Regulatory Challenges
The regulatory environment for kratom is inconsistent across the United States. While approximately half of all states have implemented bans or regulations on the substance, the lack of uniform policy complicates public health efforts. This patchwork of laws makes it hard to control access, particularly for children.
From a clinical perspective, kratom use is often under-reported. Because kratom does not typically appear on standard drug tests and requires specialized testing to detect, healthcare providers may remain unaware of a patient’s usage.
Federal agencies have also signaled concern. The U.S. Food and Drug Administration (FDA) has not approved kratom for any medical use and has warned about potential risks, including addiction and serious side effects. The U.S. Drug Enforcement Administration (DEA) has flagged kratom as a drug or chemical of concern.
Key Takeaways
- Rising Prevalence: Lifetime kratom use in the U.S. Exceeds 5 million people, with use increasing from 1.6% in 2021 to 1.9% in 2024.
- Youth Impact: Over 100,000 children aged 12–17 have reportedly used kratom.
- Health Correlations: Kratom use is frequently associated with substance use disorders, cannabis use, major depression, and psychological distress.
- High-Potency Risks: Synthetic 7-OH products can be 5 to 50 times more potent than standard kratom.
- Detection Difficulties: Standard drug tests often fail to detect kratom, necessitating specialized testing in clinical settings.
Frequently Asked Questions
Is kratom legal in the United States?
The legality of kratom varies significantly by state. While it is legal in many areas, approximately half of U.S. States have implemented some form of regulation or ban.
Can kratom be detected in a standard drug test?
No, kratom use is likely under-reported in clinical settings because it does not show up on standard drug tests. Specialized testing is required to identify its presence.
What is the difference between regular kratom and 7-OH?
7-hydroxymitragynine (7-OH) is a synthetic derivative of the kratom plant. Unlike regular kratom, 7-OH products can be significantly more potent—potentially up to 50 times more potent than the plant itself.