Prevalence, Characteristics, and Reasons for Kratom Use among Psychiatrically Ill Inpatients Who Use Substances

Abstract

Objective

Despite kratom impacting neurobiological systems involved in psychiatric disorders, little is known about the prevalence of use among patients with severe psychopathologies. Here, we investigated the prevalence of kratom use, motives for use, and the clinical associations among inpatients with severe psychiatric disorders.

Methods

A total of 578 patients, aged 18 to 65, were evaluated by New Hampshire Hospital’s Addiction Services from January 1, 2020, to February 28, 2022. The study collected demographic information and used chi-square tests, multivariable logistic regression, and subgroup analyses with 95% confidence intervals to examine trends among kratom users. A receiver operating characteristic curve analysis was also conducted. All statistical tests were performed using IBM SPSS Version 28.0.1.

Results

Of the patients assessed, 2.2% (n = 13) reported using kratom. The reasons for kratom use were managing withdrawal symptoms (15.4%), maintaining sobriety and reducing cravings for opioids (53.8%), improving focus and concentration (30.8%), alleviating low moods (38.5%), and managing pain (15.4%). Compared to non-kratom users, the only factor with a fair to good association with kratom use is postsecondary education (Area Under Curve, AUC = 0.77).

Conclusions

Prevalence of kratom use among patients with serious mental illness at our site aligns with that reported in the general population. Users often cite self-management of cravings and sobriety from opioids, as well as treatment of low mood states, as motivations for consumption. While observations suggest a possible association between kratom use and individuals with post-secondary education, multiple substance use, and experience of substance-induced psychosis or mood disorders, it is essential to interpret these links cautiously until further rigorous studies are carried out to substantiate these findings.

Keywords:

• Kratom
• Mitragyna speciose
• substance use disorder
• serious mental illness
• addiction medicine

Acknowledgements

The authors would like to acknowledge the contribution made by Karen Goodman, MSLIS, MA, medical librarian at the Dorothy M. Breene Memorial Library at New Hampshire Hospital, as she assisted with the literature search and procuration of the articles needed for this article.

The authors would also like to acknowledge the contribution made by Susan Tierney, RN-BC, nurse informaticist at New Hampshire Hospital, as she assisted with generating some of the included data.

Disclosure statement

Through Pinney Associates one of the authors (Jack Henningfield, PhD) has consulted and/or are presently consulting to the American Kratom Association and other sponsors of kratom products as well as to pharmaceutical products including opioid and nonopioid analgesics and other CNS acting products concerning their abuse potential, appropriate regulation, and medicinal application.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

The preparation of this report was financed under a contract with the State of New Hampshire Department of Health and Human Services, with funds provided in part by the State of New Hampshire.