Associations Between Kratom-Related State Policy Environments and Kratom Use in a Nationally Representative Population in the United States

Matthew S. Ellis, Mance E. Buttram, Alyssa Forber, Joshua C. Black

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Limited research has resulted in conflicting views on the risks versus benefits associated with kratom use. Despite no federal policy in the United States, individual states have implemented diverging policies through kratom bans, and legalization and regulation through Kratom Consumer Protection Acts (KCPAs). The Survey of Non-Medical Use of Prescription Drugs (NMURx) Program employs nationally-representative, repeated cross-sectional surveys on drug use. In 2021, weighted prevalence of past−12 month kratom use was compared across three state legal frameworks: no overarching state policy, KCPAs, and state bans. There was lower estimated prevalence of kratom use in banned states (prevalence: 0.75% (0.44, 1.06) relative to states with a KCPA (1.20% (0.89, 1.51)), and relative to states with no policies (1.04% (0.94, 1.13), though odds of use were not significantly associated with policy type. Kratom use was significantly associated with medicated treatment for opioid use disorder. While there were observed differences in the prevalence of past−12 month kratom use by state policy type, low uptake mitigated meaningful distinctions by limiting statistical precision, and potentially confounding effects, such as accessibility online. Future kratom-related policy decisions should be informed through evidence-based research.

Original languageEnglish
Pages (from-to)333-341
Number of pages9
JournalJournal of Psychoactive Drugs
Volume56
Issue number3
DOIs
StatePublished - 2024

Keywords

  • Kratom
  • United States
  • opioid use disorder
  • state drug policy

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