TY - JOUR
T1 - Associations Between Kratom-Related State Policy Environments and Kratom Use in a Nationally Representative Population in the United States
AU - Ellis, Matthew S.
AU - Buttram, Mance E.
AU - Forber, Alyssa
AU - Black, Joshua C.
N1 - Publisher Copyright:
© 2023 Taylor & Francis Group, LLC.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - Kratom
KW - United States
KW - opioid use disorder
KW - state drug policy
UR - http://www.scopus.com/inward/record.url?scp=85163127085&partnerID=8YFLogxK
U2 - 10.1080/02791072.2023.2223622
DO - 10.1080/02791072.2023.2223622
M3 - Article
C2 - 37306164
AN - SCOPUS:85163127085
SN - 0279-1072
VL - 56
SP - 333
EP - 341
JO - Journal of Psychoactive Drugs
JF - Journal of Psychoactive Drugs
IS - 3
ER -