Most Addiction Specialists Lack Knowledge of Kratom and Emerging Nootropics, Yale-Led Survey Finds

Why it matters

Addiction specialists are the clinicians most likely to treat kratom dependence, yet this study finds the majority report limited knowledge about kratom, phenibut, and tianeptine -- a gap with direct patient-safety implications as more patients present with dependence on these unregulated substances.

The big picture

Kratom, phenibut, and tianeptine are marketed as dietary supplements or nootropics but carry significant dependence and addiction risk. Unlike prescription opioids or controlled stimulants, they bypass FDA regulatory oversight and are widely available online and in retail stores. This Yale-led cross-sectional survey, conducted at a national addiction conference dedicated session on nootropics, is one of the first to formally document provider knowledge gaps about these specific substances.

Key findings

• Of 34 respondents (57.6% response rate), most were physicians (91%) attending a dedicated nootropics session at a national addiction conference
• 61.8% reported limited overall knowledge of nootropics
• 64.7% reported limited specific knowledge of phenibut; 58.8% limited knowledge of tianeptine
• Despite the knowledge gaps, 91.2% expressed concern about patient accessibility to kratom, phenibut, and tianeptine
• 97.1% -- nearly all respondents -- endorsed the need for further research
• 70.6% supported stronger regulatory oversight

What they say

"Surveyed respondents attending a dedicated nootropics session at an addiction conference reported substantial knowledge gaps about kratom, phenibut, and tianeptine, yet consistently endorsed the need for greater regulation and research." -- Alam, Weleff, Anand et al., Substance Use & Addiction Journal, 2026

Bottom line

Even addiction specialists with enough interest to attend a dedicated nootropics session lack basic knowledge of kratom and related substances -- a training gap that needs urgent attention as use and clinical presentations rise.