Kratom Use Rises Sharply Among Adolescents and College Students; Systematic Review Identifies Gender, Regional, and Polydrug Patterns

Why it matters

First comprehensive systematic review reveals that kratom use among youth and college students is rising globally, with distinct regional patterns, gender disparities, and consistent polydrug use. Understanding these trends is critical for targeted public health interventions and regulation.

The big picture

The kratom landscape differs dramatically between Southeast Asia (traditional cultural use) and the United States (commercialized recreational use). In all regions studied, kratom use was significantly higher in males and concentrated among individuals with substance use histories, psychological distress, and opioid dependence. Unlike older surveys limited to college cohorts, this review captures use across vulnerable adolescent populations.

Key findings

• Six eligible studies reviewed; conducted in Malaysia, Thailand, and the United States
• Kratom use more prevalent in males across all regions, shaped by socioeconomic status and psychosocial factors
• Primary driver in U.S. youth: self-management of opioid (heroin) and methamphetamine withdrawal symptoms
• Polydrug use identified in 100% of studies—kratom consistently combined with other substances, complicating assessment of kratom-specific effects
• Limited studies available; evidence on safety, efficacy, and long-term outcomes in adolescents remains scarce

What they say

"The rising prevalence of kratom use among adolescents and college students demands attention. While kratom may hold potential as a harm reduction tool, evidence on its safety, efficacy, and long-term outcomes remain limited." — Systematic Review Authors

Bottom line

**Youth kratom use is expanding faster than research can evaluate it; immediate needs include targeted education, regulatory clarity distinguishing traditional from commercial use, and longitudinal safety studies.**