Kratom Use Strongly Associated With Mental Health Disorders in National Study

Why it matters

The study — one of the first to use nationally representative survey data — shows kratom use is rising and disproportionately concentrated among people with existing substance use disorders and serious psychological distress, raising urgent questions for clinicians screening patients for polysubstance use.

The big picture

Researchers from the University of Michigan and Texas State University drew on the National Survey on Drug Use and Health (NSDUH) 2021–2024 data to examine kratom use trends across the U.S. adult population. They found that lifetime and past-year kratom use were highest among adults aged 21 to 34 — the same age cohort most affected by the opioid epidemic. The findings appear against the backdrop of rising kratom sales and the DEA's July 2026 scheduling action against high-concentration 7-OH products.

Key findings

• Lifetime and past-year kratom use were highest among adults aged 21 to 34 — lifetime at 3.40% and past-year at 1.01%
• Kratom use was strongly associated with cannabis use and DSM-5 substance use disorders
• Users with serious psychological distress reported kratom prevalence exceeding 2%
• The study used nationally representative NSDUH data from 2021 through 2024
• Estimated 1.85 million Americans aged 12 and older used kratom in 2024, up from 1.63 million in 2023

What they say

Authors McCabe, Bogan, and colleagues concluded that "kratom use is increasing and strongly associated among individuals who use cannabis, have a DSM-5 substance use disorder, and experience serious psychological distress." (McCabe SE et al., J Addict Med. 2026 May 13. doi: 10.1097/ADM.0000000000001701)

Bottom line

Kratom use has climbed to an estimated 1.85 million Americans and clusters heavily among people with existing substance use disorders and mental health conditions — a pattern that demands attention from addiction medicine clinicians.