Survey of 161 kratom users finds it rarely preceded other substances or care

Why it matters

The survey offers a snapshot of when respondents began using kratom relative to other substances and medical care. Because participants were recruited through two kratom advocacy organizations, the results do not represent all kratom users and cannot show that kratom replaced treatment.

The big picture

Researchers asked 161 adults with current or past kratom use to report their substance use and treatment history. The cross-sectional, self-reported survey describes timing within this sample, not what caused people to use kratom or whether the pattern holds across the broader population.

Key findings

• The anonymous online survey ran from March to September 2025 and recruited adults through the American Kratom Association and Global Kratom Coalition.
• Among 161 respondents, 95.7% reported current kratom use; 90.3% reported whole-leaf products, 38.3% concentrated extracts, and 16.9% single-alkaloid isolates. Product categories could overlap.
• For reasons of use, 50.3% reported therapeutic use, 16.1% non-therapeutic use, and 33.5% both; pain was the most commonly cited reason for self-treatment.
• Only 3% to 10% of respondents with a substance-use history said kratom was the first substance they tried; among those with relevant conditions, 0% to 20% said they started kratom before medical care.
• The advocacy-group recruitment and self-reported, cross-sectional design limit generalizability and do not establish causation.

What they say

The authors conclude that kratom was rarely the first substance or therapeutic treatment tried, and call for larger follow-up studies to confirm the findings.

Bottom line

In this self-selected sample, kratom generally followed or coincided with other substance use or care; broader studies are needed.