First National Study: 5 Million Americans Have Used Kratom, Use Rising Among Young Adults

Why it matters

This is the first national study to quantify kratom prevalence across all age groups using representative survey data from 2021-2024, providing the clearest picture yet of how widespread kratom use is in the U.S. and its associations with mental health and substance use disorders.

The big picture

Kratom policy has been debated at state and federal levels for years, but comprehensive national data on how many Americans use it—and who—has been limited. Researchers at the University of Michigan and Texas State University used the National Survey on Drug Use and Health (NSDUH) to analyze kratom use patterns from 2021-2024, representing the most up-to-date national prevalence data available. The study appears in the Journal of Addiction Medicine.

Key findings

• More than 5 million Americans report lifetime kratom use, including over 100,000 children ages 12-17
• The share of Americans 12+ who ever used kratom rose from 1.6% in 2021 to 1.9% in 2024
• Adults ages 21-34 had the highest use rate: ~3.4% lifetime, ~1% past year
• Most kratom users also reported having a substance use disorder and cannabis use
• Many kratom users reported serious psychological distress and major depression
• The study cannot determine whether kratom causes these conditions or whether people with these conditions seek out kratom

What they say

"Policy changes regarding kratom and 7-OH products are needed in all states if we are serious about protecting our children. Five million people is more than the entire population of the six smallest states in the U.S. combined," said Sean Esteban McCabe, principal investigator at the University of Michigan School of Nursing.

Bottom line

The largest national study to date finds kratom use has reached 5 million Americans and is rising—particularly among young adults—with strong associations to substance use disorders and mental health issues, though causality remains unclear.