Scoping Review Maps 43 Studies on Kratom Use Among U.S. Adults: Pain, Mental Health, Withdrawal Dominate

Why it matters

A comprehensive scoping review published in Substance Use and Misuse synthesizes the full body of U.S. research on kratom use patterns and health outcomes, providing policymakers and clinicians with the most current evidence base at a moment when federal scheduling and state bans are reshaping the legal landscape.

The big picture

Kratom research has accelerated dramatically in the past five years but studies remain scattered across disciplines — pharmacology, toxicology, addiction medicine, and public health. A scoping review that maps the evidence across 43 available studies gives regulators and clinicians a consolidated starting point. The review arrives as both the DEA and multiple states finalize major policy decisions based on a still-incomplete evidence record.

Key findings

• Researchers identified and synthesized 43 published studies examining kratom use among U.S. adults
• Kratom is primarily used for self-management of pain, mental health symptoms, and opioid withdrawal
• The substance remains minimally regulated at the federal level despite growing use
• Self-reported benefits include reduced pain, improved mood, and decreased opioid cravings
• Evidence base remains largely observational with few controlled clinical trials
• The review highlights significant regulatory and research gaps that complicate safe-use guidance

What they say

The authors note that kratom is increasingly used by U.S. adults for pain management, mental health symptoms, and substance withdrawal, yet remains minimally studied through rigorous clinical methods — a gap this scoping review is intended to help address.

Bottom line

Forty-three studies document widespread kratom use for pain and opioid withdrawal in the U.S., but the research base remains almost entirely observational — a significant problem when regulators are making permanent Schedule I decisions.