University of Michigan National Study: Over 5 Million Americans Have Used Kratom; Use Rising Among Young Adults

Why it matters

This is the first national study using current data to quantify kratom use across the U.S., including among children and adolescents, and its direct associations with mental health disorders and substance use disorder—providing critical evidence for policymakers at a pivotal regulatory moment.

The big picture

As kratom policy evolves rapidly across U.S. states, researchers have lacked population-level data. This University of Michigan and Texas State University study analyzes 2021–2024 National Survey on Drug Use and Health data to fill that gap. The findings arrive as roughly half of U.S. states have enacted some form of kratom restriction and 7-OH products complicate the regulatory picture.

Key findings

• More than 5 million U.S. adults report lifetime kratom use; over 100,000 children ages 12–17 have also used kratom
• Kratom lifetime use rose from 1.6% in 2021 to 1.9% in 2024 among Americans ages 12 and older
• Adults ages 21–34 had the highest use rate at approximately 3.4% lifetime and 1% past-year
• Most kratom users have a concurrent substance use disorder, report cannabis use, and many have serious psychological distress or major depression
• Kratom is under-reported in clinical settings because it does not appear on standard drug tests and requires specialized testing

What they say

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

Bottom line

The first national study finds kratom use is rising—especially among young adults—and is strongly associated with substance use disorders and mental health problems, strengthening the case for age restrictions and routine clinical screening.