Associations of Lifetime Nonmedical Opioid, Methamphetamine, and Kratom Use within a Nationally Representative US Sample

ABSTRACT

Co-use of non-medical opioids (NMO) and methamphetamine is increasing. So too is the use of the psychoactive botanical “kratom,” including among people with NMO and methamphetamine use histories. We assessed characteristics associated with respondent groups who reported lifetime methamphetamine and/or kratom use within a nationally representative US sample using 2019 National Survey on Drug Use and Health data from respondents reporting lifetime NMO use (diverted prescription opioids, heroin). Weighted prevalence estimates for demographic, mental health, and substance use outcomes were determined. Logistic regression examined associations between group membership and outcomes. Among this sample of respondents with lifetime NMO use, 67.6% (95% CI = 65.6–69.4%) reported only NMO use; 4.6% (3.9–5.4%) reported NMO+Kratom; 24.7% (22.7–26.7%) reported NMO+Methamphetamine; and 3.2% (2.5–3.9%) reported NMO+Methamphetamine+Kratom. Compared to those in the NMO-only group, the NMO+Kratom group was more likely to report past-year serious mental illness (SMI; OR = 2.27), suicidality (OR = 1.89), and past-month psychological distress (OR = 1.88). The NMO+Methamphetamine+Kratom group was more likely to report past-year SMI (OR = 2.65), past-month psychological distress (OR = 2.06), and unmet mental health needs (OR = 2.03); increased odds for drug injection, opioid withdrawal, and perceived treatment need also emerged. Risk factors were observed for all groups but were greatest among those reporting use of all three substances.

KEYWORDS:

• Kratom
• mitragyna speciosa
• nonmedical opioids
• stimulants
• methamphetamines
• mental health
• polydrug use
• treatment needs

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Notes

1. US states where kratom is prohibited include Arkansas, Alabama, Indiana, Rhode Island, Vermont, and Wisconsin. States with localities that prohibit kratom use and sales include California, Colorado, Florida, Illinois, Mississippi, New Hampshire, North Carolina, and Tennessee.

Additional information

Funding

This work was supported by the Intramural Research Program of the National Institute on Drug Abuse. Support was also provided by the National Institutes of Health, NIDA grant number T32 DA07209.