Where is Kratom in the United States?
Have you heard of ‘kratom,’ an emerging psychoactive plant from Southeast Asia that’s growing in popularity in the U.S.? If not, it could be because kratom use isn’t prevalent near you. Kratom is a plant in the coffee family that, in low doses, can act as a stimulant, and in high doses, can act as an opioid. As a result, many Americans have turned to the plant as a form of alternative medicine, using kratom to homeopathically treat conditions like opioid use disorder, chronic pain, and lethargy. Despite lacking research and a high potential for addiction, kratom’s popularity continues to rise, but not everywhere. Keep reading to find out where in the U.S. kratom has gained a foothold.
Who Uses Kratom?
To better understand where kratom use is prevalent in the U.S., it’s useful to understand a little bit about the average kratom user. Just shy of 1% of Americans over the age of 12 used kratom in 2020, which amounts to around 2.1 million people. The overwhelming majority of these users were older than 25, which puts the average kratom user at between 25 and 44 years of age.
A more detailed analysis of kratom users finds that the average user ages 25-44 is white and male, and often educated to or through college, and are employed. These users are predominantly middle-class, and reside in suburban communities.
However, because kratom acts on opioid receptors in the brain, some turn to the plant to alleviate symptoms of opioid withdrawal or to supplant opioid use entirely. As a result, kratom use is also rising in a second demographic: those affected by the opioid epidemic. A growing subset of kratom users are often those reporting nonmedical opioid use and a history of substance abuse disorder (SUD). Prior opioid use is the strongest predictor of kratom use, with those suffering from SUD having a five-times greater chance of being a kratom user.
Finally, local and statewide regulations also shape kratom use patterns throughout the United States. Despite the FDA’s lack of action on kratom regulation, more states across the nation have recognized the dangers of kratom use and enacted bans or strict regulations on use. Currently, Kratom is banned in six states: Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin. Small jurisdictions, such as the city of Denver in Colorado, have also passed their own, smaller-scale kratom bans.
Where in the U.S. Is Kratom Use Prevalent?
Rural Regions
The first noteworthy trend in kratom use is its prevalence in rural American communities, despite its perception as being a more trendy, cosmopolitan habit. Opioid use in rural communities is significantly higher per-capita than anywhere else in the U.S.; opioid prescribing is 33% higher in rural communities, and opioid deaths are 20-30% higher outside of cities. These statistics, combined with greater difficulty accessing healthcare resources in rural regions, paint a clear picture of why kratom use is greater in rural regions: it’s easy to access, and cheaper. Of all lifetime kratom users in the U.S., the greatest proportion lived in non-metro (or rural) areas of the country.
States
While kratom use appears to be highest in rural and small metro areas, it is also more prevalent in some states than others. Kratom appears to be most prevalent in Florida, which matches a slight trend in increased use in the American South. Based on crowdfunded search analyses, Floridians were more likely to report kratom use than citizens of any other state, which could also arise from the state being home to a greater proportion of Americans suffering from substance abuse. Kratom use is also elevated in a few Western states, most notably Oregon, California, and Idaho, which may arise due to a greater perceived cultural influence of wellness practices and alternative medicines.