Assessment, Prediction, and Treatment Unit, National Institute on Drug Abuse Intramural Research ProgramReal-world, Baltimore, MD, USA.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Am J Drug Alcohol Abuse. 2022 Nov 2;48(6):684-694. doi: 10.1080/00952990.2022.2083967. Epub 2022 Jun 29.
(kratom) is increasingly used in the United States for its pharmacological effects. Kratom's relative novelty makes for a dynamic situation, such that use motivations are not firmly established and may be changing. Investigators and clinicians require frequent updates on kratom trends. To assess the current state of kratom-use initiation, sourcing, motivations, preference, conceptualizations, and perceived stigma, using survey responses from current and former users. Between April-May 2021 we recontacted 289 respondents who reported lifetime kratom use (on an unrelated survey) to answer kratom-specific questions. The sample (N=129) was majority female (51.9%) and white (71.9%). Most (69.0%) reported first trying kratom after 2015. Mean age of use initiation (29.9 years) was older than for other substances, including opioids. Kratom ranked as a preferred substance by 48.5%. The strongest drug association with past-year kratom use was vaped nicotine (3.31,95% CI 1.23-8.88). Use was less likely among those prescribed buprenorphine in the past year (0.03, CI 0.01-0.28). Past-month cannabis use (4.18,CI 1.80-9.72) had the strongest association with past-month kratom use. Over 40 use motivations were endorsed, many (but not all) supporting the "self-treatment" narrative of kratom use, including use as an opioid, alcohol, or stimulant substitute. Treatment shortfalls were associated with decisions to try kratom. Kratom use motivations are diversifying, with multiple factors driving use. As sales continue to increase, the public-health, clinical, and policy responses to kratom should be grounded in rigorous bench-to-bedside scientific research. Comprehensive study of kratom is currently lacking.
（“咔哇潮饮”）在 美国，由于其药理学作用，使用量日益增加。咔哇潮饮相对较新，因此使用动机尚未确定，而且可能在不断变化。调查人员和临床医生需要经常了解咔哇潮饮的趋势。本研究旨在评估当前咔哇潮饮使用的起始、来源、动机、偏好、概念化和感知污名状况，使用目前和以前使用过咔哇潮饮的参与者的调查应答。在 2021 年 4 月至 5 月期间，我们联系了 289 名报告有终身咔哇潮饮使用史（在一项无关的调查中）的应答者，要求他们回答与咔哇潮饮相关的问题。样本（N=129）主要为女性（51.9%）和白人（71.9%）。大多数人（69.0%）表示他们在 2015 年以后首次尝试咔哇潮饮。使用起始年龄（29.9 岁）大于其他物质，包括阿片类药物。48.5%的人表示咔哇潮饮是他们首选的物质。过去一年使用咔哇潮饮与过去一年使用电子烟尼古丁的关联最强（3.31，95%CI 1.23-8.88）。过去一年服用丁丙诺啡的人使用咔哇潮饮的可能性较低（0.03，CI 0.01-0.28）。过去一个月大麻的使用（4.18，CI 1.80-9.72）与过去一个月使用咔哇潮饮的关联最强。超过 40 种使用动机得到了认可，其中许多（但不是全部）支持咔哇潮饮使用的“自我治疗”说法，包括将其用作阿片类药物、酒精或兴奋剂替代品。治疗缺陷与尝试咔哇潮饮的决定有关。咔哇潮饮的使用动机正在多样化，多种因素驱动着使用。随着销售继续增加，应对咔哇潮饮的公共卫生、临床和政策应立足于严格的基础到床边的科学研究。目前缺乏对咔哇潮饮的综合研究。
