Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Mail Slot 611, Little Rock, AR 72205, USA.
Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Mail Slot 611, Little Rock, AR 72205, USA.
Int J Drug Policy. 2022 Oct;108:103817. doi: 10.1016/j.drugpo.2022.103817. Epub 2022 Aug 8.
The legal status of kratom in the United States is complex and varies by state. The U.S. Food and Drug Administration (FDA) and the U.S. Drug Enforcement Administration have repeatedly subjected kratom to regulatory review. However, there hasn't been a systematic review of the public's perception of kratom. The present study analyzed open-ended responses from the public to an FDA solicitation for information regarding kratom with the goal of providing a comprehensive assessment of motives for kratom use.
To guide decisions regarding kratom regulation, the FDA solicited comments regarding kratom abuse potential, medical usefulness, and impact of scheduling changes from July through August 2021 and posted them to the Federal Register website. We analyzed comments posted during the first 6 weeks of comment solicitation (6,353) using an inductive approach via qualitative content analysis.
Respondents reported 106 independent health-related reasons for kratom use, with most categorized as mental health, pain management, substance use disorder, or miscellaneous purposes that included increasing focus, treating insomnia, and decreasing fatigue. Neurological diseases and digestive disorders were also reported. Relatively few (< 2%) responses reported recreational use, abuse potential, or adverse effects of kratom.
Although kratom is not approved as a safe and effective therapy for any indication, individuals use kratom for a broad spectrum of health-related purposes. Limitations of this study include potential bias for respondents with perceived positive experiences using kratom, lack of demographics data, and lack of independent verification of claims made by respondents. Regardless, this study reflects perceptions regarding the therapeutic uses of kratom and provides insight into potential individual-level consequences of regulating kratom in the U.S. It is important to study the public's perception of kratom use, which can aid regulatory purposes and provide clinically important information on individuals' use and valuation of kratom.
美国的咔哇潮饮法律地位复杂，各州情况不同。美国食品和药物管理局（FDA）和美国缉毒署（DEA）曾多次对咔哇潮饮进行监管审查。然而，目前尚未对公众对咔哇潮饮的看法进行系统审查。本研究分析了公众对 FDA 征求咔哇潮饮信息的开放式回复，目的是全面评估咔哇潮饮使用的动机。
为指导咔哇潮饮监管决策，FDA 征求了有关咔哇潮饮滥用潜力、医学用途以及时间表变更影响的意见，并在 2021 年 7 月至 8 月期间将其发布在联邦公报网站上。我们通过定性内容分析，对征求意见的前 6 周（6353 条）发布的评论进行了分析。
受访者报告了 106 个独立的与健康相关的咔哇潮饮使用原因，其中大多数与心理健康、疼痛管理、物质使用障碍或包括提高注意力、治疗失眠和减少疲劳在内的其他用途有关。还报告了神经疾病和消化疾病。相对较少的（<2%）的回复报告了咔哇潮饮的娱乐用途、滥用潜力或不良影响。
尽管咔哇潮饮尚未被批准为任何适应症的安全有效治疗方法，但个人将咔哇潮饮用于广泛的健康相关用途。本研究存在一些局限性，包括对认为使用咔哇潮饮有积极体验的受访者存在潜在偏见、缺乏人口统计学数据以及缺乏对受访者所做声明的独立验证。尽管如此，本研究反映了对咔哇潮饮治疗用途的看法，并为了解美国监管咔哇潮饮的潜在个体层面后果提供了见解。研究公众对咔哇潮饮使用的看法很重要，这有助于监管目的，并为个人对咔哇潮饮的使用和评估提供重要的临床信息。
