Kratom in Clinical Practice: Knowledge, Attitudes, and Screening Behaviors Among U.S.-Based Healthcare Providers

Kratom (Mitragyna speciosa), is frequently used to self-manage pain, reduce opioid use/dependence, and for mood enhancement. Despite growing use in the U.S., little is known about knowledge, attitudes, and screening practices among licensed healthcare providers.

The web-based survey was distributed to U.S.-based licensed healthcare providers between 10/2025-12/2025. Descriptive statistics characterized the participants and group comparisons were conducted using t-tests and chi-square test. A multiple linear regression explored factors associated with frequency of screening for kratom use.

Most providers (N = 136) identified as White (72.8%), female (68.4%), with an average age of 45.1 years. Most participants (78.7%) reported awareness of kratom; 33.6% felt very or extremely comfortable discussing kratom, 41% reported confidence assessing for problematic use. Over half (55.9%) reported treating problematic kratom use or kratom use disorder. Only 7.8% reported always screening, whereas 36.9% reported never screening kratom use in their practice. Self-rated kratom knowledge was the strongest predictor of kratom use screening frequency (β = 0.70, p < 0.001). Female providers reported greater screening frequency than male providers (β = 0.63, p < 0.01). Other predictors were no longer significant after accounting for self-rated knowledge.

Screening for kratom use is not yet well-integrated into clinical practice across disciplines in the U.S. Provider's self-perceived knowledge of kratom appears central to screening practices, underscoring the need for education and assessment strategies to improve identification of kratom use across clinical settings.