157: Self-perceived Differential Effects of Kratom (Mitragyna speciosa Korth) “Strains” Do Not Correlate With Alkaloid Content

Statement of Purpose: Preparations of Kratom (Mitragyna speciosa, Rubiaceae) are being used by approximately 5-15 million adults in the US alone. These products are often sold as different “strains” which are all harvested from the same tree native to Southeast Asia. Marketing of kratom “strains” purport different effects that have not been evaluated in the literature or attributed to specific kratom alkaloids. We conducted an anonymous online survey among kratom users to evaluate if self-reported motivations to consume and effects of kratom “strains” align with advertised effects.

Description of Methods & Materials: The anonymous online survey was conducted between July and September 2022 and distributed to current kratom users by distributors, through social media, and websites. A total of 644 responses were included in the final analysis. Validated questionnaires were used to determine motives for use and effects of kratom “strains”. Correlational analysis of nominal data was conducted using a Chi-square or Friedman test for motivations and effects of kratom “strain” use while Student’s t-test and one-way ANOVA analysis followed by post-hoc Bonferroni comparison were used for interval data with significance set to p≤0.05.

Data & Results: Six kratom products (2 white, 2 red, and 2 green “strains”) were ranked by respondents (59 responses for red, 43 for white, and 98 for green) according to their preferred uses. Feeling less anxiety and/or stress was ranked highest by all “strain” users while improving the effects of other substances was ranked last. Motivations for red “strain” use were ranked significantly higher for treating a medical condition (p=0.049), helping to relax or sleep (p < 0.001), or to induce or enhance a spiritual experience (p=0.021) compared to other strains. The motivations for using white “strains” were ranked significantly higher for improved concentration, study, or work (p=0.001) and to be more sociable (p=0.005), while green strains” were significantly higher ranked for improving mood or feeling less depressed (p=0.007) versus other strains. On a visual analogue scale, the effects of white “strains” were significantly higher rated for increasing concentration compared to red “strains” (p=0.017). Certificates of analysis provided by the supplier of the kratom strains did not identify significant differences in alkaloid content.

Interpretation, Conclusion or Significance: Despite an increasing consumer market for kratom products in the US, substantial variability in composition and a lack of regulation allow for unsubstantiated benefit claims. Kratom users and their healthcare providers should be aware that different colored ”strains” may not exert a distinct pharmacological effect. Further clinical research is needed to distinguish perceived from objective effects to better inform consumers and healthcare professionals.

Disclosures: The authors declare no conflicts of interest.