Date of Award

5-10-2026

Date Published

June 2026

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Psychology

Advisor(s)

Joseph Ditre

Keywords

Kratom;Mitragynine;Opioid misuse;Opioids;Psychological distress;Veterans

Subject Categories

Psychology | Social and Behavioral Sciences

Abstract

Kratom (Mitragyna speciosa) is a plant-derived substance increasingly used in the United States for its reported stimulant and analgesic effects. Although many adults report using kratom to self-manage pain, psychological distress, and symptoms of prescription opioid withdrawal, sustained or heavy use may produce tolerance and withdrawal. U.S. military veterans experience disproportionately high rates of chronic pain, prescription opioid exposure, opioid-related harms, and co-occurring psychological distress, suggesting kratom use may be especially relevant among veterans. The present study used pooled 2021–2023 NSDUH data to provide the first nationally representative comparison of kratom use among veterans and non-veterans and to examine whether, among veterans, past-year kratom use (vs. never use) was associated with prescription opioid-related variables and psychological distress. Descriptive analyses estimated the prevalence of lifetime, past-year, and past-month kratom use and compared veterans and non-veterans on sociodemographic, health-related, prescription opioid, and psychological distress indicators. Among veterans, multivariable logistic and linear regression models tested whether past-year kratom use was associated with prescription opioid use, prescription opioid misuse, prescription opioid use disorder (POUD), and psychological distress. Prevalence of kratom use did not differ as a function of veteran status. Among veterans, past-year kratom use was associated with greater odds of prescription opioid use, prescription opioid misuse, and POUD, but not psychological distress. Findings suggest that veterans who report kratom use may represent a subgroup at elevated risk for opioid-related involvement and harms. Further research is needed to identify whether these patterns reflect prescription opioid substitution, supplementation, or both. This and future work may inform clinical screening and harm reduction strategies for veterans.

Access

Open Access

Available for download on Thursday, June 17, 2027

Included in

Psychology Commons

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