Global prevalence of kratom use: a meta-analysis focusing on regional and population-level disparities.

This systematic review and meta-analysis synthesized prevalence data from 21 studies conducted in Southeast Asia and the United States to provide the most comprehensive estimate to date of global kratom (Mitragyna speciosa) use. The pooled prevalence was 1.6% (95% CI: 0.6%-3.8%) for current use and 3.8% (95% CI: 1.8%-7.8%) for lifetime use. Prevalence varied substantially across countries and populations, with the highest estimates observed in Thailand and among high-risk and substance-using populations. These differences likely reflect variation in cultural practices, legal frameworks, and study methodologies. Although considerable between-study heterogeneity was identified, the findings indicate that kratom use remains relatively uncommon in the general population but is substantially more prevalent among substance-using populations, highlighting the need for standardized surveillance and targeted public health strategies.