Association between kratom (Mitragyna speciosa Korth.) use and methamphetamine craving in males who used methamphetamine with and without heroin use history.

Field and preclinical studies suggest that kratom (Mitragyna speciosa) may have therapeutic potential in moderating methamphetamine (METH) craving. However, there is a lack of clinical studies to affirm this claim. This study explored patterns and motivations of kratom use among people who used METH with and without a history of heroin use, and determined the associations of kratom use patterns with METH craving. A treatment sample of 403 male respondents who had used METH, with and without kratom and with and without a history of heroin use was recruited for this cross-sectional study. A semi-structured questionnaire including Kratom Dependence Scale (KDS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Visual Analog Scale was administered. Our results showed that none of the assessed kratom use indicators were identified as risk factors for the presence of METH craving. Only heroin use history (aOR = 2.61, p = 0.014) and somatic/vegetative symptoms related to depression (aOR = 1.26, p = 0.023) were risk factors for the presence of METH craving. A significant association between the severity of METH craving and age at first kratom use (β = -0.19, p = 0.0497) was observed among people who used METH with a history of heroin use. Our findings suggest that kratom use patterns may influence METH craving among people who used METH with a history of heroin use. These findings further support the perceived self-therapeutic utility of kratom among people who use drugs (PWUDs).