[2026-01-26] Exploring Kratom Use in High-Prevalence Areas of Southern Thailand: Attitudes, Knowledge, and Consumption Patterns – A Mixed-Methods Study
DOI:
https://doi.org/10.33165/rmj.2026.e272935Keywords:
Mitragyna speciosa, Kratom, Consumption patterns, Behavioral predictors, Southern ThailandAbstract
Background: Kratom (Mitragyna speciosa), a tropical tree native to Southeast Asia, has traditionally been used in Thailand for medicinal and recreational purposes. Although recently legalized for medicinal use, concerns remain regarding its safety and potential for abuse.
Objectives: To investigate kratom consumption patterns and identify demographic, behavioral, and cognitive predictors of current and harmful use in high-prevalence rural communities in southern Thailand.
Methods: A cross-sectional study was conducted among 169 participants from southern Thai communities with high kratom use. A structured questionnaire assessed demographics, attitudes, knowledge, and usage patterns. Harmful use was defined as consumption of more than 20 leaves per day. Multiple logistic regression analysis identified predictors of current and harmful use.
Results: Among participants, 45 (26.6%) were current users, and of those 22 (48.9%) met the criteria for harmful use. Predictors of current use included younger age (adjusted OR [AOR], 0.97; 95% CI, 0.94-0.99), tobacco use (AOR, 16.12; 95% CI, 5.01-51.86), poor mental health (AOR, 8.8; 95% CI, 2.2-35.16), and favorable attitudes toward kratom (AOR, 1.12 per point; 95% CI, 1.06-1.18). Harmful use was associated with long-term consumption (AOR, 10.54; 95% CI, 1.01-109.9), boiling as the method of use (AOR, 80.96; 95% CI, 4.98-1315.6), and lower knowledge scores (AOR, 17.8; 95% CI, 1.57-201.68).
Conclusions: Current and harmful kratom use are linked to specific demographic and behavioral factors. These findings support the need for targeted public health education and regulation in high-risk communities.
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