Kratom use among ethnobotanical tea bar patrons in Colorado: Subjective drug effects, adverse reactions, and perceived benefits of use.

Introduction: Kratom use is increasing in the US, yet data characterizing use patterns, risks, and benefits is limited. Additionally, there are few data on the acute subjective effects of kratom in humans, and no studies to-date have examined kratom use within US public consumption settings, which have become increasingly popular in recent years. Methods: Using field methods, we administered surveys to 102 ethnobotanical tea bar patrons in northern Colorado. Surveys assessed demographic information, kratom use patterns, perceived benefits, and adverse reactions. We also assessed subjective drug effects acutely after participants consumed kratom at the bars. Data were analyzed using a mixed-methods approach. Results: Participants (mean age=22.34 years, 39.2 % women), reported frequent kratom use (73.4 % endorsed weekly use, 19.3 % endorsed daily use). Reported benefits included mental and physical health benefits, social enhancement, and substance use harm reduction. Adverse reactions primarily involved gastrointestinal issues, though acute psychological effects (e.g., anxiety), and withdrawal symptoms were also cited. Kratom use in a bar setting was associated with acute stimulation and mild euphoria, and minimal sedation. Conclusions: While most participants reported perceived benefits, the presence of adverse reactions highlight the need for more data on safety and risks of kratom use, particularly within public consumption spaces. Results also highlight the possible role of kratom in supporting substance use disorder recovery, with some ethnobotanical tea bars potentially functioning as recovery spaces.