(86) Health Claims and Marketing Practices in the Online Kratom Marketplace

Background & Introduction: Kratom (Mitragyna speciosa) is a federally unregulated botanical with opioid- and sedative-like effects that is increasingly accessible through online markets. The Drug Enforcement Administration (DEA) proposed placing kratom and mitragynine into the controlled substance schedule I; however, widespread opposition led to an indefinite hold on this action. Kratom remains listed only as a “Drug and Chemical of Concern,” while the Food and Drug Administration (FDA) has recommended scheduling action for its derivative, 7-hydroxymitragynine. Online kratom vendors employ explicit and implicit health claims, persuasive marketing strategies, and provide insufficient safety information, which may mislead consumers and increase adverse outcomes. This study evaluated the information provided to consumers on kratom vendor websites, determined the prevalence and types of health claims made, and reviewed disclaimers, side effect warnings, dosing recommendations, age restrictions, and marketing strategies.

Methods: This cross-sectional, qualitative study was conducted over an eight-day period. Fifty-one kratom vendor websites were identified and screened from the American Kratom Association’s list of Good Manufacturing Practice (GMP)-qualified vendors, of which 36 met the inclusion criteria. Website content was extracted using a web scraper tool, organized using natural language processing software, and analyzed using a standardized template. Two researchers independently verified the data. Descriptive statistics, chi-square tests, odds ratios, and sentiment analysis were used to assess associations between key variables.

Results: Of the 36 websites analyzed, 89% contained health claims (39% explicit, 89% implicit), with the majority related to mood enhancement (86%) and cognitive focus (81%). Health claims demonstrated a strongly positive sentiment (mean = 0.88). Age restrictions were present on all websites (100%), while dosing recommendations (50%), disclaimers (92%), and potential adverse effects (94%) were variably reported. Marketing techniques identified included social media links (72%), user testimonials (78%), and scientific references (22%). Implicit claims were significantly associated with social media links (p = 0.02, OR = 10.7), whereas explicit claims were significantly associated with the use of scientific references (p = 0.001, OR = 21.0).

Conclusion & Discussion: Online kratom vendors employ widespread implicit and occasional explicit health claims that may violate FDA and Federal Trade Commission (FTC) regulations governing the marketing and packaging of unregulated products. These findings raise significant public health concerns, as such language may encourage self-medication for conditions including anxiety, depression, or chronic pain. Additionally, the strongly positive sentiment observed in these health claims reflects the optimistic emotional tone vendors seek to convey. Despite the frequent inclusion of disclaimers and adverse effect warnings, the overall kratom advertising landscape remains persuasive and potentially misleading to consumers. These findings underscore the need for enhanced regulatory oversight and clearer guidance to protect consumer health and safety. Limitations include small sample size, cross-sectional design, selection bias from using GMP-qualified vendors, and potential subjectivity in claim classification.

References: 1. Eastlack SC, Cornett EM, Kaye AD. Kratom—Pharmacology, Clinical Implications, and Outlook: A Comprehensive Review. Pain Ther. 2020;9(1):55-69. doi:10.1007/s40122-020-00151-x
2. Prozialeck WC, Avery BA, Boyer EW, et al. Kratom policy: The challenge of balancing therapeutic potential with public safety. Int J Drug Policy. 2019;70:70-77. doi:10.1016/j.drugpo.2019.05.003
3. Henningfield JE, Grundmann O, Huestis MA, Smith KE. Kratom safety and toxicology in the public health context: research needs to better inform regulation. Front Pharmacol. 2024;15. doi:10.3389/fphar.2024.1403140