JMIR Publications

ABSTRACT

Background:

Kratom (Mitragyna speciosa) and kratom-derived products are increasingly encountered through online vendors, social media, forums, video platforms, public comment spaces, and retail-linked digital advertising. Newer products containing added or concentrated 7-hydroxymitragynine (7-OH) or mitragynine pseudoindoxyl have intensified public-health concern because they may be marketed under the broad label of kratom while differing from traditional leaf or powder products. Digital environments may shape consumer perceptions by emphasizing natural, therapeutic, functional, or harm-reduction narratives while providing inconsistent information about dependence, withdrawal, product variability, and safety.

Objective:

This review aimed to map empirical evidence on how kratom, 7-OH, mitragynine pseudoindoxyl, and related kratom-derived products are represented, marketed, and discussed in digital environments, with attention to benefit claims, risk messaging, product-form distinctions, and gaps for future infodemiology research.

Methods:

A scoping evidence map was conducted using a PRISMA-ScR–informed rapid review workflow. Two retained database exports were audited: a Scopus export and an FIU Libraries discovery-layer RIS export. After deduplication by DOI and title-year, 2920 unique records remained for screening. Sources were eligible if they focused on kratom, 7-OH, mitragynine, mitragynine pseudoindoxyl, or clearly kratom-derived products and empirically analyzed a digital environment, including social media, forums, Reddit, Facebook, YouTube, Erowid, public comments, vendor websites, product pages, online markets, or online product marketing. Narrative reviews, editorials, agency webpages, offline-only clinical or toxicology studies, and online surveys that did not analyze the online information environment itself were excluded. Data were charted by platform, study design, sample or unit of analysis, product type, claims, risk themes, marketing patterns, and limitations, then synthesized narratively.

Results:

Of 2920 unique records, 2879 were excluded at title, abstract, and gateway screening. Forty-one reports underwent detailed assessment, 21 were excluded with record-level reasons, and 20 empirical digital-environment sources were included. Included sources examined Reddit, Facebook, YouTube, Erowid experience reports, FDA public comments, social-media corpora, online vendor websites, darknet or cryptomarket listings, ready-to-drink product websites, and online pages for 7-OH or mitragynine pseudoindoxyl products. Across sources, kratom was frequently framed as self-treatment, harm reduction, natural wellness, functional enhancement, or a safer alternative to regulated substances. Commonly discussed motivations included pain, anxiety or depression symptoms, opioid withdrawal, fatigue, focus, energy, and mood. Vendor and product-marketing studies documented incomplete consumer health information, limited balanced risk communication, variable disclosure of dependence or withdrawal risks, and emerging concern around concentrated alkaloid products, beverages, gummies, tablets, strips, and other consumer-friendly dosage forms.

Conclusions:

The digital kratom literature is small but coherent. Online discourse and marketing frequently present kratom and related products as natural, therapeutic, functional, or useful for self-treatment, while risk communication is inconsistent. Emerging evidence on concentrated 7-OH, mitragynine pseudoindoxyl, ready-to-drink products, and youth-appealing dosage forms highlights the need to distinguish botanical kratom leaf or powder from extracts and concentrated alkaloid products. Clinicians and public-health professionals should ask not only whether patients use kratom, but also what product form they use, why they use it, where they learned about it, and whether they understand potential risks related to product variability, dependence, withdrawal, and co-use. Future infodemiology research should directly examine short-form video platforms and performance-oriented marketing. Clinical Trial: Not applicable. This study is a scoping evidence map and did not involve a clinical trial.