Kratom use in the U.S. is rising, with diverse products making assessment and diagnosis complex. Kratom Use Disorder (KUD) often differs from severe opioid use disorders, and clinicians should specify product type in evaluation. Treatment should be individualized; use of opioid medications is reserved for cases with co-occurring opioid use disorder. Novel 7-OH products complicate diagnosis and care. Not all kratom use is disordered, so careful, nuanced assessment is essential.

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