Addiction Specialists’ Knowledge About and Assessment Practices for Kratom, Phenibut, and Tianeptine

Abstract

Background: Kratom, phenibut, and tianeptine are marketed as “nootropics” or cognitive enhancers but carry significant risk for misuse and addiction. Their widespread availability through internet and retail outlets, where they are often illegally marketed as dietary supplements, allows them to bypass regulatory oversight. We evaluated the knowledge, attitudes, and clinical practices of attendees at a national addiction conference regarding these little-known emerging substances. Methods: We conducted a cross-sectional, 46-item web survey of attendees at a national addiction conference attending a dedicated nootropics session. Items assessed self-reported knowledge, perceived patient use, assessment practices, and opinions on regulation regarding kratom, phenibut, and tianeptine. Responses were collected using Qualtrics and rated on 5-point Likert scales. Chi-square tests examined exploratory subgroup differences. Results: Thirty-four of 59 eligible attendees responded (34/59, 57.6%). Most were physicians (31/34, 91%) and female (18/34, 53%). Most (21/34, 61.8%) reported limited knowledge about nootropics, particularly regarding phenibut (22/34, 64.7%) and tianeptine (20/34, 58.8%). Despite limited self-assessments of knowledge, most respondents were concerned about the accessibility of kratom, phenibut, and tianeptine (31/34, 91.2%) and their use among patients (23/34, 67.6%). The majority also supported stronger regulatory oversight (24/34, 70.6%) and almost all endorsed the need for further research (33/34, 97.1%). Conclusions: Surveyed respondents attending a dedicated nootropics session at an addiction conference reported substantial knowledge gaps about kratom, phenibut, and tianeptine, yet consistently endorsed the need for greater regulation and research. Clinical assessment practices and educational strategies warrant further study.