His initial reasons for trying were twofold: severe, chronic pain (with concomitant sleeping disturbances) from an 8-year-old construction accident, and wanting to abstain from opioids: "I had an issue with pain pills...I played football in college in the '80s, and here they handed them out like candy. I got my first (oxycodone product) when I was 14 years old...we didn't know the dangers of it, but it got to the point where, you know...I would get a prescription...and that would last me maybe 3 days...I really got dependent on them. I got clean without the kratom. I realized there was a problem there, you know? I actually went to rehab...went to a sober living house for a while because...I gave up control of it...I tried everything." 
Following his injury and surgeries, he always "over-took the pain medicine." He expressed frustration that he reached a point where he could not continue using opioids, but still needed pain management:his primary reason for continued kratom use: "... it's definitely not an opiate, but it's way better than ibuprofen...it's not so much 'peaks and valleys.' The opioids it seems like, you know, they come on and they hit you and you get the euphoric rush and then it's all downhill... after, I'd say, an hour or two, after taking the opiates, the beneficial part was over. It was all the detrimental part. It was the itching, it was the sweating, it was the craving for more. With this, it's kind of smoother. It's not as high, but it's also not as low...I always wanted more [opioids]; with kratom, if I take too much, ugh, it gives me kind of a 'blah' feeling, it's kind of a negative return on investment, I guess you'd say. I don't know, it's not like I feel like I could overdo it." 
Describing a time when he took too much kratom during his dose-finding phase: "...it's like when you do cocaine and you have all the energy in the world, but you can't get out of your chair, you know? It's like this restlessness but inability to act on it." During that dose-finding, when he used 4 times per day, he had experienced perspiration and difficulty sleeping. Now, using less, he said he has no unwanted effects (but dislikes kratom's taste).
Although he used primarily for analgesia, he noted other benefits: "...it kind of helps my focus you know?... it seems like I'm a little more on task and a little more, you know, productive throughout the day with [kratom]." He elaborated that kratom helps him work or exercise at modest doses: "Less IS more. You know? And if I just need an energy boost, I'll take one scoop instead of two, you know? If I'm just feeling a little sluggish and want to go to the gym. When I have pain, I'll take two, but if I just need a little bit of energy I'll take one and it works way better." 
When asked whether kratom helped him resist temptations to return to opioid use: "Oh, for sure. No, this is something that's legal, and it's something that... I don't feel there's an element of danger to it, I mean... that's why I want to participate in the study, because if you guys find out that it turns your liver purple or something... [laughs] you know, I'd like to know that...as far as I'm concerned, it's just kind of a juiced-up version of coffee... I mean, it's a step above, like I said, it's not an opiate, but it's not ibuprofen." 
Although he never attempted quitting, he discontinued use for 3 weeks when moving. Withdrawal symptoms did not begin until 3 days after his last dose. These included restless legs, muscle clenching/spasms, cold sweats, and irritability. Comparing kratom withdrawal to opioid withdrawal, he responded: "(laughs) not even close. A walk in the park" 
He was the only participant to describe encountering adulteration: he had tested positive for opioids on a urine drug screen for work after having used only kratom products. This incident, along with other kratom marketing trends and lack of standardization, disturbed him: "Turn off the hype machine. All the BS with the different strains... and this and that, the vape pen, and whatever kind of BS. Legitimize your product. Standardize dosages. Make it easy for people to figure out...I know there's charts that they say, you know, 2-4 g for this, 4-6 for that, 6-8 for this. Come on... just try to do your best to put on a standardized product, and sell it for what it is, you know?!?...Once the marketing people get into it, you know, then you have [kratom] gummies, and you have all this stuff...have ya tried a gummy?! They're awful!"