Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological report
BackgroundKratom (Mitragyna speciosa) use in the United States is becoming increasingly popular and its legal status varies widely from state to state. Multiple reports of adverse events associated with kratom use have ranged from liver injury, seizures, psychiatric disturbance, and rarely death.Met...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1332999/full |
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| author | Tyler Torrico Kajal Patel Nicole Nikolov Md. Towhid Salam Md. Towhid Salam Ranjit Padhy David Weinstein |
| author_facet | Tyler Torrico Kajal Patel Nicole Nikolov Md. Towhid Salam Md. Towhid Salam Ranjit Padhy David Weinstein |
| author_sort | Tyler Torrico |
| collection | DOAJ |
| description | BackgroundKratom (Mitragyna speciosa) use in the United States is becoming increasingly popular and its legal status varies widely from state to state. Multiple reports of adverse events associated with kratom use have ranged from liver injury, seizures, psychiatric disturbance, and rarely death.MethodsThis study investigated coroner autopsy reports from Kern County in California for the year 2020 which included qualitative data on substances from blood toxicological reports. Of the 214 opioid-associated accidental overdoses reported, 4 subjects (1.9%) had mitragynine (kratom) exposure on the autopsy report and were included in the study. We reported available demographic information and comorbid substance findings from the associated autopsy reports.ResultsAll 4 individuals with mitragynine (kratom) toxicology had accidental opioid overdose deaths noted in autopsy reports. Each subject also had toxicology positive for at least one other substance. Fentanyl was found in 3 (75%) of the cases and suspected to be the primary contributor to opioid-related deaths in those cases. However, one fatality was without fentanyl, but instead had tested positive for benzodiazepines, cannabis, and other psychiatric medications.DiscussionThe findings of this brief report provide insight into the role that mitragynine (kratom) may have in modulating risk of opioid-related deaths. The combined use of kratom with opioids such as fentanyl appears most likely to increase the risk of a fatal overdose, but it may also occur with other medications such as benzodiazepines and psychiatric medications. It is a serious concern that in the midst of the opioid overdose epidemic there is a growing presence of kratom use in the U.S. population with a largely unregulated status. |
| first_indexed | 2024-03-08T15:30:59Z |
| format | Article |
| id | doaj.art-d3af57c6ef7d416aaba8157dc60aa772 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-03-08T15:30:59Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-d3af57c6ef7d416aaba8157dc60aa7722024-01-10T04:41:28ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402024-01-011410.3389/fpsyt.2023.13329991332999Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological reportTyler Torrico0Kajal Patel1Nicole Nikolov2Md. Towhid Salam3Md. Towhid Salam4Ranjit Padhy5David Weinstein6Department of Psychiatry, Kern Medical, Bakersfield, CA, United StatesRoss University School of Medicine, Miramar, FL, United StatesRoss University School of Medicine, Miramar, FL, United StatesDepartment of Psychiatry, Kern Medical, Bakersfield, CA, United StatesDepartment of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United StatesDepartment of Psychiatry, Kern Medical, Bakersfield, CA, United StatesDepartment of Psychiatry, Kern Medical, Bakersfield, CA, United StatesBackgroundKratom (Mitragyna speciosa) use in the United States is becoming increasingly popular and its legal status varies widely from state to state. Multiple reports of adverse events associated with kratom use have ranged from liver injury, seizures, psychiatric disturbance, and rarely death.MethodsThis study investigated coroner autopsy reports from Kern County in California for the year 2020 which included qualitative data on substances from blood toxicological reports. Of the 214 opioid-associated accidental overdoses reported, 4 subjects (1.9%) had mitragynine (kratom) exposure on the autopsy report and were included in the study. We reported available demographic information and comorbid substance findings from the associated autopsy reports.ResultsAll 4 individuals with mitragynine (kratom) toxicology had accidental opioid overdose deaths noted in autopsy reports. Each subject also had toxicology positive for at least one other substance. Fentanyl was found in 3 (75%) of the cases and suspected to be the primary contributor to opioid-related deaths in those cases. However, one fatality was without fentanyl, but instead had tested positive for benzodiazepines, cannabis, and other psychiatric medications.DiscussionThe findings of this brief report provide insight into the role that mitragynine (kratom) may have in modulating risk of opioid-related deaths. The combined use of kratom with opioids such as fentanyl appears most likely to increase the risk of a fatal overdose, but it may also occur with other medications such as benzodiazepines and psychiatric medications. It is a serious concern that in the midst of the opioid overdose epidemic there is a growing presence of kratom use in the U.S. population with a largely unregulated status.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1332999/fullaccidental overdosedrug abusemitragynineopioidstimulantsubstance abuse |
| spellingShingle | Tyler Torrico Kajal Patel Nicole Nikolov Md. Towhid Salam Md. Towhid Salam Ranjit Padhy David Weinstein Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological report Frontiers in Psychiatry accidental overdose drug abuse mitragynine opioid stimulant substance abuse |
| title | Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological report |
| title_full | Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological report |
| title_fullStr | Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological report |
| title_full_unstemmed | Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological report |
| title_short | Presence of kratom in opioid overdose deaths: findings from coroner postmortem toxicological report |
| title_sort | presence of kratom in opioid overdose deaths findings from coroner postmortem toxicological report |
| topic | accidental overdose drug abuse mitragynine opioid stimulant substance abuse |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1332999/full |
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