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A drug fatality involving Kratom.

Michael F Neerman¹, Randall E Frost, Janine Deking

¹Bexar County Medical Examiner's Office, 7337 Louis Pasteur Drive, San Antonio, TX 78229, USA. Michael.Neerman@bexar.org

Journal of Forensic Sciences

|October 23, 2012

Summary

A young man with a history of heroin abuse died, with toxicology revealing mitragynine (Kratom). The Medical Examiner cited possible Kratom toxicity as the cause of death, classifying it as an accident.

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Area of Science:

Forensic Toxicology
Clinical Toxicology
Pharmacology

Background:

A 17-year-old male with a history of heroin abuse and chronic pain self-medicated with Kratom.
Kratom (mitragynine) is a psychoactive substance derived from a Southeast Asian tree, often used for pain relief and recreational purposes.

Observation:

The decedent was found unresponsive with no signs of trauma.
Autopsy revealed pulmonary congestion and edema, and a distended bladder, consistent with opiate use.
Toxicology screening detected therapeutic levels of cold medications and benzodiazepines, alongside a mitragynine level of 0.60 mg/L.

Findings:

The presence of mitragynine at 0.60 mg/L in the context of the decedent's history and autopsy findings.
The Medical Examiner's certification of death due to "possible Kratom toxicity".

Implications:

This case highlights the potential toxicity of Kratom, even at levels not previously considered lethal.
It underscores the importance of comprehensive toxicology in cases of unexplained death, particularly with a history of substance use.
Further research is needed to establish definitive toxic levels and long-term effects of mitragynine.