A Case of 7-Hydroxymitragynine Use Disorder Treated With Buprenorphine

Area of Science:

• Pharmacology
• Addiction Medicine
• Toxicology

Background:

• Kratom contains mitragynine and the more potent 7-hydroxymitragynine (7-HMG).
• Concentrated 7-HMG products are increasingly marketed, posing risks due to higher potency.
• Limited research exists on managing 7-HMG withdrawal and addiction.

Purpose of the Study:

• To describe the clinical management of a patient with 7-HMG use disorder.
• To highlight the potential benefits of medication for opioid use disorder (MOUD) in treating 7-HMG addiction.

Main Methods:

• A case study of a male patient in his 30s hospitalized for 7-HMG use disorder treatment.
• Management included stabilization with methadone (50 mg) over 36 hours.
• Tapering of methadone followed by buprenorphine induction (16 mg/day) for craving and depression.

Main Results:

• Opioid withdrawal symptoms emerged within 8 hours and were managed with methadone.
• Buprenorphine treatment led to resolved craving and improved depression.
• The patient showed positive response to MOUD for 7-HMG use disorder.

Conclusions:

• 7-HMG is an underrecognized, potent opioid with increasing public health implications.
• Medication for opioid use disorder (MOUD) shows promise for managing 7-HMG use disorder.
• Further research is crucial to understand 7-HMG's effects and refine treatment strategies.