A year after we first took a look at mitragynine (kratom), we are back with an update episode looking at how the landscape surrounding mitragynine is evolving.

We begin by examining poison centre data, exploring trends in reported exposures in the US and internationally, and the increase in its use.

We then discuss a case involving semi-synthetic mitragynine derivatives, including 7-hydroxymitragynine and mitragynine pseudoindoxyl, highlighting the clinical features including dose escalation, and challenges associated with withdrawal.

Finally, we turn to reports of combined use of kratom and kava, and consider how this may influence toxicity and withdrawal.

Join us as we examine emerging data, evolving patterns of use, and the clinical implications of mitragynine and its derivatives, and consider what these findings mean for toxicology and public health.

Hope you enjoy!

If you'd like us to cover an episode on Kava, please let us know in the comments!

Links to the papers we discussed:

https://www.cdc.gov/mmwr/volumes/75/wr/mm7511a1.htm

https://www.cureus.com/articles/467977-severe-early-onset-withdrawal-following-intentional-use-of-mitragynine-pseudoindoxyl-a-case-report-and-emerging-clinical-considerations#!/

https://www.cdc.gov/mmwr/volumes/75/wr/pdfs/mm7512a1-H.pdf

https://journals.lww.com/journaladdictionmedicine/abstract/9900/kava_potentiated_withdrawal_in_persons_using.687.aspx

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