Is commercial kratom being spiked with a naturally occurring potent opioid

January 24, 2017, 2:15 pm

 

★★★½☆

Suspected Adulteration of Commercial Kratom Products with 7-Hydroxymitragynine. Lydecker AG et al. J Med Toxicol 2016;12:341-349.

Abstract

This well done paper provides — among other things — a helpful short review kratom, a psychoactive product  derived from the Mitragyna speciosa plant.

M speciosa contains more than 40 distinct alkaloids. The primary alkaloid — mitragynine — is an opioid agonist at the mu and delta receptors. Mitragynine has about 33% the opioid potency of morphine.

A minor component of M speciosa —  7-hydroxymitragynine — is a much more potent  opioid agonist with about 17 times the mu-receptor activity of morphine. However, it is normally present in only small amounts in the plant (approximately 2% of content.) This alkaloid produces much of the analgesic effect attributed to kratom. In animal models it has been shown to produce dependence, tolerance, and cross-tolerance to morphine.

The effects of kratom are often described as dose-dependent, with low doses producing stimulation while higher doses produce opioid-like manifestations. This phenomenon may be related to the relative amounts of mitragynine and 7-hydroxymitragynine in the plant.

This authors purchased several commercially-available kratom preparations and quantitatively analyzed the amounts of the 2 alkaloids present. They found amounts of 7-hydroxymitragynine in most of those products. They conclude:

We have found multiple packaged commercial Kratom products to contain artificially elevated concentrations of7-hydroxymitragynine, the alkaloid responsible for M speciosa‘s concerning mechanistic and side effect profile. The amount of 7-hydroxymitragynine exceeded that found in naturally occurring material by up to 500%.

The authors argue that this observation can not be explained by natural chemical conversion or variation in alkaloid content among different specimens of the plant. They suggest that the most convincing explanation is that some products had been spiked with added 7-hydroxymitragynine, and that these products should be regulated more closely by the FDA.

Although it is not remarked upon in the body of the paper. I note from Table 2 that all the products with elevated 7-hydroxymitragynbine levels came from the same manufacturer.

The legal situation regarding kratom is somewhat murky. Although it is legally available in most states, the FDA has seized shipments into the country. Last year, the DEA announced their intention to classify the active alkaloids in kratom as Schedule I drugs. There were strong protests against this move by people who use kratom for pain control or to alleviate withdrawal symptoms, as well as inquiries from members of congress. As a result, the DEA ended up delaying the rescheduling.

The long recent feature on kratom from PBS Newshour at the head of this post is excellent and balanced and well worth watching.

Related posts:

Kratom, it’s a stimulant AND it’s an opioid

Kratom: a unique leaf with stimulant and opiate-like effects

Hepatotoxicity from abuse of kratom: first reported case

 

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