Learn about Mitragynine, a compound found in the leaves of a Kratom plant and its impact on poison control centers, investigations of death and/or driving under the influence of drugs (DUID)
- Prevalence in the United States — Increased detection on both postmortem toxicology and DUID investigations
- Poly Drug Intoxication — Mitragynine is often detected in combination with opioids, prescription and over-the-counter drugs
- Poison Control — Call count increase of 400% from 2016-2017 and continues to climb
Kratom use is becoming widespread in the USA and internationally. Its major psychoactive ingredient, Mitragynine, represents significant challenges in both testing and interpretation.
Mitragynine is the primary active drug in the leaves of the tropical tree Mitragyna speciosa. Preparations and extracts of the leaves have historically been used for their psychopharmacological effects in parts of Africa and Southeast Asia, but have gained popularity in the United States. Mitragynine is one of 25 different alkaloids in the Kratom plant, and is considered to be the primary active alkaloid, making up approximately 60% of its alkaloid content.
The effects of typical recreational doses of mitragynine are reported to include euphoria, relaxation, increased energy, analgesia and sensory enhancement. At higher doses the drug is a µ-opioid agonist with analgesic effects and is gaining increasing use to aid as an adjunct to opioid use in the treatment of chronic pain, and is also used in opioid cessation therapies to minimize the effects of withdrawal.
In the US currently, kratom, and mitragynine are not regulated or scheduled at the federal level. Kratom is illegal however in several states and counties. The toxicity of the drug is widely debated—with strong advocates for maintaining its unregulated status as a supplement, while in many regions of the world where it has been used for a much longer time, it is considered a dangerous drug and is scheduled alongside opioids in these countries.
The lab analysis of mitragynine is challenging due to the number of related compounds present in the plant, and the fact that the drug has three chiral centers, with up to eight diastereomers, all with similar mass spectra. In addition, mitragynine has poor stability at room temperature. NMS Labs is the first lab to develop and offer both clinical and forensic testing for this compound.
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