@article{ref1,
title="A case of fatal overdose involving both hydromorphone and kratom",
journal="Journal of forensic sciences",
year="2023",
author="Shi, Thomas and Shea, Jennifer L.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Kratom is a plant originating in Southeast Asia that has been used for its dose-dependent stimulant and opioid effects. The main active compound in kratom is mitragynine, an alkaloid with affinity for the mu-opioid receptor. Toxicity and fatalities related to kratom use have increased substantially in recent years. In this case report, we describe a 44-year-old man who was found deceased in bed. The only significant finding at autopsy was abdominal distension with >4 L of ascites. Toxicology testing was performed on femoral blood which showed 79 ng/mL of hydromorphone, 560 ng/mL of mitragynine, and 240 ng/mL of olanzapine. In addition, creatinine and urea in vitreous humor were significantly elevated, consistent with renal impairment. Death was attributed to hydromorphone toxicity with mitragynine being a contributing factor.<p /> <p>Language: en</p>",
language="en",
issn="0022-1198",
doi="10.1111/1556-4029.15394",
url="http://dx.doi.org/10.1111/1556-4029.15394"
}