Management of acute withdrawal from 7-hydroxymitragynine following high-dose chronic use: A case report - PubMed
8 days ago
- #7-hydroxymitragynine
- #opioid withdrawal
- #kratom
- A case report details acute opioid withdrawal symptoms in a 43-year-old male after abrupt cessation of high-dose 7-hydroxymitragynine (7-OH), a concentrated kratom derivative.
- Symptoms included nausea, diarrhea, abdominal cramping, restlessness, chills/clamminess, and anxiety, with a Clinical Opioid Withdrawal Scale (COWS) score of 5.
- The patient transitioned from kratom to 7-OH 18 months prior due to perceived stronger opioid-like effects and smaller quantities needed to avoid withdrawal.
- Emergency department management involved buprenorphine/naloxone, adjunct medications (clonidine, ondansetron, loperamide, methocarbamol, NSAIDs, acetaminophen), and counseling on precipitated withdrawal.
- A Naranjo assessment indicated probable causality (score = 6) for withdrawal symptoms linked to 7-OH cessation.
- The report emphasizes the need for pharmacists to screen for concentrated 7-OH products, manage withdrawal with buprenorphine timing, and incorporate state regulations into patient education.