A Case of 7-Hydroxymitragynine Use Disorder Treated With Buprenorphine.
Reuben Hendler, Zoe Karavolis, Jungjin Kim et al.
✦ AI-curated · Sources linked
Case in brief
A man in his 30s was hospitalized for intensive treatment of 7-hydroxymitragynine (7-HMG) use disorder. He developed opioid withdrawal symptoms within 8 hours, which were stabilized with methadone 50 mg over 36 hours. Methadone was tapered, followed by low-dose induction of buprenorphine at 16 mg per day. By discharge from residential aftercare, his craving had resolved and co-occurring depression had improved.
What made this case unusual
The case describes treatment of use disorder involving concentrated 7-HMG, a more potent µ-opioid receptor agonist than mitragynine, for which management of withdrawal and addiction has been little described.
Diagnostic / clinical pearl
Withdrawal can emerge rapidly after cessation of 7-HMG use; this patient was stabilized with methadone before transition to buprenorphine by low-dose induction.
Why it matters
Concentrated 7-HMG is increasingly marketed and may be underrecognized. The case highlights a potential role for medication for opioid use disorder, while underscoring the need for further evidence to guide management.