{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T12:53:07Z","timestamp":1793019187009,"version":"4.5.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T00:00:00Z","timestamp":1527811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Academic Forensic Pathology"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:p>Mitragynine is amongst the more than 40 natural indole alkaloids derived from the Mitragyna speciosa, or kratom tree, also referred to as ketum. The compound is unique in that it exhibits dose-dependent clinical outcomes with stimulant effects at lower doses but sedative effects at higher concentrations. It is indigenous to Southeast Asia, where the local population has had extensive experiences utilizing the substance for its medicinal as well as recreational effects. Mitragynine is advertised as an herbal remedy and is readily accessible via the Internet, resulting in its expansive distribution throughout the world. The addictive potential of this substance is quickly becoming recognized and mitragynine has been implicated in multidrug toxicity deaths. We present a case of the first reported mitragynine-associated fatality in Canada where an independently fatal mitragynine concentration was detected in the postmortem femoral venous blood and the source drug was likely obtained as a powder from Indonesia. Acad Forensic Pathol. 2018 8(2): 340-346<\/jats:p>","DOI":"10.1177\/1925362118782076","type":"journal-article","created":{"date-parts":[[2018,6,6]],"date-time":"2018-06-06T10:46:01Z","timestamp":1528281961000},"page":"340-346","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":28,"title":["Fatal Mitragynine-Associated Toxicity in Canada"],"prefix":"10.1177","volume":"8","author":[{"given":"Carol","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo E.","family":"Walker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,6,6]]},"reference":[{"key":"bibr1-1925362118782076","doi-asserted-by":"crossref","unstructured":"Domingo O, Roider G, Stover A, Mitragynine concentrations in two fatalities. Forensic Sci Int. 2017 2; 271: e1\u2013e7. 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An accidental poisoning with mitragnine.\n                      Forensic Sci Int\n                      . 2014 Dec; 245: e29-32. PMID: 25453780. https:\/\/doi.org\/10.1016\/j.forsciint.2014.10.025.","DOI":"10.1016\/j.forsciint.2014.10.025"},{"key":"bibr5-1925362118782076","doi-asserted-by":"crossref","unstructured":"Hassan Z, Muzaimi M, Navaratnam V, From Kratom to mitragynine and its derivatives: physiological and behavioral effects related to use, abuse and addiction. Neurosci Biobehav Rev. 2013 2; 37(2):138\u201351. PMID: 23206666. https:\/\/doi.org\/10.1016\/j.neubiorev.2012.11.012.","DOI":"10.1016\/j.neubiorev.2012.11.012"},{"key":"bibr6-1925362118782076","doi-asserted-by":"crossref","unstructured":"Babu KM, McCurdy CR, Boyer EW. Opioid receptors and legal highs: salviadivinorumandKratom.ClinToxicol(Phila).2008 2;46(2):146\u201352. 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Available from: http:\/\/healthycanadians.gc.ca\/recall-alert-rappel-avis\/hc-sc\/2017\/63338a-eng.php."}],"container-title":["Academic Forensic Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1925362118782076","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1925362118782076","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1925362118782076","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T08:53:11Z","timestamp":1777366391000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1925362118782076"}},"subtitle":["A Case Report and Review of the Literature"],"short-title":[],"issued":{"date-parts":[[2018,6]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1177\/1925362118782076"],"URL":"https:\/\/doi.org\/10.1177\/1925362118782076","relation":{},"ISSN":["1925-3621","1925-3621"],"issn-type":[{"value":"1925-3621","type":"print"},{"value":"1925-3621","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6]]}}}