Autopsy: Fentanyl, kratom, cocaine, heroin

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GRAND RAPIDS, Mich. (WOOD) — The fatal overdose of a 26-year-old Jenison man is the fifth death Kent County medical examiners have tied to kratom, a plant used as a pain reliever.

All five who died were young men in their 20s. The most recent death happened in early June, but the autopsy only became available Monday.

According to the autopsy, a friend of the young man told investigators that when she went to pick him up, he told her that he had done cocaine, heroin and the benzodiazepine Klonopin and wasn’t feeling well.

He reportedly became less and less responsive as she drove, ultimately failing to respond at all. The friend just kept driving, taking him straight to the emergency room at Metro Health-University of Michigan Hospital.

The man’s mother confirmed that he had a history of drug use, but said she thought he had been clean.

According to the newly-released autopsy, the 26-year-old’s official cause of death was “acute fentanyl, mitragynine (Kratom), cocaine and heroin toxicity.”

The fact that multiple drugs are listed is significant because kratom advocates have argued that fatal overdoses are caused not by kratom alone, but rather by mixed drug toxicity or underlying conditions not identified by medical examiners.

Kent County’s longtime medical examiner Dr. Stephen Cohle stands firmly by his cause of death determinations.

The autopsy reported that toxicology tests measured the 26-year-old’s kratom level at 920 ng/mL, the highest concentration reported among the five Kent County deaths. The Pennsylvania-based lab that tests for kratom, National Medical Services, reports the potentially toxic range as 20 to 600 ng/mL.  

In three of Kent County’s five kratom-related deaths, the causes of death listed multiple drugs. Two deaths were attributed to kratom toxicity, with no other drugs involved.

The botanical supplement is sold as powder and capsules online and in head and smoke shops.

Kratom advocates are fighting hard to keep the U.S. Drug Enforcement Administration from banning it altogether. The American Kratom Association held an online news conference Monday, touting its own scientific research showing kratom is not dangerous.

“Millions of Americans have chosen under the Dietary Supplement Act to use kratom,” said Jane K. Babin, a lawyer and molecular biologist who has researched kratom extensively. “The FDA and other agencies within the federal government need to respect those choices.”

The AKA says the millions of people who rely on kratom to relieve anxiety, depression and pain will be devastated if it’s outlawed. Seven states have banned it, though it remains legal in Michigan.

The Food and Drug Administration has repeatedly warned consumers against using kratom, which the agency categorizes as an opioid. In addition to calling the botanical supplement addictive and unsafe, the FDA has issued warnings regarding an outbreak of illnesses from salmonella-contaminated kratom.

“Most Kratom that flows into the United States is sourced from southeast Asia, particularly rural regions of Indonesia and Thailand,” FDA Commissioner Scott Gottlieb wrote in a July 2 statement regarding the “ongoing risk of salmonella in kratom products.”

“In these locations, the plant is being grown, harvested and processed in problematic conditions that readily create the circumstance for widespread contamination with foodborne pathogens,” he continued.

“As we have previously stated, there are no proven medical uses for kratom and the FDA strongly discourages the public from consuming kratom…”

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