ArticleCureus2025
7-Hydroxymitragynine and Nicotine Pouch Withdrawal Syndrome: A Case Report.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Novel psychoactive substances (NPSs) such as kratom and oral nicotine pouches present new challenges in clinical management, particularly regarding dependence and withdrawal. We report a case of severe withdrawal from concentrated 7-hydroxymitragynine (7-OH), a potent kratom alkaloid, and high-dose oral nicotine pouches, following long-term use in a patient with a history of polysubstance use. The patient developed acute, overlapping opioid-like (insomnia, myalgia, anxiety, diaphoresis, and gastrointestinal upset) and nicotinic (intense craving, irritability, restlessness, and difficulty concentrating) withdrawal symptoms. These symptoms rapidly escalated to severe agitation, psychosis, and respiratory compromise requiring intubation and intensive care. The clinical course was further complicated by failed outpatient management, precipitated withdrawal after initiation of buprenorphine, and eventual discharge against medical advice (AMA). This case report highlights the diagnostic and therapeutic complexities of managing withdrawal from novel psychoactive substances, the need for multidisciplinary and flexible approaches, and the importance of systematic assessment and harm reduction as these products become increasingly prevalent.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.