Pravalence of Mitragynine in Forensic Autopsy Cases at the Forensic Investigation Center Chulalongkorn University from 2022 to 2023

Abstract

Background: Mitragynine is an active compound found in Kratom, a substance experiencing growing usage both in Thailand and globally. While Kratom is commonly perceived as safe with minimal adverse effects, instances of fatalities associated with its use and misuse have been documented.

Objective: Investigating the prevalence of mitragynine in forensic autopsy cases from 2022 to 2023. Analyzing demographic data, causes of death, and proposed lethal level. Materials and Method: A retrospective study was conducted on the forensic toxicological analysis of 213 forensic autopsy cases from 2022 to 2023 at the Forensic Investigation Center of Chulalongkorn University.

Results: The prevalence of positive mitragynine findings rose significantly from 3.14% in 2021 to 13.39% in the years 2022-2023. The male-to-female ratio was approximately 9:1. The common causes of death were attributed to traffic accidents, undetermined and cardiovascular diseases. Mitragynine concentrations varied widely, ranging from 0.10 to 1,423.23 ng/mL, with a mean concentration of 109.85 ng/mL. However, a definitive proposed lethal level could not be determined based on the data analyzed.

Conclusion: The increasing use of kratom, coupled with the rising number of deaths associated with its consumption, necessitate a comprehensive reassessment of its safety profile. A thorough study on its safe usage, including potential positive effects and adverse reactions, is imperative. Additionally, regulatory measures governing kratom distribution and consumption require re-evaluation to ensure public safety and mitigate the risks associated with its use and misuse.