Talk:7-Hydroxymitragynine

7-Hydroxymitragynine is a terpenoid indole alkaloid structurally related to mitragynine but with a hydroxyl group that increases its potency at opioid receptors.

Its molecular formula is C23H30N2O5, & its molar mass is 414.50 g/mol.

It is both a δ-opioid and κ-opioid competitive antagonist, & a partial μ-opioid agonist, (approximately 13.5 times more potent than morphine), making it a potent opioid. 7-Hydroxymitragynine has a unique pharmacodynamic profile, showing high μ-opioid receptor affinity while avoiding significant activation of the β-arrestin pathway. This minimizes typical opioid side effects such as respiratory depression and constipation, similar to mitragynine (the primary alkaloid in (kratom)).

7-Hydroxymitragynine has a low toxicity relative to dose. Like most opioids, safe usage of 7-Hydroxymitragynine is not known to cause any dangerous long-term complications. Heavy dosages of 7-Hydroxymitragynine can result in increased respiratory depression, leading onto fatal or dangerous levels of anoxia (oxygen deprivation). This is significantly less powerful than the respiratory depression of heroin or morphine. This occurs because the breathing reflex is suppressed by agonism of µ-opioid receptors proportional to the dosage consumed.

7-Hydroxymitragynine can be fatal when it is combined with other depressants such as alcohol or benzodiazepines. Nausea, dizziness, dry mouth, and constipation are common with higher doses.

It is strongly recommended that one use harm reduction practices when using this substance.

Dependence and abuse potential

Due to its high potency at μ-opioid receptors, 7-Hydroxymitragynine carries a significant risk of addiction and dependence with prolonged use and is capable of causing both physical and psychological dependence. When physical dependence has developed, withdrawal symptoms may occur if a person suddenly stops their usage.

Regular use can rapidly increase tolerance, diminishing its effects. This results in users having to administer increasingly large doses to achieve the same effects. 7-Hydroxymitragynine presents cross-tolerance with all other opioids, meaning that after the consumption of morphine all opioids will have a reduced effect.

While 7-Hydroxymitragynine has a reduced risk of respiratory depression compared to morphine, high doses can still result in severe sedation and potential respiratory issues.

Dangerous interactions

• Alcohol - Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely
• Stimulants - Stimulants increase respiration rate which allows for a higher dose of opiates than would otherwise be used. If the stimulant wears off first then the opiate may overcome the user and cause respiratory arrest.
• Benzodiazepines - Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position blackouts/memory loss likely.
• DXM - Generally considered to be toxic. CNS depression, difficulty breathing, heart issues, and liver toxicity have been observed. Additionally if one takes DXM, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.
• GHB/GBL - The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position
• Ketamine - Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.
• MAOIs - Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.
• MXE - MXE can potentiate the effects of opioids but also increases the risk of respiratory depression and organ toxicity.
• Nitrous - Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are common.
• PCP - PCP may reduce opioid tolerance, increasing the risk of overdose.
• Tramadol - Increased risk of seizures. Tramadol itself is known to induce seizures and it may have additive effects on seizure threshold with other opioids. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present.
• Grapefruit - While grapefruit is not psychoactive, it may affect the metabolism of certain opioids. Tramadol, oxycodone, and fentanyl are all primarily metabolized by the enzyme CYP3A4, which is potently inhibited by grapefruit juice. This may cause the drug to take longer to clear from the body. it may increase toxicity with repeated doses. Methadone may also be affected. Codeine and hydrocodone are metabolized by CYP2D6. People who are on medicines that inhibit CYP2D6, or that lack the enzyme due to a genetic mutation will not respond to codeine as it can not be metabolized into its active product: morphine.

• United States: Not explicitly scheduled but regulated indirectly through restrictions on (kratom) in certain states or local jurisdictions.
• Brazil: 7-Hydroxymitragynine is scheduled Class F1, along with other psychoactive alkaloids found in (kratom).
• International: Legal status varies by country. In some regions, (kratom) and its alkaloids are controlled substances.

• Responsible use

• Opioids

• Kratom

• Naloxone

• 7-Hydroxymitragynine (Wikipedia)[1]