San Francisco reports first fatal overdose from synthetic opioid sold in gas stations, smoke shops

A San Francisco resident has died after ingesting a semi-synthetic opioid sold in gas stations and smoke shops, the first such case in the city involving dihydro-7-hydroxymirtragynine, also known as MGM-15, health officials said.

The kratom-derived opioid, estimated to be up to 50 times more potent than morphine, is not approved for any medical use and was recently designated as a Schedule 1 drug by the U.S. Drug Enforcement Agency. The San Francisco Department of Public Health issued an alert to the public and health care providers on Wednesday about MGM-15, and said the person who ingested it died late last month.

Despite it being illegal for sale, MGM-15 has been found in products marketed as "uncaria tomentosa" or "cat's claw," and SFDPH said MGM-15 has also been identified in overdoses in Utah and Washington. The "Script botanicals x Maui labs" tablets the San Francisco decedent consumed do not list kratom or 7-hydroxymitragynine (7-OH) in the packaging, SFDPH said, although the medical examiner's office found MGM-15 in both the decedent and the product packaging.

It was the second time this year that San Francisco's health department issued a public warning about a synthetic opioid. In April, SFDPH alerted about the drug cychlorphine following the overdose death of a 16-year-old boy. San Francisco police said cychlorphine, estimated to be 10 times estimated more powerful than fentanyl, can be found in counterfeit pills designed to look like Xanax, Adderall and Oxycontin. 

Health officials recommend administering naloxone to anyone who appears to be overdosing and calling 911.