Photo credit: Yanawut Suntornkij | Dreamstime

Tragedy struck the village of Tupper Lake, New York last month when Tupper Lake police Sgt. Matthew Dana was found dead. After a month long investigation by Franklin County Coroner Shawn Stuart the death was ruled an accidental overdose. Stuart's tests were publicly released today based on a toxicology report and have been corroborated by medical examiner Dr. C. Francis Varga. Several members of the kratom community however are not so sure that an overdose of mitragynine (as suggested by the coroner's report) would result in a pulmonary edema.

Kratom is a South East Asian plant that has been used for hundreds of years as a folk medicine. Related to the coffee plant it is known as a pain reliever, antioxidant and immunostimulant and scores of research journals contain dozens of clinical studies and reviews of potential uses for kratom as wide-spread as treating chronic pain, addiction, treatment resistant depression, PTSD and even tumors or cancer.

<a href="http://www.adirondackdailyenterprise.com/news/local-news/2017/09/coroner-kratom-overdose-killed-tupper-lake-police-sergeant/?fb_comment_id=1476166832433219_1476377902412112&comment_id=1476183919098177&reply_comment_id=1476377902412112">The formal cause of death was a pulmonary edema</a> (blood in the lungs) that is being claimed to have resulted from an overdose of mitragynine. Mitragynine and 7-hydroxy-mitragynine are the two primary active constituents in kratom. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425236/">Studies of lab rodents and other animals have shown</a> that respiratory depression death from any amount of kratom's active contents is unlikely which is why it has been explored as a possible alternative to dangerous and addictive opiates and opioids.

<blockquote class="twitter-tweet" data-lang="en"><p lang="en" dir="ltr">BREAKING: Coroner says kratom overdose killed Tupper Lake police Sgt. Matt Dana <a href="https://t.co/PRpeJIvRuq">https://t.co/PRpeJIvRuq</a> <a href="https://t.co/0rkrDP04wH">pic.twitter.com/0rkrDP04wH</a></p>— Adk Daily Enterprise (@AdkEnterprise) <a href="https://twitter.com/AdkEnterprise/status/907645380816457728">September 12, 2017</a></blockquote>

<script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script>

<a href="https://www.reddit.com/r/kratom/comments/6zocwd/we_need_to_investigate_the_reported_kratom/">Some Reddit users have formed opinions</a> about an alternative possible cause of death, however. Many kratom users choose a method colloquially termed "the toss and wash." With a toss and wash you take your spoonful (or spoonfuls) of kratom and wash it back with water. Due to the hydrophobic nature of kratom however it has a tendency to get stuck in the soft palate of the mouth and esophagus. Toss and wash nightmare stories ending in serious coughing fits or regurgitation are rare but have been reported. If you recall the "cinnamon challenge" several kids who tried to swallow ridiculous amounts of cinnamon ended up <a href="https://www.today.com/parents/poison-centers-warn-about-cinnamon-challenge-470441">dying of pulmonary edema</a> in the same manner as Sgt. Dana.

<blockquote class="twitter-tweet" data-lang="en"><p lang="en" dir="ltr">Check out this infographic on the relative safety of Kratom and energy drinks: <a href="https://t.co/r0usysO5m5">pic.twitter.com/r0usysO5m5</a></p>— Phytoextractum (@phytoextractum) <a href="https://twitter.com/phytoextractum/status/875059233825452033">June 14, 2017</a></blockquote>

<script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script>

<blockquote class="twitter-tweet" data-lang="en"><p lang="en" dir="ltr">FACT: <a href="https://twitter.com/hashtag/Kratom?src=hash">#Kratom</a> is not a problem: It's time for unscientific attacks to stop. <a href="https://t.co/iqoKgWx2bT">https://t.co/iqoKgWx2bT</a> See infographic: <a href="https://t.co/vVwjtcoJpc">pic.twitter.com/vVwjtcoJpc</a></p>In 2015 a high school student in Michigan spent four days in the hospital after attempting the cinnamon challenge due to pneumonia, inflammation and scarring of the lungs. Collapsed lungs, asphyxiation and pulmonary edema had also been reported among those who attempted to down too much fine powder. — Paul Kemp (@healthseeker) <a href="https://twitter.com/healthseeker/status/847974107983470592">April 1, 2017</a></blockquote>

<script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script>

As is, no human or laboratory animal deaths have been shown to be directly attributable to kratom alone. In at least one case however, kratom adulterated with research chemicals or other substances has been reported.

In 2015 a high school student in Michigan spent four days in the hospital after attempting the cinnamon challenge due to pneumonia, inflammation and scarring of the lungs. Collapsed lungs, asphyxiation and pulmonary edema had also been reported among those who attempted to down too much fine powder.

Our thoughts and prayers are with the family of Sgt. Dana and hopefully the full details about what led to Sgt. Dana's unfortunate passing can be fully understood soon. It's a sad story regardless how you slice it, but it would be a double tragedy if an unfortunate death due to inhalation of plant powder (akin to the cinnamon challenge deaths) led to the people who really need kratom no longer having access.