Cases: Multiorgan failure in a 38-year-old man with recent consumption of kratom, an atypical opioid
Bibliographic record
Abstract
We present the case of a young man with acute-onset chest and back pain to the emergency department with what was initially thought to be a myocardial infarction complicated by mixed respiratory failure. However, several days into the admission, the patient disclosed using a substance known as “kratom,” a novel psychoactive substance with mu-opioid receptor agonist and norepinephrine and serotonin reuptake inhibitor properties. The present case report emphasizes the under-recognition of kratom as an increasingly common recreational psychoactive substance and how kratom intoxication and withdrawal might be incorporated into differential diagnoses for a spectrum of presentations. Unfortunately, there are few Canadian data on kratom use's epidemiology or clinical implications. Still, available US data suggests that the prevalence of kratom use parallels that of illicit opioids, with an approximately lifetime prevalence of 1%. Furthermore, we provide recommendations for assessing and treating kratom use disorder based on the best available evidence.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.003 |
| Insufficient payload (model declined to judge) | 0.017 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".