Sold as cat’s claw, found to contain an opioid: San Francisco warns after death

Warnings about opioids hidden in products sold as cat’s claw have reached San Francisco’s fatal-overdose record. After reports of deaths involving misrepresented herbal products in Utah and Washington, San Francisco health officials issued an October 21 warning about the city’s first known fatal overdose involving MGM-15, a semi-synthetic, kratom-derived opioid not approved for any medical use. ^{2 3 4}

The local case concerns a 37-year-old man who died in late September after consuming tablets branded “Script botanicals x Maui labs.” The product was marketed as cat’s claw, but testing detected MGM-15 in the man and in the associated product or package. The opioid was not disclosed on the label. ²

That mismatch is the central danger: someone buying what is represented as a botanical supplement can encounter an opioid capable of causing a fatal overdose, without the package telling them it is there. The warning is directed to health-care providers as well as consumers because the label can also obscure an exposure when someone becomes ill. ⁴

San Francisco’s “first known” designation is narrow. It describes a fatal overdose involving MGM-15 within the city—not the first death nationwide, a count of all local exposures, or proof that earlier cases could not have gone undetected. The city’s alert explicitly notes overdoses involving the compound elsewhere. ³

The Los Angeles Times reported that Utah officials linked MGM-15 and a related compound to four deaths in that state. The Washington Poison Center separately reported four confirmed deaths involving misrepresented herbal products containing those compounds. Those warnings also concerned products sold as cat’s claw; they do not establish that every case involved the brand identified in San Francisco. ²

San Francisco’s medical examiner ruled the man’s death accidental and attributed it to the “toxic effects of kratom alkaloids,” according to a coroner’s report obtained by the Los Angeles Times. That finding is broader than a determination that MGM-15 alone caused his death. ²

The detection in both the man and the associated product is important: it establishes exposure to an opioid that the packaging did not disclose. But the publicly available case details do not include a complete quantitative toxicology file. They do not identify every substance tested for, its concentration, or everything excluded. It would therefore be wrong to declare either that no other drugs or alcohol were present or that other substances must have contributed.

The published descriptions also leave a smaller but relevant laboratory question unresolved. CBS Bay Area described MGM-15 as detected in the product packaging; the Times described detection in a package of tablets. Neither account supplies enough detail to distinguish testing of intact tablets, package contents or packaging residue. The supported conclusion is detection in the associated product or package—not a measured opioid dose. ^{1 2}

Cat’s claw itself does not contain MGM-15. It is a woody vine found in the Amazon and other tropical areas of Central and South America. Kratom is a different plant. MGM-15 is produced by chemically modifying 7-hydroxymitragynine, or 7-OH, a compound that occurs naturally in trace amounts in kratom. Calling the product cat’s claw did not explain what testing found inside it. ²

The tested package was described as containing four chewable tablets labeled “uncaria tomentosa extract,” the botanical name used for cat’s claw, with a labeled amount of 100 milligrams per tablet. The packaging did not list kratom or 7-OH, and it did not disclose MGM-15. ^{1 2}

Those numbers need to stay attached to what they actually describe. Four is the number of tablets in the package, not the number investigators have established the man swallowed. And 100 milligrams is the labeled amount of extract—not a laboratory finding of 100 milligrams of MGM-15. The available findings establish neither the amount of MGM-15 per tablet nor the man’s ingested dose. A printed quantity can look reassuringly precise while answering the wrong question.

Products of this kind are marketed through gas stations and smoke shops, but the warning does not identify the particular store where the man obtained his tablets. Nor does it establish that every retailer carrying the brand had the same affected stock. The Times said it sought comment from Script botanicals and did not receive an immediate response. ^{1 2}

The confirmed official action is a health warning. A recall notice, affected-lot list and defined distribution boundary have not been verified. That is not proof that no recall exists, and the finding cannot responsibly be extended to every package of the brand or every supplement sold as cat’s claw.

The immediate response does not depend on resolving those supply questions. Health officials advise calling 911 and administering naloxone to someone who appears to be overdosing. An herbal description on the package is no reason to rule out an opioid emergency. ¹