Addiction medicine, toxicology and general-practice clinicians get an update on kratom, concentrated 7-hydroxymitragynine products and opioid-like dependence. Product type, total dose, dosing interval, sedative co-use, withdrawal timing, naloxone access and appropriately timed buprenorphine treatment guide assessment and harm reduction.

Alcohol use disorder pharmacotherapy is broader than naltrexone and acamprosate. The clinical focus is matching medication to the patient’s agreed goal, whether abstinence, reduced heavy-drinking days or safer consumption, while checking adherence, liver disease, renal function and co-existing symptoms.

Hospital opioid use disorder care can stall when methadone cannot be verified. The practical move is to keep treating withdrawal while confirming dose, last administration, missed doses and take-home bottles, then recognise medetomidine withdrawal when autonomic symptoms and nausea persist.