San Francisco Confirms First Death from Synthetic Opioid Hidden in Gas Station Supplements

Key points

• A 37-year-old man died in late September 2026 after consuming a supplement containing dihydro-7-hydroxymirtragynine (MGM-15).
• The product, branded 'Script botanicals x Maui labs,' was sold as 'cat's claw' or 'uncaria tomentosa' but did not list kratom or 7-OH on the packaging.
• MGM-15 is a semi-synthetic opioid estimated to be up to 50 times more potent than morphine and is classified as a Schedule 1 drug by the DEA.
• San Francisco is the first city to report a fatal overdose involving this specific synthetic compound, though similar deaths have been recorded in Utah and Washington.
• Health officials recommend administering naloxone (Narcan) to reverse the effects of the overdose, which can cause respiratory depression.

Background

This incident follows a broader national crisis involving kratom and its derivatives. In 2026, Los Angeles County halted kratom sales after linking the substance to multiple deaths. Federal authorities designated three synthetic compounds, including MGM-15, as Schedule 1 drugs in August 2026 due to their high potential for abuse. Earlier this year, San Francisco also issued a warning about cychlorphine, another synthetic opioid linked to a teen's death. The current case highlights the ongoing challenge of regulating unapproved substances sold in retail environments like gas stations and smoke shops.

How outlets are covering it

The Los Angeles Times emphasizes the deceptive nature of the product, noting that the packaging did not disclose the presence of kratom or 7-OH, despite forensic confirmation of MGM-15. CBS News highlights the potency of the substance, comparing it to morphine, and notes that this is the second synthetic opioid warning issued by San Francisco this year. Patch focuses on the accessibility of the drug, describing it as 'gas station heroin' and noting that it remains available despite being illegal. KTVU provides practical advice, emphasizing the use of naloxone and the availability of free Narcan at local health services. All sources agree on the danger of the substance but differ in emphasis: LA Times focuses on the mislabeling, CBS on the potency and history, Patch on the retail availability, and KTVU on the medical response.

Why it matters

This case underscores the risks of unregulated supplements sold in everyday retail locations. The use of misleading labels to hide potent opioids poses a significant threat to public health, as consumers may unknowingly ingest dangerous substances. The incident also highlights the need for better regulation and enforcement to prevent the sale of illegal substances in gas stations and smoke shops. Additionally, it serves as a reminder of the importance of naloxone availability and education to combat opioid overdoses.

What to watch

San Francisco health officials will likely continue to monitor for additional cases of MGM-15 overdose and may collaborate with law enforcement to seize more products from retail locations. Federal agencies may also increase scrutiny of synthetic kratom derivatives. Public health campaigns may focus on educating consumers about the risks of unapproved supplements and the importance of using naloxone in case of overdose. Further investigations may be conducted to identify other products containing similar synthetic compounds.