Case Report: Cannabis and Kratom-Induced Self-Amputation of Ears and Penis

Broul, Marek; Rudenko, Xenia; Bajus, Adam; Král, Jiří; Kyenge, Dan Mwemena; Staňková, Zdenka; Albrecht, Jakub

doi:10.3389/fpsyt.2025.1479863

CASE REPORT article

Front. Psychiatry

Sec. Addictive Disorders

Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1479863

This article is part of the Research Topic Impulsivity and Compulsivity Related to Substance Use Disorders View all 10 articles

Case Report: Cannabis and Kratom-Induced Self-Amputation of Ears and Penis

Provisionally accepted

Xenia Rudenko ⁴

Jiří Král ⁶

¹ Department of Sexology, Krajská zdravotní, a.s., Masaryk Hospital in Ústí nad Labem, o.z, Czech Republic, Ústí nad Labem, Czechia
² Department of Urology, Krajská zdravotní, a.s., Hospital Litoměřice, o. z., Czech Republic, Litoměřice, Czechia
³ Faculty of Health Studies, Jan Evangelista Purkyně University in Ústí nad Labem, Ústí nad Labem, Ústí nad Labem, Czechia
⁴ Psychiatric clinic of The Faculty of Health Studies of Jan Evangelista Purkyně University in Ústí nad Labem and Krajské zdravotní, a.s. - Masaryk Hospital in Ústí nad Labem, o.z., Ústí nad Labem, Czechia
⁵ Department of Reconstructive and Plastic Surgery, Krajská zdravotní, a.s., Masaryk Hospital in Ústí nad Labem, o.z, Czech Republic, Ústí nad Labem, Czechia
⁶ Department of Urology, Most Hospital, Krajska zdravotni a.s., Czech Republic, Most, Czechia
⁷ Department of Psychiatry, Most Hospital, Krajska zdravotni a.s., Czech Republic, Most, Czechia

The final, formatted version of the article will be published soon.

This report describes the case of a 31-year-old male lumberjack with severe self-inflicted injuries, including the amputation of both auricles and the penis, under the influence of cannabinoids, mitragynine, and 7-hydroxymitragynine. Emergency surgery was performed, and psychiatric evaluation revealed substance-induced psychosis. The patient's motivation for reconstructive penile surgery led to abstinence from the substance use and cooperation with treatment. Five months after hospitalization, successful penile reconstruction was completed. The patient remained abstinent and was engaged in regular psychiatric follow-ups, showing no signs of acute psychopathology. This case underscores the importance of using a multidisciplinary approach to manage severe self-harm behaviors, and highlights the critical role of patient motivation in achieving positive outcomes.

Keywords: case report, Substance-induced psychosis, Self-inflicted injuries, Self-amputation, Cannabinoids, Kratom, Psychotic episodes, paranoia

Received: 12 Aug 2024; Accepted: 18 Feb 2025.

Copyright: © 2025 Broul, Rudenko, Bajus, Král, Kyenge, Staňková and Albrecht. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Marek Broul, Department of Sexology, Krajská zdravotní, a.s., Masaryk Hospital in Ústí nad Labem, o.z, Czech Republic, Ústí nad Labem, Czechia

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