Chemicals of concern: Kratom and 7-hydroxymitragynine (7-OH)

Chemicals of concern: Kratom and 7-hydroxymitragynine (7-OH)

What happens when a drug people can buy in everyday stores behaves like an opioid—yet regulators still treat it as a “gray zone”? In The Lancet Pulse episode, host Matthew Gilbert and co-host Niall Boyce are joined by Dr. Liza Hutchison, Assistant Professor of Family Medicine at the University of Michigan, an addiction medicine physician overseeing services at a federally qualified health center in Washtenaw County, Michigan, and supervising a statewide telehealth on-demand buprenorphine service. Dr. Hutchison explains how natural leaf kratom contains multiple alkaloids (serotonergic, noradrenergic, and opioid-acting), with only about 1% opioid-active component, while concentrated 7-hydroxymitragynine (7-OH) products are reported to be 15–20 times more potent and can drive rapid tolerance, opioid-like withdrawal, and overdose risk. They also discuss the clinical use of buprenorphine/Suboxone (reducing overdose death risk by 50%+ in traditional opioid use disorder), policy proposals in Michigan (including a prohibition bill), and why naloxone reverses the opioid-like breathing suppression but not other causes like seizure or liver injury. The Lancet Pulse is part of the Lancet Group podcast offering.  Editorial team: Chloe Wilson, Ben Abbott, Matthew Gilbert, and Jonathan Pimm Podcast editing and production: Matteo Simonetti Visit https://www.thelancet.com/multimedia [https://www.thelancet.com/multimedia?dgcid=buzzsprout_podcast_tlp_mm] to learn more about our multimedia offering.  Find the best science for better lives at https://www.thelancet.com [https://www.thelancet.com] Follow us today at... https://thelancet.bsky.social/ [https://thelancet.bsky.social/] https://instagram.com/thelancetgroup [https://instagram.com/thelancetgroup] https://facebook.com/thelancetmedicaljournal [https://facebook.com/thelancetmedicaljournal] https://linkedIn.com/company/the-lancet [https://linkedin.com/company/the-lancet] https://youtube.com/thelancettv [https://www.youtube.com/thelancettv]

What is in a name change? Moving from the term PCOS to PMOS

In this episode of The Lancet Pulse, Chloe Wilson joins Helena Teede and Terhi Piltonen to discuss a recent health policy published in The Lancet that details a global consensus process that puts forward a new name for PCOS - termed PMOS (polyendocrine metabolic ovarian syndrome) to more accurately reflect the disease process. Listen now to hear more about the process and how it is hoped the name change will lead to better care for those affected by the condition. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00717-8/fulltext [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00717-8/fulltext?dgcid=podcast_acq-may2026_lancetpulse] The Lancet Pulse is part of the Lancet Group podcast offering.  Editorial team: Chloe Wilson, Ben Abbott, Matthew Gilbert, and Jonathan Pimm Podcast editing and production: Matteo Simonetti Visit https://www.thelancet.com/multimedia [https://www.thelancet.com/multimedia?dgcid=buzzsprout_podcast_tlp_mm] to learn more about our multimedia offering.  Find the best science for better lives at https://www.thelancet.com [https://www.thelancet.com] Follow us today at... https://thelancet.bsky.social/ [https://thelancet.bsky.social/] https://instagram.com/thelancetgroup [https://instagram.com/thelancetgroup] https://facebook.com/thelancetmedicaljournal [https://facebook.com/thelancetmedicaljournal] https://linkedIn.com/company/the-lancet [https://linkedin.com/company/the-lancet] https://youtube.com/thelancettv [https://www.youtube.com/thelancettv]

Is there a link between diet and mental health?

In this episode of The Lancet Pulse, Niall Boyce and Matt Gilbert speak with Professor Daniel Smith about the emerging connection between diet and mental health, with a focus on the ketogenic diet and bipolar disorder. Together, they explore what bipolar disorder is, why its depressive phases can be so difficult to treat, and why researchers are beginning to investigate whether changes in metabolism and brain energy use could play a role in improving symptoms. The conversation also looks at the bigger picture: how much evidence is there so far, what makes this area of research so promising, and where caution is still needed. From early feasibility studies to questions about long-term safety, affordability, and dietitian support, this episode offers a thoughtful look at a fast-evolving field — and asks whether nutritional approaches could become a meaningful add-on to mental health care in the future. The Lancet Pulse is part of the Lancet Group podcast offering.  Editorial team: Chloe Wilson, Ben Abbott, Matthew Gilbert, and Jonathan Pimm Podcast editing and production: Matteo Simonetti Visit https://www.thelancet.com/multimedia [https://www.thelancet.com/multimedia?dgcid=buzzsprout_podcast_tlp_mm] to learn more about our multimedia offering.  Find the best science for better lives at https://www.thelancet.com [https://www.thelancet.com] Follow us today at... https://thelancet.bsky.social/ [https://thelancet.bsky.social/] https://instagram.com/thelancetgroup [https://instagram.com/thelancetgroup] https://facebook.com/thelancetmedicaljournal [https://facebook.com/thelancetmedicaljournal] https://linkedIn.com/company/the-lancet [https://linkedin.com/company/the-lancet] https://youtube.com/thelancettv [https://www.youtube.com/thelancettv]

Is the opening of an AI hospital closer to reality than we think?

Professor Tien Yin Wong, from Tsinghua University, talks to Lancet editors Helena Wang and Ben Abbott about Tsinghua’s world-first AI hospital project, providing insights into both its enormous potential and some of the reality checks that have occurred along the way. Professor Wong also paints a picture of China’s overall health challenges and its readiness and enthusiasm for AI as a potential solution to some of these, acknowledging that there is much that AI cannot (yet) solve. --------------------------------- The Lancet Pulse is part of the Lancet Group podcast offering.  Editorial team: Chloe Wilson, Ben Abbott, Matthew Gilbert, and Jonathan Pimm Podcast editing and production: Matteo Simonetti Visit https://www.thelancet.com/multimedia [https://www.thelancet.com/multimedia?dgcid=buzzsprout_podcast_tlp_mm] to learn more about our multimedia offering.  Find the best science for better lives at https://www.thelancet.com [https://www.thelancet.com/?dgcid=https://www.thelancet.com/multimedia?dgcid=buzzsprout_podcast_tlp_mm] Continue this conversation on social! Follow us today at... https://thelancet.bsky.social/ [https://thelancet.bsky.social/] https://instagram.com/thelancetgroup [https://instagram.com/thelancetgroup] https://facebook.com/thelancetmedicaljournal [https://facebook.com/thelancetmedicaljournal] https://linkedIn.com/company/the-lancet [https://linkedin.com/company/the-lancet] https://youtube.com/thelancettv [https://www.youtube.com/thelancettv] The Lancet Pulse is part of the Lancet Group podcast offering.  Editorial team: Chloe Wilson, Ben Abbott, Matthew Gilbert, and Jonathan Pimm Podcast editing and production: Matteo Simonetti Visit https://www.thelancet.com/multimedia [https://www.thelancet.com/multimedia?dgcid=buzzsprout_podcast_tlp_mm] to learn more about our multimedia offering.  Find the best science for better lives at https://www.thelancet.com [https://www.thelancet.com] Follow us today at... https://thelancet.bsky.social/ [https://thelancet.bsky.social/] https://instagram.com/thelancetgroup [https://instagram.com/thelancetgroup] https://facebook.com/thelancetmedicaljournal [https://facebook.com/thelancetmedicaljournal] https://linkedIn.com/company/the-lancet [https://linkedin.com/company/the-lancet] https://youtube.com/thelancettv [https://www.youtube.com/thelancettv]

Are we ready for AI to transform pathology?

The field of pathology is starting to look very different, as we increasingly understand the potential for AI to support clinical diagnosis and decision-making, alleviate high clinician workloads, and perform complex tasks that humans can't.  But the adoption of AI isn't without challenges. Sebastian Försch and Inti Zlobec join Ben Abbott and Chloe Wilson, from The Lancet, to discuss. --------------------------------- The Lancet Pulse is part of the Lancet Group podcast offering.  Editorial team: Chloe Wilson, Ben Abbott, Matthew Gilbert, and Jonathan Pimm Podcast editing and production: Matteo Simonetti Visit https://www.thelancet.com/multimedia [https://www.thelancet.com/multimedia?dgcid=buzzsprout_podcast_tlp_mm] to learn more about our multimedia offering.  Find the best science for better lives at https://www.thelancet.com [https://www.thelancet.com/?dgcid=https://www.thelancet.com/multimedia?dgcid=buzzsprout_podcast_tlp_mm] Continue this conversation on social! Follow us today at... https://thelancet.bsky.social/ [https://thelancet.bsky.social/] https://instagram.com/thelancetgroup [https://instagram.com/thelancetgroup] https://facebook.com/thelancetmedicaljournal [https://facebook.com/thelancetmedicaljournal] https://linkedIn.com/company/the-lancet [https://linkedin.com/company/the-lancet] https://youtube.com/thelancettv [https://www.youtube.com/thelancettv] The Lancet Pulse is part of the Lancet Group podcast offering.  Editorial team: Chloe Wilson, Ben Abbott, Matthew Gilbert, and Jonathan Pimm Podcast editing and production: Matteo Simonetti Visit https://www.thelancet.com/multimedia [https://www.thelancet.com/multimedia?dgcid=buzzsprout_podcast_tlp_mm] to learn more about our multimedia offering.  Find the best science for better lives at https://www.thelancet.com [https://www.thelancet.com] Follow us today at... https://thelancet.bsky.social/ [https://thelancet.bsky.social/] https://instagram.com/thelancetgroup [https://instagram.com/thelancetgroup] https://facebook.com/thelancetmedicaljournal [https://facebook.com/thelancetmedicaljournal] https://linkedIn.com/company/the-lancet [https://linkedin.com/company/the-lancet] https://youtube.com/thelancettv [https://www.youtube.com/thelancettv]