The conversation around kratom has been heating up in recent years. Once considered a relatively niche herbal supplement, kratom has grown in popularity across the United States. While many people view it as “natural” or even safer than opioids, public health experts have raised concerns about one of its compounds: 7-hydroxymitragynine, often shortened to 7-OH. Recent headlines have put 7-OH in the spotlight, with some states moving to ban it altogether. Understanding what this substance is, why it’s risky and how it connects to the rehab and recovery process can help individuals and families make informed decisions.
What Exactly Is 7-OH?
Kratom (Mitragyna speciosa) is a tropical tree native to Southeast Asia. Traditionally, its leaves have been used for mild stimulation, for pain relief or in social and cultural rituals. The plant contains dozens of alkaloids, chemical compounds that interact with the body in different ways.
The two most important alkaloids are:
- Mitragynine. The most abundant, providing much of kratom’s stimulating and pain-relieving effects
- 7-hydroxymitragynine (7-OH). A much less common alkaloid in raw kratom but far more potent in its effects
Even though 7-OH is present in tiny amounts in the natural leaf, researchers have found that it binds strongly to the same opioid receptors targeted by drugs like oxycodone or morphine. In fact, some preclinical studies suggest 7-OH may be several times stronger than morphine by weight.
Why Is 7-OH Considered Dangerous?
When taken in traditional forms, like brewed teas or ground leaf capsules, kratom typically produces a mild stimulant effect at low doses and sedation at higher doses. But when 7-OH is extracted, concentrated or enhanced in manufactured products, the risk profile changes dramatically.
7-OH Mimics Opioids
7-OH acts directly on μ-opioid receptors in the brain. This is the same mechanism that drives both the pain relief and the addictive potential of drugs like heroin and prescription painkillers.
Higher Risk of Dependence
Because it’s more potent than mitragynine, 7-OH carries a higher likelihood of dependence and withdrawal, especially the 7-OH found in gummies, shots and other products on the market that contain higher levels of 7-OH compared with raw kratom. People may not realize they’re developing an opioid-like tolerance until they experience cravings or uncomfortable withdrawal symptoms such as:
- Anxiety or agitation
- Insomnia
- Sweating and chills
- Nausea, diarrhea or stomach cramps
- Muscle aches and restlessness
Breathing Risks
At high enough doses, opioid-like compounds can slow down breathing. This respiratory depression is one of the leading causes of opioid overdose deaths, and it’s a key concern with concentrated 7-OH products.
How 7-OH Shows Up in the Market
One reason 7-OH has become such a hot topic is how it’s being sold. In recent years, a wave of kratom shots, gummies, capsules and powders has hit smoke shops, gas stations and even convenience stores.
Some of these products are marketed as energy boosters, stress relievers or pain solutions. Others are packaged in bright colors that appeal to younger customers. While the labels may simply say “kratom,” what many of these items actually contain is isolated or enhanced 7-OH, not just ground kratom leaf.
This means someone may believe they’re trying a “herbal supplement” but actually be consuming a compound with opioid-level potency. That misunderstanding puts them at much higher risk of developing dependence or experiencing a medical emergency.
The Legal Landscape: Florida Leads the Way
Because of rising health concerns, government agencies are starting to take action.
- At the federal level. In mid-2025, the FDA formally asked the DEA to classify concentrated 7-OH as a Schedule I controlled substance. This is the strictest drug category, reserved for substances with high abuse potential and no accepted medical use. Importantly, the FDA has emphasized that raw kratom leaf isn’t the focus of this request; it’s the concentrated 7-OH products.
- At the state level. Florida made headlines in August 2025 by becoming the first state to ban 7-OH. Under an emergency rule, any product containing 1% or more 7-OH is now classified as a Schedule I substance in the state. Lawmakers cited growing reports of poisonings and ER visits tied to these products, particularly among young people.
Other states may soon follow Florida’s lead, especially if the federal government takes broader action.
The Connection Between 7-OH and the Opioid Epidemic
Public health officials worry that 7-OH could fuel what some are calling a potential “fourth wave” of the opioid crisis.
- First wave. Prescription painkillers in the 1990s and 2000s
- Second wave. Heroin use in the 2010s
- Third wave. Synthetic opioids like fentanyl
- Potential fourth wave. Kratom derivatives like 7-OH, marketed as “safe” or “legal” but carrying many of the same risks
For people already struggling with opioid addiction or those who’ve been trying to avoid it, 7-OH presents a dangerous loophole. Its accessibility, low cost and “herbal” branding could lure individuals into dependence without realizing they’re essentially using an opioid analog.
What to Do If You’re Using 7-OH or Kratom Products
If you or a loved one is experimenting with kratom, energy shots or smoke shop supplements, it’s worth pausing to consider what’s inside. The label may not list “7-OH,” but that doesn’t mean it isn’t present.
Warning Signs of a Problem
You may want to seek professional help if you notice:
- Needing more of the product to get the same effect
- Feeling unable to cut back despite wanting to
- Experiencing withdrawal symptoms between doses
- Prioritizing use over responsibilities, work or relationships
- Spending more money or time on kratom products than intended
Treatment and Recovery Options
Treatment for kratom or 7-OH misuse often parallels treatment for other opioid use disorders. This may include:
- Medical detox to safely manage withdrawal symptoms
- Residential or inpatient rehab, providing structured support away from triggers
- Outpatient care, allowing recovery while maintaining daily responsibilities
- Therapies and support groups, including cognitive behavioral therapy (CBT), group counseling and peer support networks
A Word of Hope
If you’ve been caught off guard by the risks of 7-OH, you’re not alone. Many people try kratom, thinking it’s a safer alternative to prescription painkillers or a “natural” way to manage stress. Unfortunately, addiction doesn’t always announce itself until it’s already taken hold.
The good news is that help is available, and recovery is possible. Whether you’ve just started using kratom products or you’re already experiencing dependence, reaching out for support is a powerful first step.
The story of 7-OH is still unfolding, but one thing is clear: Despite being marketed as natural, this compound carries real risks similar to opioids. Knowing the facts can help you make informed choices for yourself or someone you care about.
If you or a loved one is struggling with kratom, 7-OH or any other substance, don’t wait until it becomes a crisis. Call the National Rehab Hotline today for free, confidential guidance. Help is available 24-7, and recovery is within reach.