Kratom and 7-OH: What You Need to Know About the Growing Risks

Written by Jo-Ann Richardson
Clinically reviewed by Kimberly Reid, M.Ed., LPC., LADC.

Kratom and products containing 7-hydroxymitragynine (7-OH) have become increasingly visible in Oklahoma and across the United States. They are often sold in gas stations, smoke shops, convenience stores and online, sometimes marketed as natural, herbal or plant-based products.

But "natural" does not automatically mean safe. Oklahoma health officials and the Oklahoma Bureau of Narcotics are now warning about an increase in deaths involving kratom-related compounds, particularly concentrated and manufactured products containing potent opioid-like substances. These products can differ substantially from traditional kratom leaf, and their labels may not always make that distinction obvious to consumers.

In Oklahoma, the concern has become particularly serious. According to Dr. Kacey Cliburn of the Oklahoma Medical Examiner's Office, more than 50 kratom-related deaths were identified statewide between January 2025 and June 2026, including 14 in Tulsa County. Cliburn said her office has seen a sharp increase in cases involving 7-OH-related compounds in recent months.

That concern comes as federal regulators are also taking action against some of the more potent compounds appearing in these products.

For anyone using kratom or 7-OH — or anyone concerned about a loved one's use — understanding the differences among traditional kratom and concentrated or chemically modified products is important. Those figures should not be interpreted to mean that kratom necessarily caused every one of those deaths; people involved in kratom-related deaths may also have been exposed to other substances.

For anyone using kratom or 7-OH — or anyone concerned about a loved one's use — understanding the differences among traditional botanical kratom, concentrated 7-OH products and synthetic kratom-related compounds is important.

What Is Kratom?

 

Kratom comes from the leaves of Mitragyna speciosa, a tree native to Southeast Asia. In the United States, kratom is sold in several forms, including powders, capsules, teas, extracts and other products.

Kratom contains naturally occurring compounds called alkaloids. The two most commonly discussed are mitragynine and 7-hydroxymitragynine, commonly known as 7-OH. Kratom can affect the brain's opioid receptors, and its effects can vary depending on the product, dose and chemical composition.

The U.S. Food and Drug Administration has warned about serious potential risks associated with kratom products, including addiction, withdrawal, seizures and liver toxicity. The FDA also says kratom is not lawfully marketed in the United States as an approved drug, dietary supplement or conventional food additive.

That regulatory position does not mean every kratom product is chemically identical or carries the same level of risk. Product composition, concentration and the presence of other substances matter.

What Is 7-OH?

7-hydroxymitragynine, or 7-OH, is an alkaloid associated with kratom. Small amounts occur naturally in kratom leaves. The important distinction is between those naturally occurring trace levels and products that are manufactured or concentrated to contain much higher amounts of 7-OH.

The FDA describes concentrated 7-OH products as potent opioid products and recommends that consumers avoid them. The agency has reported adverse effects associated with 7-OH products including addiction, anxiety, depression, gastrointestinal distress, insomnia, seizures and withdrawal symptoms.

Concentrated 7-OH products can be sold as tablets, gummies, drink mixes, shots and other products. Some are marketed as "7-OH," "enhanced kratom" or under other names that may not make their potency obvious to consumers. That is one reason a person should not assume that a product labeled "kratom" has the same effects or risks as ordinary botanical kratom leaf.

Why Are Oklahoma Officials Concerned?

Oklahoma officials say they are seeing increasingly serious cases involving potent kratom-related compounds. One compound drawing particular attention is MGM-15, also known as dihydro-7-hydroxymitragynine.

The Oklahoma Bureau of Narcotics has warned retailers that products exceeding Oklahoma's legal requirements could expose businesses to state enforcement and other consequences.

The warning is not simply about traditional kratom leaf. Officials are particularly concerned about concentrated, manufactured or chemically modified products that can deliver much stronger opioid activity.

The distinction is important because some products marketed to consumers as "kratom" or "enhanced kratom" may contain concentrated 7-OH or synthetic compounds rather than simply powdered botanical leaf.

Can Kratom and 7-OH Be Addictive?

Yes. Regular kratom use can lead to physical dependence. A person who becomes dependent may experience withdrawal symptoms when they reduce or stop using it.

Possible withdrawal symptoms can include:

• Irritability or anxiety
• Restlessness
• Difficulty sleeping
• Muscle aches
• Sweating or cold sweats
• Nausea or other gastrointestinal problems
• Cravings
• Fatigue
• Low mood

The FDA has reported withdrawal symptoms associated with 7-OH products, including restlessness, body aches, fatigue, irritability and cold sweats. Concentrated 7-OH products are particularly concerning because 7-OH has potent activity at opioid receptors.

It is important to distinguish physical dependence from addiction. Physical dependence means the body has adapted to repeated exposure and may experience withdrawal when the substance is reduced or stopped. Addiction, or a substance use disorder, involves a pattern of compulsive use despite harmful consequences and difficulty controlling use.

A person can develop a substance use disorder involving kratom or 7-OH even if the substance was initially used for pain, anxiety, stress or another reason.

When Does Kratom Use Become a Problem?

There isn't a single amount or frequency that determines whether someone has an addiction. Instead, look at what the substance is doing to the person's life. Warning signs can include:

• Feeling unable to stop or cut back
• Experiencing strong cravings
• Needing increasing amounts to achieve the desired effect
• Continuing to use despite physical or emotional problems
• Spending significant time obtaining or using the substance
• Hiding use from family members or friends
• Experiencing withdrawal when attempting to stop
• Prioritizing kratom or 7-OH over work, school, relationships or responsibilities
• Repeatedly trying to quit and returning to use

If several of these signs sound familiar, it may be worth talking with an addiction professional. You don't have to wait until substance use has caused a major crisis before asking for help.

Kratom, 7-OH and Recovery

For someone already in recovery from opioid or another substance use disorder, kratom and 7-OH can present an additional challenge. Because these substances can interact with opioid receptors, someone may use them believing they are avoiding another drug while still developing or maintaining opioid-related reinforcement or physical dependence.

That does not mean everyone who uses kratom will develop an addiction. It does mean that people with a history of substance use disorder should take the potential risks seriously.

Recovery is not about replacing one substance with another. It is about addressing the underlying factors that contribute to substance use and developing healthier ways to manage cravings, stress, pain, trauma and other challenges.

What Does Oklahoma Law Say About Kratom and 7-OH?

Oklahoma regulates kratom products under its Kratom Consumer Protection Act. Senate Bill 891 became law in 2025 and modified Oklahoma's rules concerning kratom products. Among other provisions, the law establishes requirements concerning qualifying kratom products and prohibits their sale to people under 18. Oklahoma law also establishes a specific limit involving 7-OH.

For a product to qualify under the state's definition of a kratom product, its 7-hydroxymitragynine content cannot exceed 1% of the amount of total kratom alkaloids. The law also excludes products containing synthesized kratom alkaloids, synthesized kratom constituents or synthesized metabolites of kratom constituents from the definition of a qualifying kratom product.

That distinction is important. A product marketed as "kratom" is not necessarily treated the same way under Oklahoma law if it contains concentrated or synthesized compounds.

Because state and federal regulations are changing, consumers and retailers should rely on current laws and regulatory guidance rather than older information about a particular product.

The Director of the Oklahoma Bureau of Narcotics and Dangerous Drugs, Mr. Donnie Anderson, has warned that businesses selling addictive and potentially fatal products have "no excuse." Anyone selling these items with a reckless disregard for public safety—including contributing to a fatal overdose—could face criminal or civil liability.

While kratom is not currently classified as a Controlled Dangerous Substance (CDS) in Oklahoma (meaning direct enforcement of the Kratom Consumer Protection Act falls primarily to the health department), Anderson's agency has taken a proactive stance alongside the Oklahoma State Department of Health to educate the public and warn noncompliant retailers.

What Is Happening at the Federal Level?

 

Federal regulators have also moved against potent kratom-related compounds. On July 1, 2026, the Drug Enforcement Administration announced the beginning of a temporary scheduling process involving 7-OH above a proposed threshold, as well as three related compounds: mitragynine pseudoindoxyl, MGM-15 and MGM-16.

The federal situation has since advanced. Effective August 26, 2026, the DEA temporarily placed mitragynine pseudoindoxyl, MGM-15 and MGM-16 in Schedule I under the federal Controlled Substances Act. The temporary order is scheduled to remain in effect through August 26, 2028, unless it is extended or made permanent.

The separate process involving 7-OH itself is still underway. Federal regulators are considering whether to temporarily place 7-OH above a specified threshold into Schedule I. The current federal request for information allows additional comments through September 10, 2026. The federal actions are intended to distinguish concentrated or manufactured opioid products from ordinary botanical kratom containing only naturally occurring trace levels of 7-OH.

For consumers, the takeaway is simple: the legal status of these products is changing rapidly, and a product's label does not necessarily tell the whole story about what compounds it contains.

What Does the FDA Say?

The FDA has not approved kratom or 7-OH as a treatment for a medical condition. The agency recommends that consumers avoid products containing 7-OH and says there are no FDA-approved products containing 7-OH. The FDA has reported potential harms associated with 7-OH products including addiction, withdrawal, seizures and other serious adverse effects.

The FDA has also taken enforcement action against companies marketing concentrated 7-OH products. In December 2025, the FDA announced the seizure of approximately 73,000 units of 7-OH products from three Missouri companies.

The FDA has repeatedly emphasized that products marketed as botanical or natural should not automatically be assumed to be safe.

What If Someone Wants to Stop Using Kratom or 7-OH?

If you or someone you love is having difficulty stopping, don't be ashamed to ask for help. Stopping a substance that has caused physical dependence can be difficult, and withdrawal can be uncomfortable. The safest approach depends on the person's history, how frequently they have been using the substance, whether they are using other substances and their overall health.

An addiction-treatment professional can help determine what level of care may be appropriate. Depending on the circumstances, treatment can include medical evaluation, withdrawal management, residential treatment, counseling, peer support and other services.

Someone who has been using 7-OH or kratom regularly should talk with a healthcare or addiction professional about the safest way to stop rather than assuming that stopping suddenly will be easy or appropriate.

What to Do in an Emergency

If someone is experiencing severe confusion, loss of consciousness, difficulty breathing, a seizure or another potentially life-threatening symptom, call 911 immediately.

If an opioid overdose is suspected and naloxone (Narcan) is available, administer it while emergency medical help is being sought. Naloxone may help reverse opioid-related respiratory depression, but it does not treat every possible complication associated with kratom or 7-OH. A person can experience other serious effects, including seizures or other medical complications, that require emergency treatment.

If someone is unresponsive, call 911 immediately. The FDA also directs people who believe they have experienced an adverse reaction to a 7-OH product to contact the Poison Help Line at 1-800-222-1222.

You Don't Have to Wait for Things to Get Worse

Kratom, concentrated 7-OH and synthetic kratom-related compounds are not all the same thing.

Traditional kratom leaf contains naturally occurring alkaloids, including mitragynine and small amounts of 7-OH. Concentrated or enhanced 7-OH products can contain substantially higher levels of 7-OH, while synthetic compounds such as MGM-15 and MGM-16 represent another category altogether. Federal regulators have increasingly emphasized these distinctions.

Kratom and 7-OH may be sold as herbal or natural products, but dependence and addiction can still develop.

If you find yourself needing kratom or 7-OH to get through the day, experiencing withdrawal when you don't use it, repeatedly trying unsuccessfully to stop, or continuing to use despite negative consequences, those are reasons to reach out for professional support.

Addiction is a treatable condition, and asking for help is a sign of strength — not failure. If you're concerned about your own use or a loved one's use of kratom or 7-OH, an addiction-treatment professional can help you understand your options and take the next step toward recovery.

Call Narconon Arrowhead to learn more about treatment and recovery options.

Sources and Further Reading:

• U.S. Food and Drug Administration — Products Containing 7-OH Can Cause Serious Harm U.S. Food and Drug Administration

• U.S. Food and Drug Administration — Hiding in Plain Sight: 7-OH Products U.S. Food and Drug Administration

• U.S. Food and Drug Administration — FDA Seizes 7-OH Opioids to Protect American Consumers U.S. Food and Drug Administration

• Drug Enforcement Administration — DEA to Temporarily Schedule 7-OH and Related Substances to Protect Public Safety DEA

• Federal Register — Temporary placement of mitragynine pseudoindoxyl, MGM-15 and MGM-16 in Schedule I Federal Register

• Oklahoma Legislature — Senate Bill 891, Oklahoma Kratom Consumer Protection Act Oklahoma Legislature

This article is intended for general educational purposes and is not a substitute for medical advice, diagnosis or treatment. If you are concerned about substance use, speak with a qualified healthcare or addiction-treatment professional.