Highly concentrated 7-OH products, often sold as kratom at gas stations, smoke shops and online, have helped some people manage pain and opioid withdrawal. They have also led others into a new addiction, NPR reported.
Tyler, now 38, told NPR that kratom leaf powders helped him stop using opioids for a decade after an addiction that began in his early 20s. He asked NPR to use only his first name because of the stigma attached to his history with drug use. In early 2025, he saw tablets at a gas station labeled as "kratom products" and tried them because the powders had been hard on his stomach. At first, 7-OH gave him a feeling of euphoria he described as similar to opioids, which "felt like a kind of a miracle." Nearly a year and a half later, he was in a rapid detox program in Michigan, sedated to sleep through withdrawal.
7-OH, or 7-hydroxymitragynine, is one of the major psychoactive ingredients in kratom, which comes from a tree in the coffee family. It is naturally found in kratom in very small amounts and seems to act more like an opioid in the human brain than whole-leaf products do, NPR reported. The concentrated versions can come as tablets, gummies, tonics and chocolate, and they are not always clearly labeled, making it difficult for users to know how much they are taking. "I did not know at all what I was in for. It was much more potent than I had imagined," Tyler said.
A narrower federal restriction, as soon as Friday
Estimates of U.S. kratom use range widely, from more than 5 million people who have used it in their lifetime to as high as 15 million, according to David Epstein, a senior investigator at the National Institute on Drug Abuse Intramural Research Program. Those estimates usually do not distinguish between whole-leaf kratom, 7-OH and related products.
No federal actions have been taken against "traditional botanical kratom," but a new federal restriction on some 7-OH products could go into place as early as Friday, Nov. 13, 2026, NPR reported. In August, the Drug Enforcement Administration restricted the making and sale of three semi-synthetic opioids derived from 7-OH and related compounds — MGM-15, MGM-16 and mitragynine pseudoindoxyl, or MGPI — listing them under the Controlled Substances Act alongside highly restricted drugs such as heroin and LSD. The American Kratom Association filed a federal lawsuit on Aug. 26, asking the DEA to ensure that natural kratom products with traces of MGPI would remain legal.
The Department of Health and Human Services issued a new recommendation on Oct. 9, and the DEA changed course. Officials now plan to restrict a narrower range of products: those that contain higher concentrations of 7-OH and/or MGPI. HHS and the DEA say they are not focusing on natural kratom products.
Poison-center calls, and users who say it is 'life-changing'
A recent report of data from 53 U.S. poison control centers found that calls related to kratom increased about 1,200 percent between 2015 and 2025. Chris Holstege, a physician and professor of emergency medicine and pediatrics at the University of Virginia School of Medicine and an author of that report, said the authors "were a bit stunned." The report included 233 deaths associated with kratom during 2015–2025, with 79 percent of those deaths involving multiple substances. The most severe outcomes were linked to people using kratom products alongside opioids, stimulants and benzodiazepines. Still, 62 percent of the calls involved people using kratom without other drugs.
Some users say the products have kept them away from traditional opioids or helped with chronic pain. Angela Wilson, 44, of Delaware, told NPR that 7-OH has helped her manage excruciating pain related to endometriosis and symptoms of depression. She said she has been taking 32 to 40 milligrams a day, split into three doses, for the last year and a half, and that she does not have health insurance. Losing access, she said, would be "devastating." Epstein said his ongoing research suggests the risk of addiction or dependence is higher with 7-OH products than with whole-leaf kratom. Some people, he said, found they "couldn't make it through the night" without another dose.
Opioid deaths in the United States have been falling — a KFF report found more than 79,000 in 2023 and 54,000 in 2024 — which some advocates cite as context for leaving alternatives available. The federal plan now on the table is narrower than the August rule, and it is aimed at the concentrated products that have spread far beyond traditional leaf powders.