Kratom and 7-OH: a guide for families

Kratom and 7-OH are not the same thing

Kratom (Mitragyna speciosa) is a tree native to Southeast Asia. Products made from its leaves are sold as powders, capsules and drinks. The FDA explains that kratom's main compounds, including mitragynine and 7-hydroxymitragynine (7-OH), act on the same brain receptors as opioid drugs.

7-OH occurs naturally in kratom leaves only in small, trace amounts. Separately, some products now sell 7-OH as an added or concentrated ingredient, in forms like tablets, gummies, drink mixes and shots. The FDA's 7-OH warning is aimed at these concentrated or enhanced products, which it describes as novel, potent opioid products that have not been proven safe or effective for any use. The FDA has also separately warned consumers not to use kratom because of risks including liver toxicity, seizures and substance use disorder.

Labels are not always reliable. The American College of Medical Toxicology (ACMT) notes that independent testing has found some products contain more 7-OH than their labels state. Rules for these products are changing and differ by place, so this guide does not describe legal status; check current, official sources where you live.

Possible dependence and withdrawal

In an August 2026 position statement, ACMT reported that clinical experience links 7-OH with opioid-like effects, including intoxication, slowed or depressed breathing, dependence and withdrawal, and it emphasized that clinical data are still emerging. The FDA has received reports of harmful effects from 7-OH products, including addiction, anxiety, depression, stomach problems, insomnia, seizures and withdrawal symptoms such as restlessness, body aches, fatigue, irritability and cold sweats.

Things a family might notice include using more or more often than intended, strong cravings, feeling unwell between uses, spending more money on products, or continuing despite problems at work, at home or with health. These are possibilities, not proof. Many of them have other explanations, and only a qualified healthcare professional can assess what is happening.

Starting a compassionate conversation

Many people begin using kratom or 7-OH hoping to manage pain, low mood, anxiety or opioid withdrawal. Starting from that understanding, instead of accusation, usually makes it easier to keep talking.

Pick a calm, private moment when your loved one is not intoxicated or in withdrawal. Describe what you have seen and how you feel ("I've noticed you seem sick in the mornings, and I'm worried") rather than labeling them. Ask open questions, listen more than you speak, and offer one small next step, such as seeing a doctor together. If they say no, you can come back to it later; one conversation rarely settles everything.

Please do not encourage anyone to stop suddenly or change how they use on their own. Withdrawal can be uncomfortable and sometimes risky, and decisions about stopping belong with a qualified clinician.

When to seek a medical assessment

Consider a medical assessment if your loved one has tried to cut back without success, feels sick between uses, uses kratom or 7-OH alongside alcohol, sedatives or other opioids, has a health condition or is pregnant, or is using it to manage pain or mental health symptoms. The FDA advises talking with a healthcare professional about opioid addiction, pain, anxiety or mood concerns, noting that approved treatments exist.

A primary care doctor, an addiction medicine specialist or a licensed treatment program can assess the situation. FindTreatment.gov, run by SAMHSA, is a free and confidential way to search for licensed treatment facilities in the United States.

Questions to ask a qualified treatment provider

Do you have experience assessing kratom or 7-OH use? Who will complete the assessment, and what are their qualifications? How do you handle withdrawal and co-occurring mental health concerns? What levels of care do you offer, and how do you decide which fits? What are the costs, and what does insurance cover? How can family be involved with the adult's consent? What happens after the program ends? Our guide to questions to ask an addiction treatment provider has a longer checklist.

Emergency red flags

Call 911 right away if someone is unresponsive or hard to wake, has slow, shallow or stopped breathing, blue or gray lips, a seizure, or chest pain. If you believe someone is having a harmful reaction that is not an emergency, the FDA points to the Poison Help Line at 1-800-222-1222. For a mental health or substance use crisis in the US, call or text 988.

Because 7-OH has opioid-like effects, ask a pharmacist or healthcare professional whether keeping naloxone at home makes sense for your family and how to use it. Naloxone does not replace calling 911.

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Common questions

Is kratom the same as 7-OH?

No. 7-OH is found naturally in kratom only in trace amounts. The FDA's 7-OH warning targets products with added or concentrated 7-OH, though it has also warned against kratom use.

Can someone become dependent on 7-OH?

ACMT and the FDA describe reports of dependence and withdrawal. Only a qualified professional can assess an individual situation.

Should my loved one just stop?

Please talk with a qualified clinician first. Stopping on their own can be uncomfortable or risky, and this guide does not give treatment instructions.

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Sources and further reading

• FDA: Products containing 7-OH can cause serious harm

  Consumer warning about concentrated or added 7-OH products, reported harms and the Poison Help Line.

• FDA and kratom

  Background on kratom, its compounds, and reported substance use disorder and withdrawal.

• ACMT position statement on 7-hydroxymitragynine and kratom compounds (August 2026)

  Medical toxicology statement on dependence, withdrawal, respiratory depression and emerging clinical data.

• FindTreatment.gov

  SAMHSA's confidential search for licensed treatment facilities in the US.