What’s the latest on 7-OH and kratom availability and addiction care?

For two years, anyone has been able to walk into a vape shop or convenience store in Michigan and other states, hand over cash or a credit card, and walk out with as much of a substance called 7-OH as they can afford. Or they can click online and get it shipped to them.

They may have turned to 7-OH at first to get relief from pain, anxiety or stress, or as an alternative to illegal drugs.

After all, 7-OH products have been touted as “natural” relatives of plant-derived kratom products that have been around for years.

But for many, including those who “graduated” from kratom to the more potent 7-OH products, their initial relief turned into an addiction they now can’t kick.

That’s because both kratom and 7-OH act on the brain’s opioid receptors. And for some people, that triggers a need to buy ever-higher doses to get the same effect, and a pattern of craving another dose sooner than before.

Now, 7-OH users may suddenly find themselves unable to buy those products in Michigan and other states that have not yet banned them.

It could happen as soon as early August.

That’s because the United States Drug Enforcement Agency has proposed to temporarily change how 7-OH and three related chemicals are regulated, or scheduled, at the national level.

The DEA proposed this action because of the sharp rise in poisonings, cases of addiction and overdose deaths seen since 7-OH products came on the market in the U.S. in late 2024.

If the DEA goes through with the rescheduling, 7-OH and related products could not be sold or prescribed in any way, in any state.

It would place them temporarily in the same class as heroin and LSD. The temporary rescheduling would last two years and could be extended another year.

A public comment period on the proposed rules ended July 31 and brought in tens of thousands of comments.

The DEA could act after the comments are considered.

The temporary rescheduling would only affect products that contain more than 1 milligram of 7-hydroxymitragynine (known as 7-OH for short), or 0.05% by weight or volume, and products that contain any amount of mitragynine pseudoindoxyl, MGM-15, or MGM-16.

Regardless of the outcome of the DEA scheduling decision, the need for treatment access and education is increasing."

-Eliza Hutchinson, M.D. 

While 7-hydroxymitragynine is produced naturally by the kratom plant that grows in South Asia and is present in small amounts in products made from natural kratom leaf, the other three substances are entirely lab-made.

The 7-OH in the products sold as anything other than natural kratom leaf is also lab-made, or synthetic, and is present in far higher concentrations than in kratom leaves.

In states like Michigan that have not banned natural leaf kratom products, those would still be available under the temporary DEA rescheduling if they have less than the threshold amount of 7-OH.

A bill to ban all 7-OH and kratom products passed the Michigan House this past March, but has not yet been taken up by the Michigan Senate.

A recovery clinic in Tennessee and Georgia offers a map tracking other states’ laws.

Early signs of impact at addiction treatment clinics

The potential for 7-OH products to disappear from stores in states where they have not already been banned has already sent some patients to clinics to help them start the process of recovery from their addiction, said Eliza Hutchinson, M.D.

She leads the Medications for Addiction Treatment team at the Packard Health Clinic in Ann Arbor and is a Clinical Assistant Professor in the University of Michigan Department of Family Medicine.

“We had several patients come to Packard in July to start treatment specifically because they have been told by their vape shop that the products are going away in August,” said Hutchinson.

“Regardless of the outcome of the DEA scheduling decision, the need for treatment access and education is increasing.”

Because 7-OH and kratom act on the opioid system in the brain, the medication called buprenorphine can be used to help someone recover from addiction to them.

Buprenorphine is a highly effective and lifesaving medication for people with opioid use disorder.

It has been used for years to help people recover from addiction to heroin, oxycodone, hydrocodone, morphine and fentanyl.

Hutchinson expects that many other 7-OH users may be caught off guard if the DEA rescheduling takes effect soon and encourages anyone who currently uses 7-OH to talk to their healthcare provider about options for help, including buprenorphine when needed.

She also worries that some people may turn to more dangerous opioids such as fentanyl to stave off withdrawal from 7-OH if these products are no longer on the market and an individual does not have access to treatment such as buprenorphine.

Hutchinson also notes that naloxone (Narcan) rescue medication can help reverse overdoses caused by the opioid effects of kratom and 7-OH, as well as other opioids.

But it can’t reverse other emergencies caused by other effects that kratom has on the brain and body, such as seizures or liver failure.

These risks and others could also occur If people use large doses of natural leaf kratom to try to make up for the loss of 7-OH, or take kratom with other substances including stimulants or benzodiazepines such as Xanax, Valium or Ativan.

For these, it’s important to seek immediate emergency care and to tell the ambulance crew, first responder or emergency department team exactly what you or the person took.

Resources for 7-OH and kratom addiction care, for patients and providers

For people in Washtenaw County, Michigan, Hutchinson and her colleagues at the Packard Clinic offer care for substance use disorders regardless of ability to pay.

The U-M Addiction Treatment Services clinic, based in the Department of Psychiatry at U-M Health’s Rachel Upjohn Building on the East Medical Campus in Ann Arbor, also offers outpatient treatment for teens and adults with all types of substance use disorders, including kratom and 7-OH.

OPEN, which is a U-M-based effort to help clinicians and community members reduce all kinds of opioid-related risks, offers information about finding treatment for substance use disorders across Michigan. OPEN’s name is short for the Overdose Prevention and Engagement Network.

And the FindTreatment.gov website and national helpline 1-800-662-HELP (4357) can help people in any U.S. state or territory locate addiction treatment centers near them.

But more health care providers who are willing and able to prescribe buprenorphine are urgently needed, Hutchinson says.

To increase their numbers, she and her colleagues have led education sessions to help prescribers across Michigan learn how to start and maintain patients on buprenorphine, and offer supportive services to aid their recovery.

They’re offering a live half-day virtual session in October for healthcare providers across Michigan; primary care providers will receive a financial incentive to participate and receive professional education credit.

There’s also an on-demand Kratom 101 class and one about the various kratom-related products including 7-OH.

Both are available to anyone with registration and continuing education credit is available to health care providers of all kinds.

OPEN’s website has free information on prescribing medications for opioid use disorder, and a free consult service that Michigan-based clinicians can call during weekdays to speak with a U-M expert for help when treating a patient with opioid addiction.

There’s also a guide for any clinician treating a pregnant patient who has opioid use disorder.

The Michigan Department of Health and Human Services also has a general flyer on kratom and 7-OH for the public, and one specifically aimed at parents of children and young adults in kindergarten through college age.

Meanwhile, U-M researchers continue to study kratom and 7-OH use across the U.S. In May, a team from the Center for the Study of Drugs, Alcohol, Smoking and Health published a study showing a rise in kratom use even before 7-OH products came on the market, and a correlation between kratom use and mental health issues.

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