Published
Medically reviewed by Danesh Alam MD, DFAPA, DFASAM
7-OH (7-hydroxymitragynine) is an opioid-like compound that occurs in tiny amounts in kratom leaves. Products sold as 7-OH tablets, shots, and gummies concentrate it far beyond natural levels. It acts on the same brain receptors as morphine, so regular use can lead to opioid-type dependence and withdrawal. In Florida, concentrated 7-OH is a Schedule I controlled substance.
If someone cannot be woken or is not breathing normally, call 911 now and give naloxone if you have it.
What is 7-OH?
7-OH is one of the alkaloids in the kratom plant, Mitragyna speciosa. In the natural leaf it makes up less than two percent of the total alkaloid content, or occurs only in trace amounts, according to the DEA. It can also be made from mitragynine, kratom's main alkaloid, in a one-step chemical reaction. DEA: Notice of intent to schedule 7-OH
The FDA calls 7-OH "an opioid that can be more potent than morphine." FDA: Steps to restrict 7-OH products It is sold under names like 7-Hydroxy, 7-OHMG, 7-HMG, or just "7." FDA: Letter to health care professionals The DEA reports that 7-OH products are sold in smoke shops, gas stations, and online as tablets, shots, capsules, powders, syrups, vapes, strips, and chewables.
How is 7-OH different from kratom?
The difference is concentration. Kratom leaf contains mostly mitragynine and only a trace of 7-OH. 7-OH products are made to deliver much more of it. The FDA says these concentrated products "are far more dangerous than traditional kratom leaf products," and that some "enhanced" or "spiked" kratom may contain 500% more 7-OH than the leaf naturally would. FDA: Letter to health care professionals
A 2026 review by University of Florida researchers found that native leaf products have the lowest alkaloid content and a lower potential for dependence. Purified products, including semi-synthetic 7-OH, are likely tied to a higher risk of dependence and overdose. Substance Abuse and Rehabilitation: Kratom product review
This matters because packaging often blurs the line. The FDA warns that 7-OH products are "often falsely marketed as Kratom." FDA: What you need to know about 7-OH If you or a family member uses kratom, read the label. A product that lists 7-OH, 7-hydroxy, or "enhanced" alkaloids is not plain leaf. Our kratom addiction treatment page covers the leaf itself.
Why does it matter that 7-OH acts on opioid receptors?
It means 7-OH behaves like an opioid in the body. NIDA explains that mitragynine and 7-OH both activate mu-opioid receptors, the same receptors that opioid pain medicines act on. NIDA: Kratom The DEA says 7-OH "shares health risks similar to other mu-opioid receptor agonists, such as morphine," and that animal research shows tolerance, dependence, and slowed breathing "comparable to those of classic opioid analgesics." DEA: Notice of intent to schedule 7-OH
In practice, that leads to three risks:
- Tolerance: over time, it takes more to feel the same effect.
- Dependence: the body adjusts to having it, so stopping brings withdrawal.
- Slowed breathing: at high doses, or mixed with alcohol or sedatives, breathing can become dangerously slow.
The FDA also warns there is "No Safe Swap": kratom-related products, including 7-OH, are not safe or approved treatments for opioid withdrawal, chronic pain, depression, or anxiety. FDA: What you need to know about 7-OH For people who started using kratom to manage opioid withdrawal, our page on opioid addiction treatment explains care options.
What does 7-OH withdrawal look like?
7-OH withdrawal looks like opioid withdrawal. The FDA lists withdrawal symptoms, insomnia, anxiety, and seizures among the side effects of 7-OH. FDA: Letter to health care professionals In one published case, a man who had switched from kratom to concentrated 7-OH came to the emergency department with nausea, diarrhea, stomach cramps, restlessness, chills, and anxiety about two days after his last dose. He said he switched because 7-OH felt stronger and faster, and he needed smaller amounts to avoid withdrawal. Journal of the American Pharmacists Association: 7-OH withdrawal case
Those symptoms match the general opioid withdrawal pattern described by MedlinePlus. Early signs include:
- Anxiety and agitation
- Muscle aches
- Trouble sleeping
- Runny nose, watery eyes, and yawning
- Sweating
Later signs can include stomach cramps, diarrhea, nausea, vomiting, goosebumps, and dilated pupils. MedlinePlus says these symptoms "are very uncomfortable but are not life threatening." MedlinePlus: Opioid withdrawal
No approved source has yet set out a timeline for how long 7-OH withdrawal lasts. The DEA notes that people describe the 7-OH high as short-lived, with an urge to take more often. DEA: Notice of intent to schedule 7-OH
Withdrawal itself is usually not life-threatening, but what comes after can be. Tolerance drops quickly once someone stops, and MedlinePlus notes that "most opioid overdose deaths occur in people who have just detoxed." Returning to a previous amount, or switching to another opioid, carries real risk.
Can you overdose on 7-OH?
Yes. The FDA lists "fatal respiratory depression" among 7-OH's effects. FDA: Letter to health care professionals NIDA reports that in laboratory models, 7-OH can slow breathing in a way that naloxone reverses. NIDA: Kratom The DEA cites a 2026 case report of a person revived with naloxone after using 7-OH, and calls mixing 7-OH with other sedating substances "of serious concern." DEA: Notice of intent to schedule 7-OH In another 2026 report, a man died after reportedly taking three 7-OH tablets with several beers. Annals of Emergency Medicine: Fatal case report
Signs of an opioid overdose include being unable to wake up; slow, shallow, or gurgling breathing; blue or gray lips or nails; and pinpoint pupils. CDC: Responding to an overdose If you see them:
- Call 911 and give naloxone if you have it.
- Try to keep the person awake and breathing.
- Lay them on their side to prevent choking.
- Stay with them until help arrives.
Naloxone is sold over the counter in all 50 states, and it "won't harm someone if they're overdosing on drugs other than opioids." CDC: Lifesaving naloxone Our guide to Narcan and naloxone explains how it works. For other dangerous substances turning up in the drug supply, read about xylazine and nitazenes.
Is 7-OH legal in Florida?
No, not in concentrated form. Florida first placed concentrated 7-OH in Schedule I, its strictest category, by emergency rule on August 12, 2025. Florida Administrative Code: Rule 2ER25-1 The current rule, effective August 18, 2026, covers 7-OH products with more than 1 milligram per gram (solids and pills) or 1 milligram per milliliter (liquids), and any product with less than 100 parts mitragynine for every part 7-OH. It also lists three related compounds, including the lab-made MGM-15 and MGM-16. Florida Administrative Register: Rule 2ER26-2
The rule is set to expire June 30, 2027. The Attorney General has said he will ask the Legislature to make it law in 2027. Florida Administrative Register: Rule 2ER26-2 dates According to the FDA, these thresholds are meant to separate intentionally enhanced products from those more consistent with natural kratom. FDA: Hiding in plain sight Separately, Florida law makes it illegal to sell or give any kratom product to anyone under 21. Florida Statutes 500.92 This is general information, not legal advice.
Is 7-OH illegal federally?
Not yet, but the DEA has announced it intends to schedule it. The FDA recommended scheduling certain 7-OH products on July 29, 2025. FDA: Steps to restrict 7-OH products On October 14, 2026, the DEA published a notice of intent to temporarily place 7-OH and a related compound, mitragynine pseudoindoxyl, in Schedule I above the same thresholds Florida uses. The order cannot be issued until at least 30 days after that notice, so check for updates. The DEA adds that neither it nor the Department of Health and Human Services has found these substances "safe to use at below-threshold levels." DEA: Notice of intent to schedule 7-OH
How is 7-OH dependence treated?
Treatment starts with an assessment, and for many people that means medically supervised withdrawal followed by ongoing care. NIDA notes there are no approved treatments specifically for kratom withdrawal or kratom-related substance use disorder. NIDA: Kratom In a small 2026 case series, clinicians used buprenorphine, a medication for opioid use disorder, for people using purified 7-OH, and reported it was well tolerated. The authors note there is no standard clinical guidance yet. Journal of Addiction Medicine: Buprenorphine for 7-OH use
Midwest Detox at Ambrosia in West Palm Beach provides detoxification with 24/7 medical supervision by physicians and nurses, for adults and adolescents. Admission and the plan of care are based on an individual clinical assessment. Medication-assisted treatment is provided through our detox center, and whether it is right for you is a clinical decision. The medical detox program page explains the first days. Wondering how quickly care can start? Read how fast you can get into detox, and plan ahead with what happens after detox. You can also check your insurance coverage.
For free, confidential treatment referrals at any hour, call SAMHSA's National Helpline at 1-800-662-4357. SAMHSA: National Helpline If you or someone you love is in emotional crisis, call or text 988. For questions about a possible 7-OH reaction, call Poison Help at 1-800-222-1222.
Frequently asked questions
Is 7-OH the same as kratom?
No. 7-OH is one compound found in trace amounts in kratom leaves. 7-OH products concentrate it far above natural levels, which the FDA says makes them far more dangerous than traditional leaf products.
Is 7-OH an opioid?
The FDA calls it an opioid. It is not a prescription drug, but it acts on the same mu-opioid receptors as morphine and carries similar risks of dependence and slowed breathing.
What are the symptoms of 7-OH withdrawal?
They resemble opioid withdrawal: anxiety, restlessness, muscle aches, sweating, chills, trouble sleeping, nausea, diarrhea, and stomach cramps. Withdrawal is very uncomfortable but usually not life-threatening.
Does naloxone work on 7-OH?
In laboratory models and a reported case, naloxone reversed breathing problems caused by 7-OH. If you suspect an overdose, call 911 and give naloxone.
Is 7-OH legal in Florida?
No. Florida first scheduled concentrated 7-OH in August 2025, and the current emergency rule has made it a Schedule I controlled substance since August 18, 2026. Kratom products may be sold only to adults 21 and older.