Kratom is often marketed as a natural remedy for pain, anxiety, and opioid withdrawal. But not all
kratom products are created equal. One compound in particular—7-hydroxymitragynine (7-OH)—
has raised serious concerns among medical professionals, public health officials, and the FDA. While
7-OH occurs naturally in trace amounts in kratom leaves, it is increasingly being extracted,
concentrated, and sold in products that pose significant health risks[1].
What Is 7-Hydroxymitragynine?
7-OH is one of the most potent alkaloids in kratom. Though it makes up less than 0.05% of the
dried leaf mass, it binds to mu-opioid receptors in the brain with far greater strength than kratom’s
primary compound, mitragynine. In fact, 7-OH is estimated to be 13–46 times more potent than
morphine as a pain reliever[2].
Traditional Kratom vs. Concentrated 7-OH: Key
Differences
Feature Traditional Kratom
Powder Concentrated 7-OH Products
Source Ground kratom leaves Extracted or synthesized alkaloid
Potency Mild to moderate Extremely high (up to 46x morphine)
Onset 30–45 minutes 10–20 minutes
Duration 4–6 hours 3–5 hours
Risk Level Lower, with balanced
alkaloids High risk of overdose, dependence, and withdrawal
FDA
Status
Not approved, but widely
sold
Not lawful in supplements or foods; FDA warning
issued[3]
Office | 3541 Randolph Rd Ste 303 Charlotte, NC 28211
Phone|704-246-4644 Fax|704-943-3725 Web|startbupe.com
Why Concentrated 7-OH Is Dangerous
While traditional kratom powder contains a natural blend of alkaloids, concentrated 7-OH isolates
a single compound and amplifies its effects. This can lead to:

  • Rapid tolerance and dependence
  • Severe withdrawal symptoms
  • Respiratory depression
  • Overdose risk, especially when mixed with alcohol or other depressants[4]
  • Hospitalizations and ER visits[3]
    The FDA has issued multiple warning letters to companies selling 7-OH products, including
    gummies, tablets, and drink mixes. These products are often misleadingly marketed as “natural”,
    despite containing synthetic or semi-synthetic compounds[1].
    What Patients and Families Should Know
    If You’re in Recovery:
  • Avoid products labeled as “kratom extract” or “enhanced kratom.”
  • Be aware that 7-OH can mimic opioid effects and trigger relapse.
  • Talk to your provider before using any kratom-related product.
    If You’re Considering Treatment:
  • Know that kratom and 7-OH are not safe alternatives to FDA-approved medications like
    buprenorphine or methadone.
  • Seek evidence-based care from licensed professionals.
    If You’re a Loved One:
  • Watch for signs of kratom or 7-OH use: mood swings, sedation, withdrawal symptoms.
  • Encourage open dialogue and support treatment options.
    If You’re a Healthcare Professional:
  • Screen for kratom and 7-OH use during assessments.
  • Educate patients about the risks of concentrated alkaloids.
  • Stay informed about regulatory updates and treatment protocols.
    Office | 3541 Randolph Rd Ste 303 Charlotte, NC 28211
    Phone|704-246-4644 Fax|704-943-3725 Web|startbupe.com
    Final Thoughts
    While kratom in its traditional form may seem like a safer, plant-based option, the emergence of
    concentrated 7-OH products has introduced a new wave of risk. These products are not regulated,
    not approved, and not safe—especially for individuals affected by opioid use disorder.
    At our practice, we’re committed to evidence-based care, patient safety, and long-term recovery.
    If you have questions about kratom, 7-OH, or opioid treatment options, we’re here to help.

References References
[1] www.fda.gov
[2] anrclinic.com
[3] www.painnewsnetwork.org
[4] poisoncenters.org

Reviewed by a medical professional