The U.S. Drug Enforcement Administration (DEA) announced in early July its intent to temporarily classify concentrated and synthetic forms of 7-hydroxymitragynine, commonly known as 7-OH, as Schedule I controlled substances. This federal action, alongside strengthened regulations by the State of Texas on high-potency 7-OH products, stems from concerns regarding abuse and public safety. These products, often found in smoke shops, vape stores, convenience stores, and online, are significantly more potent than traditional kratom and can produce effects similar to opioids, according to Jasmine Douglas, M.D., a board-certified addiction medicine specialist at UT Health East Texas.
7-OH is a chemical naturally present in the kratom plant, though only in tiny amounts. The products now circulating widely contain highly concentrated or synthetic forms of 7-OH. Some also include related compounds identified as mitragynine pseudoindoxyl (MP), MGM-15, or MGM-16. The DEA's intended classification also extends to these specific related compounds, grouping them with 7-OH due to their potent, opioid-like characteristics.
Because of their high potency, concentrated 7-OH products carry significant risks. Repeated use can lead to physical dependence, similar to other opioid-like substances. Individuals who stop using these products suddenly may experience withdrawal symptoms. These symptoms can include agitation, anxiety, muscle aches, insomnia, a runny nose, abdominal cramps, diarrhea, nausea, vomiting, sweating, fever, and goosebumps. While withdrawal can be uncomfortable, medical help is available to manage the process, according to Dr. Douglas.
The assumption that products sold over the counter are inherently safe is not always accurate, and this holds true for high-potency 7-OH products. Medical reports have linked these substances to serious breathing problems, unconsciousness, and in some cases, cardiac arrest. Naloxone, often known by its brand name Narcan, has been shown to reverse these opioid-like effects, much as it does with other opioid overdoses. In emergency situations where someone is difficult to wake up, stops breathing normally, or becomes unresponsive after using one of these products, calling 911 immediately is critical. If naloxone is available, administering it while waiting for emergency medical services is advised.
The recent regulatory changes by both federal and state authorities are expected to impact the availability of some high-potency 7-OH products. As these products become harder to find, healthcare professionals anticipate that more people may seek medical care if they experience withdrawal after discontinuing use. Texas has specifically strengthened regulations on these high-potency products while maintaining separate oversight for traditional kratom.
For individuals struggling to stop using 7-OH products, support and treatment are accessible. Dr. Douglas emphasizes that "recovery is possible." The Addiction Medicine team at UT Health East Texas offers compassionate, evidence-based care for those experiencing dependence on 7-OH, kratom-related products, and other substances. Treatment options can encompass medications to help reduce withdrawal symptoms, counseling, and ongoing support designed to facilitate safe recovery.
