Kratom has increasingly gained attention in the United States, but growing evidence and public-health warnings have raised concerns about kratom addiction, dependence, withdrawal, and concentrated 7-hydroxymitragynine (7-OH) products.
The Centers for Disease Control and Prevention (CDC) reported that U.S. poison centers received 3,434 kratom exposure reports in 2025, compared with 258 in 2015—an increase of approximately 1,200%. The CDC also noted concerns about the shift from traditional kratom leaf products toward higher-potency extracts.
Research using federal survey data found that the percentage of Americans ages 12 and older who reported ever using kratom increased from approximately 1.6% in 2021 to 1.9% in 2024.
At the same time, concentrated 7-hydroxymitragynine (7-OH) products have emerged as a particular concern. These products may be sold as tablets, gummies, drink mixes, shots, and other products in convenience stores, smoke shops, gas stations, and online.
The U.S. Food and Drug Administration (FDA) has warned consumers about concentrated 7-OH products and says they have not been proven safe or effective for any medical use.
Understanding kratom vs. 7-OH, the potential for dependence and withdrawal, and when to seek professional help can help individuals and families make informed decisions about treatment and recovery.
What Is Kratom?
Kratom, scientifically known as Mitragyna speciosa, is a tropical tree native to Southeast Asia. Its leaves have traditionally been chewed or brewed into tea and used for purposes including reducing fatigue, increasing energy, and managing discomfort.
In the United States, kratom is sold in a variety of forms and is often marketed as a natural or herbal product. Some people use it for pain, energy, relaxation, or an attempt to manage opioid withdrawal symptoms.
However, natural does not automatically mean safe.
Kratom contains psychoactive compounds that interact with opioid receptors in the brain. Regular use may lead to tolerance, physical dependence, and withdrawal symptoms.
The FDA has also identified safety concerns associated with kratom and kratom-derived products, including reports involving liver toxicity, seizures, gastrointestinal problems, cardiovascular effects, respiratory depression, addiction, withdrawal, and death.
Kratom is sometimes described in the media as “gas station heroin.” While this phrase can attract attention, it can also oversimplify the differences between traditional kratom leaf, kratom extracts, and concentrated 7-OH products. A more useful question is: What is actually in the product, and how much of the active compounds does it contain?
What Is 7-Hydroxymitragynine (7-OH)?
One of the most important compounds associated with kratom is 7-hydroxymitragynine, commonly called 7-OH.
7-OH occurs naturally in kratom leaves in relatively small amounts. However, products marketed specifically as concentrated or enhanced 7-OH can contain much higher levels.
The FDA distinguishes between naturally occurring kratom leaf products and concentrated 7-OH products. Its primary concern is the growing availability of products containing added or enhanced levels of 7-OH.
7-OH has potent activity at opioid receptors and can produce opioid-like effects. The FDA’s scientific assessment describes 7-OH as a potent mu-opioid receptor agonist with significant potential for abuse.
Mitragynine vs. 7-OH
Kratom contains numerous naturally occurring alkaloids, but two are particularly important when discussing its effects:
Mitragynine:
Mitragynine is the primary alkaloid found in kratom leaf. It interacts with opioid receptors and contributes to both stimulant-like and opioid-like effects. The body can also metabolize mitragynine into 7-OH.
7-Hydroxymitragynine (7-OH):
7-OH occurs naturally in trace amounts in kratom but can also be concentrated and added to commercial products. It has potent opioid-receptor activity and is associated with opioid-like effects.
This distinction matters because a concentrated 7-OH product is not equivalent to ordinary kratom leaf.
How Are Kratom and 7-OH Products Sold?
Kratom products can come in many forms, including:
- Capsules and tablets
- Powders
- Dried or fresh leaves
- Teas and brewed preparations
- Liquid extracts and shots
- Gummies
- Concentrated extracts
- Tablets, gummies, shots, and other products containing enhanced levels of 7-OH
Some products are sold at gas stations, convenience stores, smoke shops, vape shops, and online retailers.
Bright flavors and packaging can also make some products look similar to energy drinks, supplements, candy, or other consumer products.
The FDA has warned that some concentrated 7-OH products may be marketed as kratom or may not clearly communicate the amount of 7-OH they contain.
What Are the Effects of Kratom?
The effects of kratom can vary depending on the product, dose, frequency of use, individual health factors, and whether other substances are used at the same time.
Lower doses
Some people report stimulant-like effects, such as:
- Increased energy
- Greater alertness
- Increased sociability
Higher doses
Higher exposure may produce more opioid-like effects, including:
- Relaxation
- Sedation
- Pain relief
- Euphoria
Kratom and concentrated 7-OH products may also cause unwanted effects such as:
- Nausea
- Vomiting
- Constipation
- Dizziness
- Anxiety
- Changes in heart rate or blood pressure
- Drowsiness
The CDC has noted that multiple-substance kratom exposures were associated with the most severe clinical outcomes in its analysis of poison-center data.
Can Kratom Be Addictive?
Yes. Kratom can lead to physical dependence and problematic patterns of use.
Someone may initially begin using kratom to manage pain, fatigue, stress, or opioid withdrawal symptoms. Over time, however, repeated use may result in tolerance, cravings, dependence, or difficulty stopping.
Possible signs of kratom addiction or kratom use disorder include:
- Using more kratom than intended
- Using kratom for longer than planned
- Strong cravings or urges to use
- Increasing the amount used to achieve similar effects
- Spending significant time obtaining, using, or recovering from kratom
- Continuing to use despite physical, emotional, financial, or relationship problems
- Attempting to stop but being unable to do so
- Experiencing withdrawal symptoms when reducing or stopping use
Physical dependence and addiction are not exactly the same thing. A person can develop physical dependence without meeting all the criteria for a substance use disorder. However, difficulty controlling use or continuing despite significant consequences can be a sign that professional assessment is appropriate.
Kratom Withdrawal: What Happens When You Stop?
People who use kratom regularly may experience kratom withdrawal symptoms when they significantly reduce or stop using it. Symptoms may include:
- Muscle aches
- Restlessness
- Anxiety or irritability
- Difficulty sleeping
- Fatigue
- Low energy
- Nausea
- Diarrhea
- Sweating
- Cravings
- Difficulty stopping or staying abstinent
Withdrawal can vary considerably from person to person.
7-OH Withdrawal
Withdrawal from concentrated 7-OH products may be particularly concerning because of their potent opioid activity.
The FDA has identified withdrawal symptoms associated with 7-OH products, including restlessness, body aches, fatigue, irritability, and cold sweats.
People who have been using high-potency 7-OH products regularly should speak with a healthcare professional before attempting to manage significant withdrawal on their own.
Is 7-OH the Same as Kratom?
No. Although 7-OH is naturally present in kratom in trace amounts, concentrated 7-OH products are different from traditional kratom leaf preparations.
The FDA’s current warnings specifically distinguish concentrated or enhanced 7-OH products from natural kratom leaf. The agency has warned consumers to avoid 7-OH products because they have not been proven safe or effective for any medical use.
This distinction is important when assessing someone’s substance use. Someone using traditional kratom leaf may have a different level of exposure and different clinical needs than someone regularly using concentrated 7-OH tablets, gummies, shots, or extracts.
Can Kratom Addiction Be Treated?
Yes. People experiencing problematic kratom use or dependence can seek professional help.
There is currently no FDA-approved medication specifically for kratom use disorder or kratom withdrawal. Treatment is generally individualized based on the person’s symptoms, substance-use history, medical needs, and whether other substances are involved.
Depending on the situation, treatment may include:
Medical assessment and withdrawal management
A healthcare professional can evaluate the severity of dependence and withdrawal, identify potential complications, and determine the appropriate level of care.
Medication when clinically appropriate
In some cases, clinicians may use medications such as buprenorphine to manage opioid-like withdrawal or dependence. Medication decisions should be made by qualified healthcare professionals based on the individual’s circumstances.
Counseling and behavioral therapy
Therapy can help individuals understand the reasons behind substance use, identify triggers, develop healthier coping strategies, and build skills that support long-term recovery.
Peer and recovery support
Recovery communities and peer support can help people reduce isolation, strengthen accountability, and maintain progress after treatment.
Treatment for co-occurring mental health concerns
Some people use kratom or other substances to cope with anxiety, depression, trauma, chronic stress, or other emotional challenges. Addressing co-occurring concerns can be an important part of comprehensive addiction treatment.
When Should Someone Seek Help for Kratom or 7-OH Use?
Consider reaching out to a healthcare professional or addiction treatment provider if you or someone you love:
- Cannot stop using kratom or 7-OH
- Experiences withdrawal when attempting to stop
- Needs increasingly larger amounts
- Uses the substance every day or repeatedly throughout the day
- Experiences cravings that interfere with daily life
- Continues using despite negative consequences
- Uses kratom or 7-OH with other substances
- Has experienced concerning physical or psychological effects
- Is using kratom or 7-OH to cope with pain, anxiety, trauma, or another underlying problem
Seeking help does not mean someone has failed. It means they are taking a step toward understanding what is happening and finding safer, evidence-based support.
Take the First Step Toward Recovery
At Recovery at the Crossroads, we recognize that substance use challenges can affect people from every background and walk of life. Whether someone is struggling with kratom addiction, 7-OH dependence, another substance, or co-occurring mental health concerns, professional support can make an important difference.
As Clinical Director Nadine Talley, MSW, LCSW, CTSS, explains, “Anyone struggling with addiction or mental health challenges often shares one common experience: pain that has become overwhelming and difficult to manage. In these moments, it is understandable to seek relief wherever it may be found. Unfortunately, manufacturers of ‘herbal’ products such as kratom often capitalize on that vulnerability, marketing their products as safe and natural solutions while downplaying potential risks.”
Reach out to Recovery at the Crossroads to learn more about treatment and recovery support.
