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7-OH (7-Hydroxymitragynine): What It Is and Why It's Riskier

Alan Lucks | MD

Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on November 9th, 2026.

Published on November 3rd, 2026. Updated on November 9th, 2026.

Key Takeaways

  • 7-OH (7-hydroxymitragynine) is a minor alkaloid in kratom leaf; products sold as 7-OH are concentrated.

  • No 7-OH product is FDA-approved for any use, and FDA calls 7-OH a potent opioid.

  • Regular use can cause physical dependence and opioid-like withdrawal.

  • Poisonings have included serious harm and deaths.

  • As of November 2026, 7-OH isn't federally controlled, but the DEA has proposed temporarily placing 7-OH products above a set strength in Schedule I.

What 7-OH Is

7-hydroxymitragynine, or 7-OH, is one of the alkaloids in kratom (Mitragyna speciosa), a tree native to Southeast Asia. In the leaf it's a minor alkaloid, under 2% of the total, while mitragynine makes up about 66%, according to FDA's 2025 assessment. The body also turns some mitragynine into 7-OH. For the plant itself, see what is kratom.

Products sold as 7-OH are different from the leaf. They have 7-OH added or concentrated, and they come as tablets, gummies, drink mixes and shots, sold online and in smoke shops and gas stations.

7-OH acts on mu-opioid receptors, the same receptors that opioid pain medicines act on. FDA calls it a potent opioid and says no 7-OH product has been proven safe or effective for any use.

How It Compares to Kratom Leaf

7-OH products aren't natural kratom. Here's how they differ from the leaf.

Feature

Kratom leaf

7-OH products

What it is

Leaves of the kratom tree, with many alkaloids

Products with 7-OH added or concentrated

Main alkaloid

Mitragynine, about 66% of alkaloids

7-OH

7-OH content

A minor alkaloid, under 2% of the total

Concentrated

FDA approval

Not approved for any medical use

No product approved for any use

What FDA says

Warns people not to use it

Calls 7-OH a potent opioid

For a fuller side-by-side, see 7-OH vs kratom.

Effects and Side Effects

FDA lists euphoria, sedation and slowed breathing (respiratory depression) among 7-OH's effects. What's in a product can also vary: DEA reports that tested 7-OH samples often contained other drugs, including fentanyl, the benzodiazepine bromazolam and ketamine.

Effects people seek

  • Euphoria: a high or sense of well-being.

  • Sedation: feeling calm, drowsy or slowed down.

Side effects reported in 7-OH poisonings

  • Stomach: nausea and vomiting.

  • Heart and circulation: sweating, a fast heart rate and high blood pressure.

  • Brain and nerves: agitation and confusion.

When to get help

Call 911 for trouble breathing, a seizure, chest pain or fainting. See Overdose Signs below for more.

Dependence and Withdrawal

7-OH causes physical dependence and withdrawal like classic opioids, FDA's 2025 assessment says, and there are reports of long-lasting withdrawal with concentrated products. Severe cases have been reported: in one, a person with agitation, psychosis and breathing problems needed a breathing tube.

No medicine is FDA-approved for 7-OH or kratom withdrawal. Buprenorphine (Suboxone) is approved for opioid use disorder, and doctors who treat opioid use disorder may use it off-label for 7-OH dependence. In a case series of 9 people using 7-OH, starting buprenorphine worked for 8. The evidence is limited to small case series, with no controlled trials. Starting it too soon can bring on sudden, severe withdrawal, so doctors time the first dose or use low-dose starts.

If you want to stop, work with a licensed doctor on a plan. For free, confidential referrals to treatment, call SAMHSA's National Helpline at 1-800-662-4357, any hour. Our guide to 7-OH withdrawal covers symptoms and what to expect, and you can get support for kratom withdrawal online.

Overdose Signs

7-OH overdose can kill. By February 27, 2026, FDA's adverse event system had 86 reports involving 7-OH, 79 of them serious, including 9 deaths. DEA's toxicology program lists 85 cases since 2019, 55 of them fatal.

Sign

What to do

Unresponsive or passed out

Call 911

Slow, stopped or difficult breathing

Call 911

Blue lips or pinpoint pupils

Call 911

Seizure

Call 911

Chest pain or fainting

Call 911

Possible poisoning, awake and breathing

Call Poison Control at 1-800-222-1222, or 911

Thoughts of harming yourself

Call or text 988

In rats, naloxone (Narcan) reversed 7-OH's effect on breathing, and it reversed a kratom overdose in a human case report. Give naloxone if you have it, and still call 911, because symptoms can return.

FDA and DEA Status (as of November 2026)

7-OH's legal status is changing. As of November 3, 2026:

  • FDA: no 7-OH product is approved for any use. On July 29, 2025, FDA recommended that certain 7-OH products be scheduled under the Controlled Substances Act. Scheduling is the DEA's decision.

  • DEA: on October 14, 2026, the DEA published a notice of intent to temporarily place 7-OH in Schedule I. It would cover products with more than 1 mg of 7-OH per gram or per mL, or too little mitragynine compared with 7-OH. The order can come on or after November 13, 2026. Until an order takes effect, 7-OH isn't federally controlled.

  • States: the DEA's notice says ten states prohibit 7-OH: Alabama, Arkansas, Connecticut, Indiana, Kansas, Louisiana, Massachusetts, Tennessee, Vermont and Wisconsin. Others limit it.

Laws change quickly, so check the DEA and your state's current law.

Continue Learning

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7-OH Withdrawal 7-OH vs Kratom Kratom Drug Interactions Can You Overdose on Kratom? How to Quit Kratom
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Frequently Asked Questions

Get answers to common questions about 7-OH.

In lab tests, yes. In an isolated guinea pig gut assay, 7-OH was about 13 times as potent as morphine (Matsumoto, 2004). FDA's 2025 assessment says it slowed breathing with more than 3 times morphine's potency in preclinical studies. These are lab and animal results, not human doses.

No amount has been shown to be safe. In the DEA's 2026 notice, neither HHS nor the DEA found 7-OH safe below the proposed limit.

No, it's risky. Mixing 7-OH with alcohol, benzodiazepines or other opioids adds to sedation and slowed breathing. The DEA calls use with a central nervous system depressant a serious concern. Our guide to kratom drug interactions has more.

No. FDA has found no 7-OH product safe and effective for opioid withdrawal, and using it this way can lead to dependence on 7-OH. The FDA-approved medicines for opioid use disorder are buprenorphine, methadone and naltrexone.

It isn't well established in people. In a small study of 9 people who used kratom regularly (Trakulsrichai, 2015), kratom's main alkaloid, mitragynine, had a half-life of about 23 hours. That doesn't tell you how long 7-OH lasts.

Still have questions? A licensed doctor can talk through your 7-OH use and your other medicines.

The Bottom Line

7-OH is a minor alkaloid in kratom leaf, but 7-OH products concentrate it, and FDA calls it a potent opioid. It can cause dependence, opioid-like withdrawal and fatal overdose, and its legal status is changing.

Doctronic doesn't treat addiction or run detox. If you have questions about your 7-OH use, Doctronic's medical AI chat is free, and a video visit with a licensed doctor is $39. The doctor can help with symptoms and refer you to addiction care.

References

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