What Is 7-OH? Kratom and 7-OH Withdrawal, Risks and How Treatment Works

7-OH is a concentrated opioid made from a compound in the kratom plant, sold as tablets, gummies and shots. Here's how it differs from kratom leaf, what withdrawal feels like, what the law says now and how treatment works.

7-OH, short for 7-hydroxymitragynine, is a compound found in tiny amounts in the leaves of the kratom plant. Companies now concentrate it and sell it as tablets, gummies and liquid shots at gas stations, smoke shops and online. The packaging often looks natural or even candy-like, but 7-OH acts like an opioid in the body.

Many people who use 7-OH started with kratom, or bought it believing it was a safe herbal product. If you or someone you love is struggling to stop, you're not alone, and help works. This guide explains what 7-OH is, what dependence and withdrawal look like, what the law says right now and how treatment works.

This article was last reviewed on October 14, 2026. Federal and state rules on 7-OH are changing quickly.

If someone is not breathing, can't be woken up or has blue lips, call 911 and give naloxone (Narcan) if you have it. For questions about a possible poisoning, call Poison Help at 1-800-222-1222. If you or someone you love is in crisis, call or text 988.

Kratom and 7-OH are not the same thing

Kratom is a tropical tree from Southeast Asia. Its leaves are sold as powder, capsules and teas. The main active compound in kratom leaf is mitragynine, and leaves contain only trace amounts of 7-OH.

7-OH products are different. According to the Minnesota Department of Health, concentrated 7-OH can produce stronger opioid effects, including slowed breathing, dependence, withdrawal and overdose. Labels may say "7-OH," "7-HMG" or "7-hydroxy," or the product may be sold as "enhanced" kratom. Product strength and contents can be unreliable.

How strong is it? An FDA review found 7-OH to be roughly two to nine times as potent as morphine, according to Becker's Hospital Review. Some people call it "gas station heroin."

Kratom leaf itself carries risks too. The Mayo Clinic notes that kratom is not approved by the FDA for any medical use, and that people who use it regularly can develop cravings and need the same medicines used to treat opioid addiction.

Why more people need help

Poison centers are seeing more cases. America's Poison Centers documented 14,449 kratom exposures from 2015 to 2025, an increase of about 1,200% over the decade, according to the DEA.

Clinicians quoted by Becker's Hospital Review report a growing number of patients who use 7-OH, including people who had been in long-term recovery from opioids. Dependence can build quickly: one addiction psychiatrist said physical dependence can develop after two to three weeks of regular use.

Signs that 7-OH or kratom use has become a problem

You don't have to hit "rock bottom" to get help. Some common signs include:

  • Needing more to get the same effect
  • Feeling sick, anxious or achy when you go too long without it
  • Planning your day around getting or taking it
  • Spending more money than you meant to
  • Trying to cut back and not being able to
  • Hiding how much you use from family or friends
  • Using it to get through work, sleep or pain

If several of these sound familiar, talk to a doctor or a treatment program. These are signs of a substance use disorder, which is a treatable health condition.

What 7-OH and kratom withdrawal feels like

Withdrawal from 7-OH is similar to withdrawal from other opioids. The Minnesota Department of Health says it often comes with fewer stomach problems and more anxiety, irritability and agitation than other opioid withdrawal. Symptoms can include:

  • Anxiety, restlessness and strong cravings
  • Muscle and joint aches
  • Runny nose and watery eyes
  • Yawning, sweating, chills and goosebumps
  • Nausea, vomiting, diarrhea or stomach cramps
  • Shakiness, a racing heart and trouble sleeping

There is no set timeline, because products vary so much. In general, symptoms may begin within the first day, peak over the next several days and improve over one to two weeks, though sleep problems, low mood and cravings can last longer, according to the International Society of Substance Use Professionals.

Withdrawal from 7-OH is rarely life-threatening by itself, but it can be severe enough that many people go back to using just to feel normal. Get urgent medical care for trouble breathing, chest pain, fainting, a seizure, confusion, signs of severe dehydration or thoughts of suicide.

Why quitting suddenly can be risky

When 7-OH suddenly becomes hard to get, for example after a local ban, some people turn to fentanyl or other street opioids to avoid withdrawal. The Minnesota Department of Health warns that this can increase overdose risk. Your tolerance also drops quickly after you stop, so going back to your old dose can be dangerous.

If you plan to stop, it's safer to do it with medical support.

How treatment for 7-OH and kratom works

The good news is that the same treatments used for other opioid use disorders work for 7-OH and kratom. Kratom is not a proven or safe way to treat opioid withdrawal, according to the Minnesota Department of Health, but proven medications are available.

Buprenorphine (Suboxone)

Buprenorphine is the main medication used for 7-OH withdrawal and ongoing treatment. The Minnesota Department of Health calls it "the backbone of withdrawal management and maintenance treatment plans." In one small study of people using 7-OH, 88.9% were successfully started and stabilized on buprenorphine with no precipitated withdrawal.

Timing matters. If buprenorphine is started too soon, it can cause sudden, intense withdrawal, called precipitated withdrawal. Some clinicians wait until you are in clear withdrawal. Others use a low-dose start that begins while you are still using, then slowly switch you over. Don't start buprenorphine on your own. A prescriber will pick the right approach for you.

Buprenorphine can be prescribed in a doctor's office, a clinic or by telehealth. Our guide to medication-assisted treatment (MAT) explains how buprenorphine, methadone and naltrexone compare.

Comfort medications

Doctors often add other medicines to ease specific symptoms, such as trouble sleeping, nausea, diarrhea, anxiety or muscle aches. Some of these are prescription only, so ask your provider rather than mixing over-the-counter products on your own.

Counseling and support

Medication works best alongside counseling and support. Depending on your needs, that can mean:

  • Medically supervised detox, if withdrawal is severe or you also use alcohol, benzodiazepines or other drugs
  • Outpatient treatment, with regular visits and counseling while you live at home
  • An intensive outpatient program (IOP), with several hours of treatment a week
  • Residential treatment, if you need a break from your environment or other treatment hasn't worked

Our guide to levels of care explains how to tell which one fits.

Tell your provider exactly what you take

Routine urine drug tests can't be relied on to detect 7-OH, according to the Minnesota Department of Health. Many people also don't think to mention it because it's sold as a supplement. Tell your doctor the product name, how much you take and how often. Bring the package if you can. It helps them choose a safe starting plan.

Can naloxone reverse a 7-OH overdose?

Yes. Naloxone can help reverse overdoses caused by the opioid effects of kratom and 7-OH, and more than one dose may be needed, according to clinicians quoted by Becker's Hospital Review.

If you think someone is overdosing:

  1. Call 911.
  2. Give naloxone. If they don't respond in 2 to 3 minutes, give another dose.
  3. Support their breathing and stay with them until help arrives.

Naloxone is available without a prescription at most pharmacies. If you or someone you live with uses 7-OH, keep some at home. Avoid using alone, and avoid mixing 7-OH with alcohol, benzodiazepines or other sedatives.

The rules are changing quickly, at both the federal and state level.

Federal rules

  • On August 26, 2026, the DEA temporarily placed three lab-made compounds related to 7-OH in Schedule I, the strictest category, through August 26, 2028, according to the Minnesota Department of Health.
  • 7-OH itself has not yet been scheduled. On October 9, 2026, the FDA reported that the DEA issued new notices based on an HHS recommendation to control concentrated 7-OH products. Under the HHS proposal, products with more than 1 milligram of 7-OH per gram or per milliliter would be covered.
  • The DEA has said its 7-OH action does not apply to botanical kratom that contains natural 7-OH below the limit.

State rules

Many states and cities have already acted on their own. For example, Becker's Hospital Review reports that Connecticut, Kansas and Tennessee have banned kratom and 7-OH, Massachusetts placed all kratom products in Schedule I by emergency rule, Ohio made its ban on synthetic kratom permanent and Virginia passed a law banning 7-OH products. Florida passed an emergency ban on 7-OH in 2025. Other states limit potency or are still debating bills.

If a ban in your area means you can't get 7-OH anymore, don't wait until you run out. Contact a doctor or treatment program now so you have a plan for withdrawal.

Paying for treatment

7-OH and kratom dependence is treated as a substance use disorder, so the same coverage rules apply as for other addiction treatment. Most health plans and Medicaid cover buprenorphine and counseling. Our guide to whether insurance covers rehab explains your options, including what to do if you don't have insurance.

Find help near you

Waypoint lists addiction treatment programs in every state, including detox, medication-assisted treatment, outpatient care and residential treatment. Search for treatment near you, and call programs directly to ask whether they treat 7-OH and kratom dependence. Searching is free, and we never ask about your health.

You can also call the free, confidential SAMHSA National Helpline at 1-800-662-4357, any time, for treatment referrals.

Frequently asked questions

Is 7-OH an opioid?

7-OH is not made from the opium poppy, but it acts on the same receptors in the brain as opioids. The FDA calls it a potent opioid. It can cause dependence, withdrawal and overdose like other opioids.

How long does 7-OH withdrawal last?

It varies by product, amount and how long you've used it. The physical symptoms often improve within one to two weeks. Sleep problems, low mood and cravings can last longer. Treatment with buprenorphine can make withdrawal much easier to get through.

Can I take Suboxone for kratom or 7-OH withdrawal?

Yes, with a prescriber's help. Buprenorphine, the main medicine in Suboxone, is widely used to treat 7-OH and kratom dependence. Starting it at the wrong time can cause precipitated withdrawal, so don't start it on your own.

Is kratom safer than 7-OH?

Kratom leaf contains much less 7-OH, but it still carries risks, including dependence and withdrawal. Neither is approved by the FDA to treat any condition.

Will 7-OH show up on a drug test?

Routine urine drug tests can't be relied on to detect it. That's one reason to tell your doctor exactly what you take.

What should I do if I had a bad reaction to a 7-OH product?

Get medical care if you need it, and call Poison Help at 1-800-222-1222 with questions. You can also report the reaction to the FDA's MedWatch program at 1-800-332-1088.

This article is general information, not medical advice. Talk with a health care provider before stopping or starting any medication. If you or someone you know is in crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or call 911.

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In crisis? Call or text 988, the Suicide & Crisis Lifeline. In an emergency, call 911.