7-OH (7-hydroxymitragynine) is an opioid compound from the kratom plant that occurs naturally in trace amounts but now sells as concentrated tablets, gummies and shots far stronger than kratom leaf.

7-OH acts on the same brain receptors as morphine, which makes 7-OH addictive. Federal regulators have moved to control 7-OH, and Florida already treats concentrated 7-OH as a Schedule I drug.

What is 7-OH (7-hydroxymitragynine)?

7-OH, short for 7-hydroxymitragynine, is an opioid alkaloid of the kratom tree (Mitragyna speciosa) that activates the brain’s mu-opioid receptors. The FDA states that 7-OH occurs naturally in kratom in trace amounts, while 7-OH products contain 7-OH as an added ingredient or at enhanced levels.

Sarah Kawasaki directs the Advancement in Recovery Program at Penn State Health. In August 2026, Kawasaki described 7-OH as “the primary psychoactive compound found naturally in kratom, but it’s been synthetically isolated and manufactured.”

What Is 7-OH key facts infographic: kratom alkaloid, more potent than morphine in lab studies, sold in stores, not FDA approved, Florida Schedule I and pending federal status

What is 7-OH used for?

7-OH has no approved medical use. NIDA reports that people use kratom products for pain, fatigue, mental health problems and opioid withdrawal, and the FDA tells consumers to avoid 7-OH products, including those claiming to treat an ailment.

Where 7-OH products are sold

7-OH products sell as tablets, gummies, drink mixes and shots through online retailers, smoke shops, gas stations and corner stores, according to the FDA. The Florida Attorney General’s office named brands such as Hydroxy, 7Tabz and 7OHMZ in its June 2026 rule announcement.

That retail reach explains why 7-OH reaches people who never meant to take an opioid, and why the way 7-OH works in the body matters.

How does 7-hydroxymitragynine affect the brain?

7-hydroxymitragynine acts on the brain by binding to mu-opioid receptors, the same receptors morphine and oxycodone act on, which blocks pain signals and slows breathing at high doses. Kruegel and colleagues (2019) showed in ACS Central Science that liver enzymes convert mitragynine, kratom’s main alkaloid, into 7-OH.

Is 7-OH an opioid?

Yes, 7-OH acts as an opioid. The FDA classifies 7-OH products as potent opioids, and the National Institute on Drug Abuse (NIDA) reports that 7-OH caused respiratory depression in laboratory studies that naloxone reversed.

7-hydroxymitragynine vs morphine

7-hydroxymitragynine outperformed morphine in animal experiments, not human trials. Takayama and colleagues (2002) found 7-OH more potent than morphine in a guinea pig tissue test in the Journal of Medicinal Chemistry. Matsumoto and colleagues (2004) found 7-OH more potent than morphine in mouse pain tests, including by mouth.

The Texas Department of State Health Services (DSHS) warned in September 2025 that “in studies, 7-OH shows up to 13 times the potency of morphine.” The “13 times” figure comes from laboratory and animal studies, so the figure describes receptor potency, not a human dose conversion. Potency at the receptor shapes the effects people feel.

What are the effects of 7-hydroxymitragynine (7-OH)?

The main 7-hydroxymitragynine effects are opioid effects: pain relief, relaxation, euphoria and sedation, with tolerance that builds quickly. Penn State Health states that 7-OH “behaves similarly to morphine or heroin” in the clinic.

What does 7-OH feel like?

7-OH feels like a prescription opioid high, according to people treated for 7-OH addiction. Michael Krause, a patient treated at Penn State Health, told Penn State in 2026: “I felt a high that was the exact same thing as an 80-milligram oxycodone.”

Is 7-hydroxymitragynine good for pain?

7-hydroxymitragynine is not an approved pain treatment. The FDA states that 7-OH is not approved for any medical use and is not lawful as a dietary supplement or food ingredient, so no product carries a tested dose, purity standard or safety review. The same strength that relieves pain drives the side effects below.

What are the side effects of 7-hydroxymitragynine?

The 7-hydroxymitragynine side effects reported to the FDA include addiction, anxiety, depression, stomach and bowel problems, insomnia, seizures and withdrawal symptoms. Florida Surgeon General Dr. Joseph Ladapo stated in June 2026 that concentrated 7-OH products have been linked to addiction, overdose and seizures.

Common side effects of 7-OH

The 5 common side effects of 7-OH are:

  • Stomach and bowel problems: Gastrointestinal distress, listed in reports to the FDA.
  • Sleep problems: Insomnia and broken sleep, also reported to the FDA.
  • Mood changes: Anxiety and depression, reported to the FDA.
  • Drowsiness: Sedation at higher doses, the pattern the DEA describes for kratom in its 2020 Drug Fact Sheet.
  • Tolerance: Needing more 7-OH for the same effect, the first step toward dependence.

Severe side effects of 7-OH

The 4 severe side effects of 7-OH are:

  • Slowed breathing: Respiratory depression, which 7-OH caused in laboratory studies, according to NIDA.
  • Seizures: Listed in FDA reports and in the Florida Surgeon General’s June 2026 statement.
  • Overdose: Florida Poison Control toxicologists quoted by the Florida Attorney General report 7-OH overdoses in patients from infants to older adults.
  • Liver injury: NIDA cites case reports of liver injury in people who use kratom products.

Get emergency care right away for slow or shallow breathing, a seizure, or a person who will not wake up.

Infographic of 5 serious side effects of 7-OH: slowed breathing, seizures, overdose, addiction and liver injury

Is it dangerous to mix 7-OH with other drugs?

Yes, mixing 7-OH with alcohol, benzodiazepines or other opioids stacks sedation and raises the risk of slowed breathing. NIDA reports that nearly all deaths linked to kratom involved other drugs or contaminants.

Long-term effects of 7-OH

Long-term 7-OH use produces physical dependence, a withdrawal syndrome when use stops, and addiction. Penn State Health reports that “physical dependence can set in within two to three weeks of regular use” and that strong cravings start sooner. Those long-term risks separate concentrated 7-OH from the kratom leaf it comes from.

Is 7-OH the same as kratom?

No, 7-OH is not the same as kratom: 7-OH is one alkaloid inside kratom leaf, and concentrated 7-OH products deliver far more of it than the leaf contains. The FDA warning targets products with added or enhanced 7-OH, not natural kratom leaf.

Florida’s June 2026 rule draws the same line. The rule caps 7-OH and related compounds at 1 milligram per gram or milliliter, and requires at least 100 times more mitragynine than 7-OH by mass. That higher potency is also why 7-OH dependence develops faster.

Is 7-OH addictive?

Yes, 7-OH is addictive: 7-OH produces tolerance, physical dependence and cravings, the same pattern as other opioids. The FDA lists addiction among the harms reported with 7-OH products.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) has no 7-OH diagnosis. Clinicians apply the 11 standard substance use disorder criteria instead, as Smith, Epstein and Weiss (2024) describe for kratom use disorder in Current Psychiatry Reports. Two or more criteria within 12 months indicate a substance use disorder.

Stopping 7-OH after daily use triggers opioid-type 7-OH withdrawal, with body aches, chills, diarrhea, anxiety and strong cravings. The FDA lists restlessness, body aches, fatigue, irritability and cold sweats among the withdrawal symptoms reported with 7-OH. Those risks drove the legal action against 7-OH.

Is 7-OH banned?

7-OH is not banned nationwide as of October 7, 2026, but Florida treats concentrated 7-OH as a Schedule I controlled substance, and the DEA has proposed temporary federal Schedule I control. 7-OH legality depends on the state and the product’s 7-OH concentration.

When will the 7-OH ban take effect?

The 7-OH federal ban date is not set yet. The DEA proposed temporary Schedule I control on July 6, 2026, and no final DEA 7-OH scheduling decision had been published as of October 7, 2026.

There are 6 federal milestones in the 7-OH ban timeline:

  1. August 2016: The DEA proposed temporary Schedule I control of mitragynine and 7-OH, then withdrew the notice in October 2016.
  2. July 29, 2025: The FDA recommended scheduling 7-OH products under the Controlled Substances Act.
  3. December 2, 2025: The FDA seized about 73,000 units of 7-OH products, valued at about $1 million, from 3 firms in Missouri.
  4. July 6, 2026: The DEA published a notice of intent to temporarily place 7-OH above a specified threshold in Schedule I.
  5. August 26, 2026: The DEA temporarily scheduled 3 related compounds, mitragynine pseudoindoxyl, MGM-15 and MGM-16, and the Department of Health and Human Services extended comments on the 7-OH threshold to September 10, 2026.
  6. October 7, 2026: No final federal order for 7-OH had been published in the Federal Register.
7-OH ban timeline infographic: FDA scheduling recommendation in July 2025, Florida Schedule I rule in August 2025 and DEA proposed Schedule I control in July 2026

Florida 7-OH ban

Florida controls 7-OH through Attorney General emergency rules, not a statute. The August 13, 2025 rule made isolated or concentrated 7-OH a Schedule I controlled substance, which made its sale, possession and distribution illegal in Florida.

The June 22, 2026 rule added 6 related compounds, set the 1 milligram per gram limit and the 100-to-1 mitragynine ratio, and carries penalties of up to 30 years in prison. The Florida Department of Agriculture and Consumer Services (FDACS) reported removing more than 23,000 illegal 7-OH packages from Florida retailers.

7-OH law in New Jersey

New Jersey has not placed 7-OH on its controlled substance schedule. On September 25, 2026, the New Jersey Attorney General added mitragynine pseudoindoxyl, MGM-15 and MGM-16 to Schedule I and stated that natural kratom remains legal. Whatever the law allows, 7-OH dependence remains a medical problem with an established treatment path.

How is 7-OH addiction treated?

7-OH addiction is treated like opioid addiction: medical detox for withdrawal, medication when appropriate, and therapy that continues after detox. Stanciu and colleagues (2019) advised clinicians in the Journal of Psychoactive Drugs to treat kratom withdrawal with the approach used for opioid withdrawal. A supervised taper is the safer way to quit 7-OH and kratom.

There are 3 parts of 7-OH addiction treatment:

  • Medical detox: Monitoring, fluids and comfort medications such as clonidine, the same approach used for kratom withdrawal.
  • Medication: Buprenorphine for cravings, and naltrexone after an opioid-free period, both used in published 7-OH and kratom cases.
  • Therapy: Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) for cravings, stress and triggers.

No medication is FDA-approved specifically for 7-OH addiction, so a physician chooses each medication based on the person’s withdrawal and health history.

How does Still Detox treat 7-OH addiction?

Still Detox treats 7-OH addiction with an in-person medical evaluation, medical detox and residential treatment, and lists 7-OH among the substances that need medical detox and specialized testing. Both Still Detox locations, in Boca Raton, Florida and Mays Landing, New Jersey, offer the same levels of care.

“A 7-OH tablet from a gas station is still an opioid. If you take 7-OH every day, stop with medical support, where our nurses check vital signs every 4 hours through detox.”

Britney Marshall, RN, Director of Nursing, Still Detox

Assessment and 7-OH detox in Boca Raton

The Medical Director evaluates every new client in person within 24 hours, and specialized testing confirms 7-OH exposure. People in South Florida begin kratom and 7-OH detox in Boca Raton on the University Hospital campus, next to Boca Regional Hospital.

Treating what drives daily 7-OH use

Dual diagnosis care at Still Detox treats co-occurring mental health conditions, including trauma, alongside 7-OH addiction. Residential treatment adds individual and group therapy, including CBT and DBT, and Medication-Assisted Treatment (MAT) is available.

7-OH care at Still Detox New Jersey

Still Detox New Jersey in Mays Landing has 44 beds on 33 acres, TMS on site and TRICARE in-network coverage. Kratom and 7-OH detox in Atlantic County, New Jersey serves people near Atlantic City, about 26 minutes away.

What else do people ask about 7-OH?

Does 7OH show on a drug test?

Standard drug screens are not built to detect 7-OH, and Stanciu (2026) notes the limits of standard toxicology with potent kratom derivatives. Detecting 7-OH requires specialized testing, which Still Detox lists for 7-OH.

What is the new 7OH replacement?

Related compounds such as mitragynine pseudoindoxyl, MGM-15 and MGM-16 now appear in products. The DEA temporarily placed all three in Schedule I on August 26, 2026, and New Jersey scheduled them on September 25, 2026.

Where is 7oh legal?

No final federal 7-OH ban existed as of October 7, 2026, so 7-OH legality depends on state law. Florida treats concentrated 7-OH as Schedule I, while New Jersey had not scheduled 7-OH as of September 25, 2026.

Can you still buy 7oh?

Not legally in Florida, where concentrated 7-OH above the Attorney General’s limits is Schedule I. Other states vary, and a final DEA order would bring federal Schedule I control for 7-OH above the set threshold.

Can you withdraw from 7-hydroxymitragynine?

Yes. The FDA lists withdrawal symptoms reported with 7-OH, including restlessness, body aches, fatigue, irritability and cold sweats, and medical detox manages that withdrawal safely.

What organs are affected by kratom?

Kratom and 7-OH put the brain, breathing and the liver at risk. NIDA reports breathing suppression from 7-OH in laboratory studies and liver injury case reports, and the FDA lists seizures among reported 7-OH harms.

Sources

  1. Florida Office of the Attorney General. (2025, August 13). Attorney General James Uthmeier files emergency rule; immediately removing dangerous 7-OH from store shelves [Press release].
  2. Florida Office of the Attorney General. (2026, June 22). Attorney General James Uthmeier signs emergency rule immediately scheduling dangerous 7-OH and related compounds as Schedule I controlled substances [Press release].
  3. Kruegel, A. C., Uprety, R., Grinnell, S. G., et al. (2019). 7-Hydroxymitragynine is an active metabolite of mitragynine and a key mediator of its analgesic effects. ACS Central Science, 5(6), 992–1001.
  4. Matsumoto, K., Horie, S., Ishikawa, H., et al. (2004). Antinociceptive effect of 7-hydroxymitragynine in mice: Discovery of an orally active opioid analgesic from the Thai medicinal herb Mitragyna speciosa. Life Sciences, 74, 2143–2155.
  5. National Institute on Drug Abuse. (2026). Kratom. National Institutes of Health.
  6. Penn State. (2026, August 20). The Medical Minute: What is 7-OH? Understanding the danger and risk of addiction.
  7. Smith, K. E., Epstein, D. H., & Weiss, S. T. (2024). Controversies in assessment, diagnosis, and treatment of kratom use disorder. Current Psychiatry Reports, 26(9), 487–496.
  8. Stanciu, C. N. (2026). Severe early-onset withdrawal following intentional use of mitragynine pseudoindoxyl: A case report and emerging clinical considerations. Cureus, 18(3), e105224.
  9. Stanciu, C. N., Gnanasegaram, S. A., Ahmed, S., & Penders, T. (2019). Kratom withdrawal: A systematic review with case series. Journal of Psychoactive Drugs, 51(1), 12–18.
  10. Takayama, H., Ishikawa, H., Kurihara, M., et al. (2002). Studies on the synthesis and opioid agonistic activities of mitragynine-related indole alkaloids. Journal of Medicinal Chemistry, 45, 1949–1956.
  11. Texas Department of State Health Services. (2025, September 2). Serious illnesses associated with 7-OH use.
  12. U.S. Drug Enforcement Administration. (2026, July 6). Schedules of controlled substance: Temporary placement of 7-hydroxymitragynine above a specified threshold in Schedule I [Notice of intent]. Federal Register, 91, 40917.
  13. U.S. Food and Drug Administration. (2025, July 29). Products containing 7-OH can cause serious harm [Consumer update].
  14. U.S. Food and Drug Administration. (2025, December 2). FDA seizes 7-OH opioids to protect American consumers [Press release].