7-Hydroxymitragynine (7-OH) is the most potent opioid-acting alkaloid in kratom. It binds directly to μ-opioid receptors and can cause respiratory depression, withdrawal, and overdose-like effects. Though naturally present in trace amounts, some manufacturers concentrate it or falsely advertise its strength. FDA data link 7-OH to coma, intubation, pediatric exposures, and naloxone-reversed poisonings.
When users boil, simmer, or reduce kratom powder into concentrated teas or resins, they dramatically increase the dose of mitragynine — which is then metabolized by the liver into 7-OH. This internal conversion is unpredictable and potentiates the same opioid effects seen with synthetic opioids. Homemade extracts unknowingly increase the body’s exposure to 7-OH, even without a product containing it directly.
Both mitragynine and 7-OH activate the brain’s opioid receptors. 7-OH is significantly more potent and acts faster, making it more likely to trigger sedation, respiratory suppression, and physical dependence. Case studies document withdrawal symptoms requiring buprenorphine, naloxone, and hospitalization.
Some kratom brands intentionally enrich products with 7-OH or label them as “enhanced.” These are sold as liquid shots, gummies, or tablets — often branded as OPMS Black, 7Tabz, or K-Shot. These high-potency formats are often flavored and marketed toward young users and carry significant overdose risk.
The majority of poison center cases and kratom-related deaths involve products without added 7-OH. Ordinary powders and capsules, metabolized naturally, produce 7-OH inside the body. If only 7-OH is banned, the kratom industry will continue selling dangerous, opioid-class products through vape shops and gas stations.
CDC SUDORS dashboards show over 3,000 kratom-related deaths since 2020. Poison control centers report more than 10,000 kratom exposure calls, with nearly half resulting in hospitalization. The FDA has repeatedly warned that both kratom and 7-OH have “opioid-like effects and carry serious risk.”