Kratom (Mitragyna speciosa) is a tropical plant from Southeast Asia whose leaves contain psychoactive alkaloids, especially mitragynine. In the U.S., it’s sold in gas stations, vape shops, and online as powder, capsules, shots, and teas. At low doses, it may act as a stimulant. At high doses, it mimics opioids, activating the brain’s μ-opioid receptors. Use can lead to dependence, withdrawal, liver damage, and even death.
7-hydroxymitragynine (7-OH) is a metabolite of mitragynine and a much more potent opioid agonist. Some products are enriched with synthetic 7-OH or advertised as “extra strength.” It is linked to overdose, coma, and hospitalizations requiring naloxone reversal. The FDA and CDC have both issued warnings about its dangers — especially in youth-targeted formats like flavored shots, tablets, and gummies.
The majority of kratom-related deaths involve plain, unmodified products. Mitragynine naturally converts to 7-OH inside the body, especially when kratom is brewed or reduced. That means even “natural” kratom can cause the same opioid effects as enriched 7-OH products. Regulating only 7-OH won’t fix the public health crisis — the full plant must be addressed.