What is 7-OH (7-hydroxymitragynine)? 

7-OH (short for 7-hydroxymitragynine) is a naturally occurring substance that your body makes when your liver breaks down mitragynine. Mitragynine is one of the main psychoactive compounds in kratom (Mitragyna speciosa), a tropical plant native to Southeast Asia that contains trace amounts of 7-OH. 

In its raw form, kratom leaves contain only small amounts of 7-OH, usually 2% or less. But many modern kratom products, like gummies or capsules, contain concentrated or synthetic versions of 7-OH, with potency levels up to 98%. That’s a big jump. And with it comes a higher risk of side effects like insomnia, anxiety, upset stomach, or even seizures. 7-OH also has a higher chance of interacting with medications, creating dependency, and causing withdrawal symptoms when you stop taking it.

This guide will walk you through what 7-OH does, why people use it, what the risks are, and how QuickMD can support you if you’re ready to stop using it.

How 7-OH works in the body 

Like most drugs, 7-OH works by binding to certain receptors, specifically mu-opioid (µ-opioid) receptors. These receptors are found throughout your brain, spine, gut, and other systems. They’re the same types of receptors that drugs like morphine and heroin target, though 7-OH is what’s called a “partial agonist,” meaning it activates the receptors, but not fully.

Here’s what makes this compound so potent: 7-OH forms powerful bonds with receptors, even when it’s consumed in small doses. 7-OH is anywhere from 5 to 50 times stronger than mitragynine and 10 to 22 times more potent than morphine. 

When someone takes kratom, their liver converts mitragynine into 7-OH with the help of an enzyme called CYP3A4. Depending on the product type (like a gummy or vape), whether the person has eaten, and their metabolism, the effects may kick in within minutes—or take longer. Those effects can last anywhere from 3 to 8+hours.

What is 7-OH used for? 

Kratom and 7-OH are used for many purposes. Some people use kratom or 7-OH for medical reasons, like managing chronic pain or anxiety. Others use it recreationally to feel calm or euphoric. And some turn to kratom as a way to cope with opioid cravings.

In Southeast Asia, where kratom has been used traditionally for hundreds of years, people typically chew the leaves or brew them as tea. In small amounts, it can act like a stimulant. In larger doses, it tends to have sedative effects. Historically, the plant’s natural form had low levels of 7-OH. However, that’s not always the case with modern kratom products sold in the U.S., which often isolate or enhance 7-OH, making them much more potent and increasing the risk of harm or dependence. 

Here are a few more fast facts about kratom and 7-OH: 

• Between 1.7 million and 15 million Americans have used kratom or 7-OH. 
• Tablets, shots, and gummies make up over 80% of 7-OH products.
• Poison control centers received almost 1,700 kratom-related calls during the first 7 months of 2025. 
• 7-OH is up to 46 times more potent than mitragynine, and can cause negative side effects like insomnia, stomach pain. 

Why do people use 7-OH? 

There are many reasons people turn to 7-OH or kratom products. Here are some of the most common:

• Pain management — Pain relief is often the most common reason why people use kratom. While studies on rodents have shown that 7-OH can be an effective pain reliever, there haven’t been any controlled studies focused on humans. So, researchers still don’t fully understand how well it works or what the long-term effects might be.

• Mood disorders — Some individuals use kratom to ease anxiety or improve mood. However, withdrawal from 7-OH can cause mood swings, irritability, restlessness, and even feelings of sadness or anger.

• Opioid withdrawal — Kratom is not a controlled substance, and it isn’t fully regulated. While federal agencies have issued warnings about the dangers of this compound, some people attempt to use it to ease the symptoms of opioid withdrawal. What makes this even more dangerous is the potential for misuse since it’s often accessed at higher concentrations. Because its potency and purity aren’t standardized, the effects can be unpredictable, increasing the risk of dependence, serious side effects, and even overdose. 
  

While there’s growing interest in kratom and 7-OH, there’s still a lot we don’t know. Large human studies haven’t been done, and the FDA hasn’t approved 7-OH for any medical use. There’s no standardized dosage, and product labeling can be inconsistent or misleading. That’s why it’s so important to approach 7-OH with caution, and get professional guidance if you need it.

Side effects of 7-OH 

7-OH can cause a variety of side effects that range from mild to serious or potentially life-threatening. According to a health advisory by America’s Poison Centers, 35% of the people who reported 7-OH exposure in 2025 experienced serious side effects, and 67% had to be treated in a healthcare setting. Tragically, the Los Angeles County Department of Public Health also reported three fatal overdoses tied to a lethal combination of 7-OH and alcohol.

Knowing the warning signs and serious side effects of 7-OH can help you seek out help immediately. Potential symptoms and side effects of 7-OH include: 

• Confusion
• Difficulty breathing 
• Dizziness 
• Drowsiness 
• High blood pressure
• Liver toxicity (liver damage) 
• Losing consciousness (fainting) 
• Nausea
• Respiratory depression (slow, shallow breathing) 
• Seizures 
• Vomiting 
• Withdrawal symptoms, which can include:
  • Cravings 
  • Diarrhea 
  • Hot flashes 
  • Runny nose 
  • Tremors (trembling) 
  • Watery eyes 

The more often someone uses 7-OH (or the stronger the dose), the more likely they are to build a tolerance. This means the body starts needing more of it to feel the same effects, which can raise the risk of overdose or dependence. And because 7-OH is not currently regulated, it can be difficult to tell just how potent a product containing this compound may be. 

It’s worth remembering: just because something comes from a plant doesn’t mean it’s automatically safe. While kratom itself is derived from a plant, many products sold in stores or online aren’t just the raw leaf. They often contain concentrated extracts or other added substances. These versions can have much higher levels of 7-hydroxymitragynine (7-OH), which significantly increases the risk of unpredictable effects, dependence, and harm.

Get help quitting 7-OH 

Scientific evidence of 7-OH 

In order to protect your health, it’s important to know fact from fiction when it comes to 7-OH. Let’s look at what the science says, and what researchers are still figuring out. 

What we know:

• 7-OH is a partial mu-opioid agonist, meaning it binds to receptors in the brain and body to create its effects.
• It’s formed in the liver when mitragynine (from kratom) is broken down by an enzyme called CYP3A4.
• It’s much more potent than mitragynine, especially in synthetic or concentrated forms.
  

What we don’t know:

• No large-scale human clinical trials have been done with 7-OH.
• Long-term effects are unknown.
• There’s no standardized dosage chart or consistent labeling for these products.
  

Despite a growing body of research, there are still major gaps in scientists’ understanding of 7-OH. That means doctors have no way to predict what long-term or delayed-onset effects might result from using 7-OH.  There’s also no standardized dosage chart for doctors or consumers to follow. This makes the unknowns even more dangerous due to inconsistent, inaccurate labeling on many 7-OH products. 

This lack of reliable data makes 7-OH risky—especially when products vary widely in strength and ingredients. Until more research is done, it’s best to use extreme caution and talk to a healthcare provider if you’ve used 7-OH.

For a deeper dive into the science, learn about 7-OH vs. kratom.

Regulation and legal landscape 

Despite being sold in convenience stores and vape shops across the U.S., 7-OH is facing increasing scrutiny from public health officials.

As of August 2025, the FDA is pushing for 7-OH to be classified as a Schedule I drug under the Controlled Substances Act (CSA), shifting 7-OH into the same legal category as heroin. Alongside the federal crackdown on 7-OH products, many states are moving to regulate or ban 7‑OH outright. States where 7-OH and kratom are illegal include Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin, with Florida joining the list in August 2025.  

Currently, kratom and 7-OH are not scheduled substances. Regulatory efforts are currently focused on targeting synthetic and enhanced 7-OH products. While natural kratom leaf products may contain only trace amounts of 7-OH, most concern centers on synthetic or enhanced versions that deliver much higher doses. Regulation currently varies by state, with some states banning 7-OH, others making it age-restricted (like alcohol), and others imposing no regulation at all. 

How QuickMD can help with 7-OH dependence 

Getting support makes a difference. Whether you’ve been using 7-OH, opioids, or are worried about someone you care about, our team of licensed providers offer compassionate, judgment-free care.

Our team provides science-backed strategies to help you quit safely, 

including counseling services and Medication-Assisted Treatment (MAT) with Suboxone®. We work with you to build a personalized care plan that works for your schedule and lifestyle. Plus, all visits take place online for your convenience and confidentiality.