7-OH: The kratom-based opioid stronger than morphine
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The bottom line
7-OH (7-hydroxymitragynine), a chemical in the leaves of the kratom tree, acts like an opioid and is stronger than morphine. Commercially available 7-OH products are more concentrated. 7-OH causes euphoria, relaxation, and sedation. Symptoms of an overdose are the same as an opioid overdose. It is highly addictive. Stopping it suddenly causes withdrawal symptoms. 7-OH is illegal or restricted in several state and local jurisdictions. Federally, it is temporarily categorized as a Schedule I drug while pending action to make this classification permanent.
Prevention tips
Store 7-OH up, away, and out of reach of children.
Avoid using 7-OH products.
Do not use 7-OH by yourself.
Keep naloxone on hand in case of an overdose.
Do not use 7-OH with alcohol, benzodiazepines, or other sedating drugs.
Be aware of other possible drug interactions.
Do not stop using 7-OH suddenly. This can cause withdrawal symptoms.
This really happened
A 29-year-old man with a history of opioid and alcohol use disorders, depression, and restless legs syndrome was self-treating his opioid use disorder with 7-OH instead of Suboxone for financial reasons. He had a cardiopulmonary arrest. He was found unresponsive, received CPR for 10 minutes, and was given 2 doses of naloxone. He then vomited and became responsive. He said he had swallowed 190 mg of 7-OH to get high while drinking alcohol. In the emergency department, he had chest soreness from CPR and mild trouble breathing. His heart rate and blood pressure were elevated. His blood alcohol level was high, and a urine drug test found amphetamines and marijuana. The remainder of his exam and labs were normal. He was admitted, given intravenous fluids and medicine for vomiting, and was stable within 24 hours.
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What is 7-OH (7-hydroxymitragynine)?
7-OH, also known as 7-hydroxymitragynine, is a chemical found naturally in small amounts in the leaves of the kratom tree. Commercially available 7-OH products have a higher concentration. As an opioid, it is stronger than morphine.
7-OH vs. kratom: What’s the difference?
Kratom is found in the Southeast Asian tree Mitragyna speciosa. The active chemicals in raw kratom leaves are mitragynine and a very small amount of 7-OH. The liver turns mitragynine into 7-OH. Commercially available 7-OH products that are extracted from the leaves or are synthetic or semisynthetic contain high concentrations of 7-OH. These products are sold as tablets, liquid shots, gummies, and drink mixes.
What to do if someone takes too much 7-OH
If someone takes too much 7-OH, call 911 right away. If they are experiencing slow or shallow breathing or are unresponsive, administer naloxone if it is available while waiting for the ambulance to arrive.
Get expert help
If someone swallows 7-OH or you have questions about 7-OH, use the webPOISONCONTROL® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
What is mitragynine pseudoindoxyl?
Mitragynine pseudoindoxyl is a semisynthetic chemical made by altering chemicals from kratom. It is a more potent opioid compound than mitragynine or 7-OH.
Where are 7-OH products sold? Are they legal?
7-OH products are sold at gas stations, in smoke and vape shops, and online. As of July 2026, concentrated and semisynthetic or synthetic 7-OH are illegal. The US Drug Enforcement Administration (DEA) banned them by temporarily placing them in Schedule I until permanent scheduling goes into effect. Many states have also passed laws making 7-OH liquid shots, gummies, and tablets illegal.
Kratom is not illegal, although it is not approved by the US Food and Drug Administration (FDA). Several states have banned kratom or put age limits on who can buy it.
Effects of 7-OH
7-OH causes euphoria, relaxation, and sedation, and it reduces anxiety. It also relieves pain. Side effects include drowsiness, dizziness, confusion, poor coordination, nausea, vomiting, and constipation.
Is 7-OH addictive?
Yes, 7-OH is addictive. It acts strongly on the same brain receptors as other opioids. People who use it become physically dependent on it. If it is stopped, the person will experience withdrawal symptoms like opioid withdrawal. People also develop tolerance, so they need to take more to feel the same effects.
Symptoms of a 7-OH overdose
Symptoms of an overdose are the same as an opioid overdose. Breathing becomes slow or shallow, and the person may stop breathing. Drowsiness, severe sedation, coma, and seizures can occur. Pupils are very small, and blood pressure and heart rate drop. Reflexes are slow, and muscles are limp.
Is it dangerous to take 7-OH with other drugs or medicines?
Yes, it is dangerous to take 7-OH with other drugs. Mixing 7-OH with other sedating drugs can cause deeper sedation and can stop a person’s breathing. Other sedating drugs include alcohol, benzodiazepines, opioid painkillers, sleep medications, and muscle relaxants. 7-OH also blocks liver enzymes that break down many other medicines. This can cause those medicines to build up in your body.