Preventing
The Next Wave
of the Opioid
Epidemic:
What You
Need to
Know About
7-OH
2 Preventing The Next Wave of the Opioid Epidemic: What You Need to Know About 7-OH The Opioid Epidemic is Evolving with 7-OH. We Can
and Must Act Now to Prevent a New Wave.
1990 2005 2015 2025
Rx
Pills
Heroin
Fentanyl 7-OH
We are
here
Note: The next potential phase of the opioid crisis may be defined by the emergence of novel synthetic opioids like 7-OH, combined with an increasing prevalance of concurrent use of opioids and other controlled substances.
Preventing The Next Wave of the Opioid Epidemic: What You Need to Know About 7-OH 3 7-OH is Engineered to be Addictive. It is a Potent
Opioid by Design.
Rx Pills Heroin
Fentanyl 7-OH
7-OH (formally known as
7-Hydroxymitragynine) is a
powerful psychoactive compound
that occurs naturally in very small
amounts in the Kratom plant.
7-OH products are concentrated
derivatives often falsely marketed
as Kratom.
Street names include 7-Hydroxy,
7-OHMG and ‘7’.
4 Preventing The Next Wave of the Opioid Epidemic: What You Need to Know About 7-OH This Opioid is not Prescribed or Purchased on the
Street - It’s Sold like Candy at Retail Stores and Online.
What began as doctor-
prescribed painkillers migrated
to back-alley dealers when
prescriptions dried up. Opioids
have disturbingly gone
mainstream with 7-OH—no
prescription needed, no dealer
required. This dangerous opioid
is sitting on store shelves,
making gas stations and
convenience stores risky places
where kids can purchase these
drugs as easily as buying candy.
Preventing The Next Wave of the Opioid Epidemic: What You Need to Know About 7-OH 5 Hiding in Plain Sight: 7-OH Products are Designed to
Look Like Everyday Treats Like Gummies, Candies and
Ice Cream.
Note: These images are select illustrative examples and do not represent the full scope of 7-OH products on the market. Consumers should read packaging and labels carefully to determine whether a product contains 7-OH. 6 Preventing The Next Wave of the Opioid Epidemic: What You Need to Know About 7-OH High Risk
Crushed/Powdered Leaves
with Natural 7-OH Levels
Kratom 7-OH Significantly
Concentrated Extract
While Some 7-OH Products are Marketed as Natural
Kratom, They are Not the Same. 7-OH Presents
Significant Risks.
“Enhanced” or “spiked” kratom products may appear to be natural leaf, but actually contain as much as 500% more 7-OH than would be expected naturally. 7-OH is 13x
more potent
than morphine.
Preventing The Next Wave of the Opioid Epidemic: What You Need to Know About 7-OH 7 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024
1800
1600
1400
1200
1000
800
600
400
200
0 Poison Center Cases Involving Kratom-related Products Number of Cases
Poison Control is Sounding the Alarm on 7-OH.
American families are reporting side effects such as dependency, withdrawals, overdose and even death.
Note: Kratom-related products refers to a broad category of botanical kratom products and other kratom-derived products, including an unknown number of 7-OH involved cases; a classification code for 7-OH products was added to the National Poison Data System only in February, 2025. *Data r eflect partial year.
In 2025*, approximately
40% of 7-OH reports
were among individuals
abusing the drug.
8 Preventing The Next Wave of the Opioid Epidemic: What You Need to Know About 7-OH There is No Safe Swap. 7-OH is an Opioid, Not an
Alternative for Approved Treatments.
Kratom-related products, including 7-OH, are not safe or approved treatments for opioid or SSRI (selective serotonin reuptake inhibitors) withdrawal symptoms, chronic pain, or to treat depression, anxiety and other mood disorders.
Preventing The Next Wave of the Opioid Epidemic: What You Need to Know About 7-OH 9 • Avoid buying any products
with 7-OH.
• When buying candy or other
treats for you or your family,
examine the packaging and
label so you don’t accidentally
buy a treat containing 7-OH.
• Talk to your health care
professional if you need help
with opioid addiction,
anxiety, mood disorders,
pain, or other ailments.
If you believe someone is
experiencing an adverse event from
a 7-OH product, contact the Poison
Help Line (1-800-222-1222) or visit
www.poisonhelp.org for help.
If someone is unresponsive,
dial 911 immediately!
Protect You and Your Family
10 Preventing The Next Wave of the Opioid Epidemic: What You Need to Know About 7-OH Even better than rolling back a public health
crisis would be never having one in the first
place: Let’s not allow 7-OH to drive the next
wave of the U.S. opioid epidemic.
- Marty Makary, M.D., M.P.H., FDA Commissioner
Scan the QR code or visit fda.gov/7-OH for
additional resources and to learn more.