Serious Illnesses Associated with 7-OH Use

Summary

The Texas Department of State Health Services (DSHS) is warning people not to use products containing 7-hydroxymitragynine (7-OH), an opioid-like chemical found in the kratom plant that, at high concentrations, can cause significant health problems and may have the potential for dependence or abuse. As of Aug. 27, the Texas Poison Center Network had received 192 reports of exposures involving kratom or another product containing 7-OH in 2025, compared with 107 for all of 2024 and 122 for all of 2023. Of the 2025 reports, 19 were for exposures to a concentrated 7-OH product with most of those calls coming in July and August. Of the 19 patients reporting exposure to concentrated 7-OH products, 11 had health problems serious enough to be treated at a healthcare facility.

DSHS recommends avoiding products containing 7-OH. Anyone who has health concerns after using 7-OH products should contact their healthcare provider or the Texas Poison Center Network at 1-800-222-1222.

Examples of (left to right) 7-OH extract, powder, and gummies. 
Image credit: U.S. Food and Drug Administration

Background

Kratom is a tropical tree native to Southeast Asia. Kratom and 7-OH products are sometimes marketed as natural remedies for pain, anxiety, or to help with opioid withdrawal. Kratom products typically contain low 7-OH concentrations (less than 2% total content or less). However, semi-synthetic or synthetic 7-OH products have concentrations up to 98% 7-OH and are now more readily available. Concentrated 7-OH is often added to kratom products. Because of its opioid-like characteristics, there is significant potential for abuse of 7-OH at concentrated levels. In studies, 7-OH shows up to 13 times the potency of morphine, an opioid pain-relieving medication. Products containing concentrated 7-OH are sold as pills, gummies, candies, and imitation ice cream cones at gas stations, smoke shops, and online. 
In July 2025, the U.S. Food and Drug Administration announced steps to restrict access to 7-OH products due to its strong opioid-like effects. Kratom and 7-OH do not have an FDA-approved medical use, and products containing 7-OH have not been proven to be safe or effective. 

Clinical Presentation

Symptoms reported after 7-OH use include, but are not limited to:

• Nausea and vomiting
• Agitation
• Confusion
• Sweating
• Rapid heart rate
• High blood pressure
• Trouble breathing
• Sleepiness or loss of consciousness
• Seizures
• Respiratory depression

Recommendations for Clinicians

Healthcare providers should:

• Provide general emergency and critical care medical support as warranted.
• Administer naloxone for reversal of respiratory depression.
• Observe and manage symptoms of opioid use disorder following use of kratom or 7-OH products. 
• Contact the Texas Poison Center Network at 1-800-222-1222 for any questions about medical management.

Recommendations for the Public

People should:

• Avoid all products containing 7-OH, including products that claim to treat a health ailment. 
• Examine the packaging and label when buying candies and other treats. 
• Keep kratom and 7-OH products away from children and pets.
• Talk to children and teens about the dangers of 7-OH and kratom products.
• Consult a doctor or pharmacist before using any supplements, especially ones marketed for pain, energy, or mood. 
• Talk to a health care provider if help is needed with opioid addiction, anxiety, mood disorders, pain, or other ailments.
• Contact a health care provider or call the Poison Help Line at 1-800-222-1222 regarding concerns about 7-OH. 
• Call 9-1-1 immediately, if someone is unresponsive or needs urgent medical attention.

Additional Information

• America’s Poison Centers
• Hiding in Plain Sight: 7-OH Products
• FDA Takes Steps to Restrict 7-OH Opioid Products Threatening American Consumers | FDA

For questions about adverse reactions or medical management related to use of kratom or 7-OH products, contact the Texas Poison Center Network at 1-800-222-1222.
For reporting adverse events from 7-OH products, contact MedWatch Online Voluntary Reporting Form or call 1-800-332-1088.

For questions about this health advisory, please contact the DSHS Environmental Surveillance and Toxicology Branch at 512-776-7269 or epitox@dshs.texas.gov.