Addiction clinics see rising cases of kratom and 7-OH withdrawal

Kratom has been sold in the U.S. for decades, historically as a powder made from the dried leaf of a Southeast Asian plant. People use it for mood and energy enhancement and pain relief, but even lower-strength products carry a risk of physical dependence. Recently, more potent products containing highly concentrated 7-hydroxymitragynine (7-OH) have become common. 7-OH is found in the kratom leaf only in trace amounts, but unlike the leaf's dominant alkaloid, it acts directly on the brain's opioid receptors, producing stronger, more opioid-like effects including sedation and euphoria.

Addiction clinics nationwide are seeing a growing number of cases tied to these gas-station products. At the telehealth addiction clinic Boulder Care, patients reporting kratom product use made up 3% of all new patients in September 2025. By July 2026, that share was 8%, and in August it jumped to 14%. "That really is quite an explosion," said Ayesha Appa, the company's head of medical affairs. The FDA recently flagged 7-OH products as an emerging opioid threat, and the DEA proposed an effective ban on 7-OH above a certain threshold. That law has yet to be finalized, but numerous states have enacted similar restrictions. Appa theorized that laws revoking access to these products may be leading people to experience withdrawal. "I think we're really seeing and feeling what happens when people lose access and need to seek care in unprecedented numbers," she said.

Even before local bans were put into place, other clinicians noticed similar trends. Last year, two inpatient clinics run by the Recovery Centers of America in Massachusetts typically saw no more than a single patient per week admitted for kratom use, said Myles Jen Kin, a medical director for the group. The withdrawal was mild, requiring only "comfort meds." But now those same clinics see anywhere from 10 to 20 people per week who are either completely dependent on kratom or 7-OH, or for whom those products are part of a larger substance use problem, Jen Kin said. The severity of withdrawal seems to be increasing with prevalence. "We're basically treating it as if it's fentanyl or oxycodone or heroin," he said.

With limited research available, clinicians at addiction treatment centers are on the frontlines treating patients going through withdrawal from these products. "Having kratom [patients] without any research, it's just another day for us. It's how we deal with addiction in general," said Jen Kin. "It's just sadly the truth in our country." Clinicians report seeing two broad categories of people seeking treatment for kratom or 7-OH dependence: those who are completely new to drug use and treatment, and others who are [the excerpt cuts off here].