Tyler's opioid addiction began in his early 20s, and when he decided he wanted to quit, he used kratom leaf powders to help ease withdrawal symptoms.
Tyler, now 38, told NPR he thinks kratom helped him stop using opioids for a decade.
Tyler asked NPR to use only his first name because of the stigma attached to his history with drug use and addiction.
In early 2025, he saw a new product at a gas station called 7-OH. He hadn't heard of 7-OH, but said the tablets were advertised as "kratom products." He decided to try them, since the kratom powders he'd taken in the past "can be hard on your stomach," he said.
At first, 7-OH gave him a feeling of euphoria he described as similar to opioids, which "felt like a kind of a miracle," he said.
Nearly a year and a half later, he was in a rapid detox program in Michigan, where he was sedated to sleep through the withdrawals he experienced when he tried to stop taking it.
In the past few years, highly concentrated products with 7-OH — sometimes alongside other semi-synthetic opioids — have popped up online, and at many smoke shops, liquor stores and gas stations. They can come in the form of tablets, gummies, tonics and chocolate.
7-OH, or 7-hydroxymitragynine, is one of the major psychoactive ingredients in kratom, which comes from a tree in the coffee family. It's naturally found in kratom in very small amounts, and seems to act more like an opioid in the human brain than kratom leaf products. Kratom is used by some people with opioid addiction to maintain long-term recovery. Some people say it makes them feel energized or focused. Others describe the effects of kratom like those of opioids, and say it can relieve pain, feel calming or even create euphoria.
"More potent than I imagined"
Some users of 7-OH and kratom show classic signs of addiction, researchers and policy officials say. But the products are not always clearly labeled, so it's difficult or impossible for users to know what quantity of the substances they are consuming.
"I did not know at all what I was in for. It was much more potent than I had imagined," Tyler said.
Estimates of how many people use kratom and 7-OH in the U.S. are wide-ranging. Some suggest over 5 million people have used kratom in their lifetime. David Epstein, a senior investigator at the National Institute on Drug Abuse (NIDA) Intramural Research Program, says he's seen estimates of kratom use as high as 15 million. Those estimates don't usually distinguish between whole leaf kratom, 7-OH or other related products.
In the last decade, the U.S. government has attempted to restrict both kratom and 7-OH products, but strong opposition to those moves by the public and powerful advocacy groups backing the substances have kept them federally legal.
That's started to change in the last few months.
A federal crackdown is likely on the way
No federal actions have been taken against "traditional botanical kratom," but a new federal restriction on some 7-OH products could go into place as early as Friday, Nov. 13, 2026.
The path there has not been straightforward. In August, the Drug Enforcement Administration (DEA) restricted the making and sale of three semi-synthetic opioids derived from 7-OH and other related compounds: MGM-15, MGM-16 and mitragynine pseudoindoxyl (MGPI). Those compounds were listed under the Controlled Substances Act alongside the most highly restricted drugs, like heroin and LSD.
That caused backlash from kratom advocates who worried the rule would affect products with "trace amounts" of the semi-synthetic opioid, MGPI. One kratom advocacy organization, the American Kratom Association, filed a federal lawsuit on Aug. 26 against the DEA. It asked the DEA to ensure natural kratom products with traces of MGPI would remain legal.
The U.S. Department of Health and Human Services (HHS) then issued a new recommendation on 7-OH and MGPI on Oct. 9, and the DEA changed its course. They now plan to restrict a narrower range of 7-OH and MGPI products: ones that contain higher concentrations of 7-OH and/or MGPI.
HHS and the DEA say they are not focusing on natural kratom products.
The research on kratom and 7-OH
Many people who oppose the restriction say kratom and 7-OH products have kept them away from traditional opioids, and helped them manage chronic pain, mood and mental health. Some also point to the fact that opioid deaths in the U.S. are decreasing. In 2023 alone, a KFF report found there were over 79,000 opioid deaths, and in 2024 there were 54,000.
A recent report of data from 53 U.S. poison control centers shows reports of calls related to kratom increased about 1,200% between 2015 and 2025. Chris Holstege, a physician and a professor of emergency medicine and pediatrics at the University of Virginia's School of Medicine, is one of the authors of that report. He said he and the other authors "were a bit stunned" by those findings, which do not distinguish between kratom or products like 7-OH.
The report included 233 deaths associated with kratom during 2015–2025, with 79% of those deaths involving multiple substances. The most severe outcomes were linked to people using multiple substances alongside kratom products, like opioids, stimulants and benzodiazepines.
But Holstege points out over half the reports of calls, 62%, involved people using kratom without other drugs.
The authors used data on kratom from the National Poison Data System (NPDS), which includes calls from the public, healthcare professionals or medical examiners, and medical records.
For some, a "life-changing" dose
Still, there are people who report benefits of using kratom or 7-OH, said Epstein, the NIDA investigator.
NPR spoke to one mom in Delaware, Angela Wilson, 44, who said 7-OH has helped her manage excruciating chronic pain related to endometriosis, and symptoms of depression she's had since she was a teenager.
She said she's been taking 32 to 40 milligrams of 7-OH a day, split into three doses, for the last year and a half.
Wilson said kratom powders made her feel anxious and shaky, and 7-OH seems to work for her without those side effects.
"It's been truly life-changing for my family situation, my personal life," she said.
Wilson doesn't have health insurance, and said losing access to 7-OH under new restrictions would be "devastating" for her and her family.
"We're not really sure, you know, what I'm gonna do when it's not available," she said.
"It was game over." Dangers of addiction
Epstein has also heard stories like Tyler's. He said people can become addicted or dependent — and some of his ongoing research suggests that risk is higher with 7-OH products than with whole leaf kratom.
He said for some people, their 7-OH use "seemed to go nicely for the first couple of days, but then they found that they had to keep using to avoid withdrawal," Epstein said. "And some of them, not all of them, but some of them, even said they had to, you know, they couldn't make it through the night. They had to get up in the middle of the night to take more."
He said other people were happy with the effects they got from taking 7-OH and didn't feel like it caused problems for them.
Tyler told NPR that 7-OH tablets gave him more energy at first. He works a job where he's on his feet a lot, and with 7-OH, he said, " I can go, go, go, go, go, you know?"
He began taking around 300 to 400 mg of 7-OH a day, about ten times the dose Angela Wilson takes. In the next year, he said he made a few attempts to stop, but the withdrawals were debilitating.
"The best way to put it, I think, is to imagine having the flu, the worst flu you've had, you know, multiply that by at least three times," he said. "And then just know that all you gotta do is take one pill, and it's gone in seconds."
Another former kratom and 7-OH consumer, Brian, 41, told NPR at the height of his use, he was using much more 7-OH than both Angela Wilson and Tyler. Brian also asked NPR to use only his first name because of the stigma associated with drug use.
Brian used 1,200 mg of 7-OH — and estimates he spent around $150 each day — on the substance. He'd quit using opioids in 2016, but found kratom at a gas station in 2022. He said it claimed to help with energy.
"And 'cause literally right next to the register, nothing taboo about it, looks like those 5-Hour Energy shot type things," he said.
Brian said within minutes of taking it, he realized he felt "exactly" like he did when he'd been taking opioids.
"I was like, 'What is this?,'" he said. "'Like, are you telling me I found a legal, you know, healthy opiate that f***s you up and, you know, you feel great and no consequences, like the legality of it and everything?"
"I was like, 'This is it,'" he said.
Brian tried to stop taking kratom multiple times, but couldn't. One day at a smoke shop, he said the clerk offered him a sample of 7-OH. The clerk described it as a "version of kratom" that Brian could take in lower doses to get the same effects.
"Once I found these little tiny tablets — that I had to take one and it felt like I had taken an Oxycontin — you know, that was it," Brian said. "It was game over."
An uncertain future
Researchers say more research should be done to understand the potential benefits of kratom and 7-OH products, including whether they can help treat addiction. On their website, NIDA says, "early studies suggest kratom and kratom compounds warrant further study as experimental treatments for substance use disorders, specifically opioid use disorder."
In the meantime, Holstege, at the University of Virginia's School of Medicine, says current marketing around kratom products seems to attract users for other reasons.
"I find it a little hard to believe that all the shops that are popping up around my campus right now are trying to advertise to people who are addicted to opioids," he said. "So the question is, what else are they advertising this product for?"
" I certainly have a growing list of patients in addiction clinics who are addicted to this, and in withdrawal, that we're having to manage," Holstege added.
Brian stopped taking 7-OH in April 2026, when he said he decided to "quit cold turkey." He said he experienced more debilitating withdrawals from 7-OH than he had from quitting opioids. He noted, though, he'd had a much easier time accessing 7-OH, and took it more frequently than he'd taken opioids.
When stopping 7-OH, he said he felt fearful, anxious, and had gastrointestinal issues. He lost the desire to leave his house.
"It was a nightmare," Brian said.
Tyler told NPR he hasn't used 7-OH or kratom since he traveled to the Michigan detox program in March. He said he doesn't think he would have been able to stop using 7-OH without that program.
"There's no chance," he said. "It's just too addictive and too accessible."
He said the road to feeling like himself again has been even longer than when he stopped using opioids. With opioids, he said, it took a few weeks to feel like he had energy again.
With 7-OH, he said the process has taken months.
"Kind of just this week I'm starting to feel kinda great," he said in October. "But it's been a long journey of getting my energy back."
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