As the popularity of kratom continues to rise—especially among younger users—U.S. health agencies are finally stepping in, particularly targeting products containing the potent opioid derivative, 7-hydroxymitragynine (7‑OH).
Widespread Use, Serious Risks
Kratom, derived from the leaves of Mitragyna speciosa, a Southeast Asian tropical tree in the coffee family, is often consumed for its stimulant, mood-enhancing, or sedative properties. Available in forms like powders, capsules, teas, and vapes, kratom remains largely unregulated in the United States.
In 2022, about 1.9 million Americans aged 12 and older reported using kratom in the past year. Usage was highest among young adults (18–25 years), followed by older adults, and then teens. SAMHSA
Why Experts Sound the Alarm
The concern over kratom is intensifying, especially from the FDA, which has launched a campaign to limit products containing 7‑OH—a compound sometimes dubbed “legal morphine.” Despite appearing in only trace amounts naturally, 7‑OH has significant potency at opioid receptors and poses serious addiction and overdose risks. Houston ChronicleThe Week
Adverse Effects—More Common Than You Think
Experts now estimate that up to one-third of kratom users experience adverse side effects, ranging from cardiac arrest and liver injury to bleeding in the brain and seizures. Some cases have even resulted in overdose deaths. Healthline
A comprehensive review highlighted liver-related complications such as hepatitis, liver failure, and jaundice; neurological effects like seizures and memory issues; cardiovascular toxicity; kidney injury; and severe muscle damage. Infants exposed in utero may also develop neonatal withdrawal. PMC
Between July 2016 and December 2017, there were 91 kratom-related overdose deaths in the U.S., reported across 27 states. GQThe SunAP NewsThe Economic Times
Kratom’s Opioid-Like Effects and Dependence Concerns
While some users take kratom to self-treat pain, anxiety, or opioid withdrawal, there’s little supportive clinical evidence for its safety or effectiveness—and it’s not FDA-approved for medical use.
At low doses, kratom may act as a stimulant; at higher doses, it behaves more like an opioid. GQWikipedia Researchers recommend that doctors routinely ask patients about kratom alongside other recreational drugs, given its habit-forming potential. Healthline
Symptoms of withdrawal—such as hostility, anxiety, irritability, hallucinations, and depression—have been reported and in some surveys, around 12% of users may meet criteria for a use disorder. Some physicians have successfully treated kratom dependence with medications like buprenorphine, commonly used for opioid addiction. HealthlinePubMed
Medical Warning and Regulation Underway
In response to rising concerns, FDA regulators are pushing to classify 7‑OH as a Schedule I controlled substance, due to its high potential for abuse and lack of accepted medical use—while natural kratom leaf remains unscheduled federally. AP NewsWikipediaThe Week
Some states, like Texas, have already enacted bans or stricter regulations on concentrated or synthetic forms of 7‑OH, as part of broader efforts to curb its availability. Houston ChronicleNypost
The Bottom Line
Kratom’s growing appeal as a “natural” remedy belies its often serious health consequences—including heart problems, liver toxicity, addiction, and death. While natural kratom remains legal in most places, the potent compound 7‑OH is rapidly becoming a regulatory target.
If you or someone you know uses kratom—especially in concentrated or unconventional forms—it’s important to discuss this openly with a healthcare provider. Better awareness and medical oversight are key to preventing potentially severe or life-threatening complications.