7-Hydroxymitragynine: The Dangers of High Potency Kratom 7-OH

Kratom has become increasingly popular in recent years, and it’s praised by some users for its stimulating, relaxing, and pain-relieving properties. Approximately 1.7 million Americans over the age of 12 used kratom in 2021.

Now, with kratom extract products hitting the market, healthcare professionals are paying attention to a metabolite or alkaloid produced when the body breaks down kratom. This compound, called 7-hydroxymitragynine or 7-OH, plays a major role in kratom’s analgesic effects and potential risks.

In this article, we’ll explore what 7-OH is and how it can be dangerous. You will learn:

• What kratom is
• What alkaloids are, and how each of Kratom’s alkaloids contributes to its effects
• The difference between mitragynine and 7-hydroxymitragynine
• The dangers of kratom extracts and high levels of 7-OH in the body
• How to spot the signs of kratom addiction
• What happens during kratom withdrawal
• Where to find treatment for kratom addiction

If you or a loved one is in need of immediate assistance or is ready to start the recovery process, please contact our team at Moving Mountains Recovery today.

What is Kratom?

Kratom is a tropical tree native to Southeast Asia, particularly Thailand, Indonesia, Malaysia, and Papua New Guinea. Its scientific name is Mitragyna speciosa, and the leaves contain compounds that have mind-altering or psychoactive effects.

Kratom is used for a number of reasons, including:

• To alleviate pain
• Boosting energy or mood
• Helping with anxiety or depression
• Managing opioid withdrawal symptoms
• To help overcome opioid addiction

At low doses, kratom can act as a stimulant, making users feel more alert and energetic. At higher doses, it tends to have sedative or opioid-like effects, causing drowsiness or euphoria.

Kratom can have side effects like nausea, constipation, dry mouth, increased urination, loss of appetite, and, at high doses, hallucinations or seizures. Long-term use can lead to dependence or withdrawal symptoms. Some people have ended up in the ER or even died, especially when kratom is mixed with other substances.

Types of Kratom Products

Kratom is sold at many smoke shops and health stores as a dietary supplement. It is sometimes found at gas stations, too. It is most commonly brewed as a tea, taken in capsule or tablet form, or mixed into food or drinks as a powder. 

Traditional kratom use involves chewing the plant’s leaves or brewing them into a tea. Natives to Southeast Asia and other countries where Kratom is taken medicinally use it in low doses to relieve fatigue and in high doses to manage pain.

What is 7-OH Kratom? 7-Hydroxymitragynine and Other Active Metabolites

7-OH (short for 7-hydroxymitragynine) is one of the main active compounds found in kratom. It’s not kratom itself, but a potent alkaloid produced by the body when it metabolizes another kratom compound called mitragynine.

While mitragynine itself acts as a partial agonist at mu-opioid receptors, 7-OH is a full agonist that binds to these receptors and increases their activity, making it significantly more potent, sometimes compared to morphine in strength.

7-hydroxymitragynine is up to five times more powerful than mitragynine. Some animal studies have shown that it is several times stronger than morphine, a powerful opioid drug.

Natural kratom leaves contain only tiny traces of 7-OH, but the body produces more of it when metabolizing mitragynine. 7-OH is mainly produced when isolated mitragynine is converted by human liver microsomes, a process that happens after the ingestion of kratom products.

7-OH has a strong binding affinity. In other words, it binds strongly to the opioid receptors in the brain. These are the same receptors that are affected by opioid drugs like heroin or oxycodone. This is part of why kratom can relieve pain and induce euphoria, but also why it may cause tolerance, dependence, or withdrawal with regular use.

Major Alkaloids in Kratom

Kratom contains over 40 alkaloids, which are naturally occurring compounds that affect the brain and body. These alkaloids are responsible for kratom’s analgesic effect, such as pain relief, stimulation, sedation, and even euphoria. 

The alkaloids mitragynine and 7-hydroxymitragynine are the most studied and active metabolites the body creates when metabolizing kratom, but there are many other minor alkaloids that are worth noting.

Kratom’s alkaloids include:

• Mitragynine – This is the most abundant alkaloid in kratom, making up around 66% of total alkaloids. It is a partial opioid agonist that can provide pain relief, mild stimulation, and elevated mood.
• 7-hydroxymitragynine – Also known as 7-OH, this alkaloid is much more potent than mitragynine. It is found in trace amounts but produces analgesic effects such as pain management, euphoria, and sedation.
• Speciogynine – After mitragynine, speciogynine is the next most abundant kratom alkaloid. It is believed to have muscle relaxant properties, but minimal psychoactive effects.
• Paynantheine – This is another alkaloid that may help with muscle relaxation. It has very mild effects on opioid receptors.
• Speciociliatine – Speciociliatine is structurally similar to mitragynine and can contribute to the drug’s sedative and analgesic effects.
• Coryantheidine – This is a natural opioid receptor antagonist that plays a balancing role, negating some of the opioid-like effects of other kratom alkaloids.

Kratom Extract

Being more potent than the kratom plant itself, some kratom vendors have found a way to boost the 7-OH levels in their extracts or enhanced powders (often marketed as “full spectrum,” “ultra,” or “enhanced” kratom products. While 7-OH is only found in trace amounts in natural kratom products, these extracts can be up to 500% more potent, causing the body to produce more 7-OH after use.

Some retailers are selling “7-OH” pills, which claim to contain the powerful compound, 7-hydroxymitragynine, itself.

Because of the increased potency, extracts and 7-OH tablets can deliver much stronger effects with smaller doses, especially in terms of pain relief, sedation, and euphoria. However, this also means there’s a higher risk of side effects, tolerance, and dependence, particularly if used frequently.

This increase in potency has drawn concern from public health officials, especially amid the ongoing opioid epidemic in the U.S. Unlike FDA-approved medications, kratom and kratom alkaloids, including 7-OH, is considered an unapproved drug in the eyes of the FDA, and their safety, dosage guidelines, and interactions have not been rigorously studied or regulated.

It’s important to note that while kratom is not illegal, neither the dietary supplements nor the extracts are regulated, and many products don’t list exact alkaloid content. Without third-party testing, there’s no way to know how much 7-OH is actually in the product, or whether it’s been artificially synthesized and added.

Side Effects of 7-Hydroxymitragynine

7-OH is the active metabolite that is largely responsible for kratom’s opioid-like pain reduction and sedative effects at higher doses. Common side effects include:

• Nausea and vomiting
• Constipation
• Dry mouth
• Drowsiness or sedation
• Itching
• Sweating
• Loss of appetite
• Dizziness or lightheadedness
• Euphoria (at low to moderate doses)
• Anxiety or irritability (especially with long-term use or withdrawal)
• Depression (usually linked to prolonged use and discontinuation)
• Brain fog or cognitive slowing

Key Differences Between Kratom and Kratom 7-OH

While 7-OH comes from kratom, there are significant differences between the kratom plant and the alkaloid 7-OH.

Potency

Kratom produces mild to moderate effects depending on your tolerance level and the amount consumed. 7-OH, on the other hand, is extremely potent, and a little goes a long way.

Binding Affinity

Binding affinity refers to how strongly a substance (like an alkaloid) attaches to receptors in your body, specifically, opioid receptors, when we’re talking about kratom. The stronger the affinity, the more powerful and long-lasting the effect can be.

7-hydroxymitragynine has a very high affinity for the mu-opioid receptor, which is the same receptor that drugs like morphine, heroin, and fentanyl target. In fact, it binds more strongly than morphine and is a full opioid agonist, causing the analgesic effects.

Kratom has a much lower affinity to the mu-opioid receptor. Its primary alkaloid, mitragynine, is only a partial agonist, meaning it has a low affinity for opioid receptors.

Form

Kratom products come in many forms, but they’re usually sold as dried or crushed leaves, as a powder in capsules or tablets, or as a powder that can be dissolved in water to make tea. 

7-OH, on the other hand, is a single compound either formed during digestion or chemically enhanced in some extracts. It’s rarely sold in the pure form.

Risk of Abuse and Dependence

Kratom is often marketed as a dietary supplement that is safe and non-addictive. Many people view it as a safer alternative to illicit opioids. However, scientific data shows that it does have abuse potential and can cause physical dependence. 

Kratom products that contain higher levels of 7-OH may have a higher risk of abuse and dependence due to the stronger effects.

Why Kratom Extracts are More Dangerous than Kratom Leaves

While kratom leaf powder has been used traditionally for centuries and can be a promising medicinal plant when used safely, kratom extracts, especially those that are enhanced with high concentrations of 7-hydroxymitragynine (7-OH), can pose significantly greater risks.

Findings suggest that kratom extract products can contain up to 98% 7-OH, together with other kratom alkaloids.

Health Risks

Kratom extracts are far more concentrated than natural leaf powder, often containing amplified levels of 7-OH, the compound responsible for kratom’s opioid-like effects. This can lead to much stronger sedation, euphoria, and reduced pain, but also comes with a higher chance of side effects, such as:

• Nausea and vomiting
• Dizziness or confusion
• Constipation
• Respiratory depression
• Increased risk of dependence and withdrawal symptoms

Because the effects are more intense and come on faster, users are more likely to overconsume, especially if they assume the same dosage as they would with regular kratom powder. 

Kratom extracts also tend to build tolerance more quickly, pushing users to take higher and higher doses over time to achieve the same effects as before.

Drug Interactions

Because 7-OH acts on opioid receptors, it can interact dangerously with other central nervous system depressants, including:

• Alcohol – Both alcohol and kratom depress respiration and alter judgment. Combining them can lead to adverse side effects like blackouts, vomiting, and slowed or stopped breathing.
• Opioids -Taking opioids with kratom can amplify the effects and can cause life-threatening respiratory depression.
• Benzodiazepines – Benzodiazepines like Xanax or Valium act on similar brain pathways, and when mixed with kratom extracts, they can drastically increase sedation and risk of overdose.

Each of these combinations can increase the risk of overdose, sedation, or death. Even seemingly mild combinations can be risky when kratom is taken in extract form.

Public Safety Concerns

In recent years, poison control centers across the United States have seen an increased reporting of overdoses and other adverse events relating to kratom abuse. 

Many of these cases involve high-potency kratom products like extracts or “enhanced” powders. According to the CDC and other public health agencies, these cases have included:

• Overdoses requiring hospitalization
• Seizures
• Comas
• Deaths, often involving co-use with other substances

Most of these instances involve people who used kratom products in combination with other substances.

Since 7-OH mitragynine products are not regulated, the only way to determine if they are free of residual chemicals or additives is to conduct third-party testing. As a result, people may not always know what they are putting into their bodies.

Is Kratom Addictive?

Kratom binds to many of the same receptors as opioids do and produces many of the same effects. People can begin craving the feelings produced by kratom again, and these reinforcing effects can lead to the development of a substance use disorder or addiction.

Like opioids, kratom and 7-OH produce rewarding effects, and taking them excessively can lead to physical dependence and psychological addiction.

Common signs of kratom addiction include:

• Needing higher doses to get the same effect that you used to get at lower doses (tolerance)
• Feeling anxious, irritable, or sick when not using (common symptoms of withdrawal)
• Having strong cravings for kratom
• Prioritizing kratom use over responsibilities or relationships
• Unsuccessful attempts to cut down or quit

Unfortunately, many people who suffer from opioid use disorder turn to kratom for withdrawal symptom relief. Since kratom activates many of the same receptors as opioids, it can reduce opioid withdrawal symptoms. 

However, using kratom to cope with opiate withdrawal can cause a person to transfer their addiction from opioids to kratom or 7-OH. They may experience withdrawal symptoms when they stop using kratom.

What Happens During Kratom Withdrawal?

Detoxing from kratom can produce symptoms similar to those of opioid withdrawal. Common withdrawal signs include:

• Depression
• Anxiety
• Cravings for kratom
• Muscle aches
• Fatigue
• Irritability
• Mood swings
• Insomnia
• Anxiety
• Restlessness
• Runny nose
• Sweating
• Nausea
• Vomiting
• Chills
• Diarrhea

Withdrawal usually starts within 12–24 hours of the last dose. For most people, acute symptoms last 3–7 days, but sleep problems, anxiety, or cravings can linger longer, sometimes for weeks.

Kratom withdrawal is typically not life-threatening, but it can be very uncomfortable. In some cases, people may relapse just to stop the symptoms. That’s why some choose to detox under medical supervision, where symptoms can be safely managed.

Is Kratom Legal?

In the U.S., kratom is legal under federal law, but some states, counties, and cities have banned it. Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin have all passed legislation to ban kratom and its byproducts, mitragynine and 7-hydroxymitragynine. 

Other states have taken steps to regulate sales based on age restrictions, permitting, registration, and other factors.

However, on a federal level and in most states, kratom is unregulated, which means it’s not FDA-approved for any medical use.

What to Do If You’re Struggling With Kratom Use or Addiction

Many people assume kratom is harmless because it’s a plant and it’s sold legally, but it can lead to real physical dependence and withdrawal, especially with long-term use. People can also begin to rely on kratom to cope with daily stressors, anxiety, or underlying health conditions.

If you’re struggling with kratom addiction, here’s what you can do:

Seek Treatment

The first step is reaching out for help. Look for a highly rated local addiction treatment center and call to inquire about their programs. They can help you understand your options, whether that’s therapy, support groups, or more structured treatment. 

Remember, you don’t have to figure it out on your own.

Verify Insurance

Before starting treatment, check whether your health insurance covers the care you need. Many rehab programs accept insurance for outpatient or inpatient services. A quick call or online form can help you find out what’s covered and save you time and stress.

At Moving Mountains Recovery, we can verify your insurance for you to make the admissions process quick and easy. Verify your insurance with us today!

Medical Detox

If you’ve been using kratom heavily or for a long time, stopping it suddenly can cause withdrawal symptoms like anxiety, body aches, or insomnia. 

A medical detox program offers a safe, supervised way to come off kratom while managing symptoms, keeping you comfortable, and helping you stay sober.

Treatment and Recovery

After detox, ongoing treatment helps you stay on track. This can include counseling, group therapy, and relapse prevention strategies. 

Whether you join a residential program or visit a center a few times a week, recovery is about building a healthier lifestyle without relying on mood- or mind-altering substances.

Find Treatment Now

Moving Mountains Recovery offers a whole-person approach to recovery by providing a continuum of care, clinically proven treatments, and holistic healing. 

Our program includes multiple levels of care, including partial care (PC), intensive outpatient programming (IOP), and outpatient (OP) with individualized treatment plans designed to meet each client’s unique needs. 

Many of our staff are in recovery themselves, so we know what you’re going through and how to help. You can rely on us to help you build a strong foundation for lasting recovery. Contact us today to get started with a confidential, risk-free assessment.

Frequently Asked Questions About 7-OH

Can you overdose on 7-OH?

7-OH isn’t sold by itself, but a potent kratom product can be so strong that your body can produce excess 7-OH, resulting in central nervous system (CNS) depression and possible overdose symptoms. 

If you’re having trouble breathing, difficulty staying awake, or other concerning symptoms, contact a healthcare provider or seek emergency assistance right away.

Is 7-OH used in medical settings?

No. Like kratom, 7-OH has not been thoroughly studied or approved for human use by the U.S. Food and Drug Administration (FDA). As a result, it is not in any prescription medications, nor is it used for medical treatment.

How are 7-OH and morphine alike?

7-hydroxymitragynine (7-OH) and morphine are alike in one key way: they both act on the brain’s mu-opioid receptors, which are responsible for pain relief, euphoria, and sedation. This means they produce similar effects, such as reducing pain and creating a sense of calm or well-being.

However, they are two very different substances. 

7-OH is a compound the body produces when metabolizing kratom, while morphine is a naturally occurring opiate found in the seed pod of the opium poppy plant. 

Additionally, morphine has FDA-approved medical uses, while kratom does not.

What are 7-OH Tablets?

7-OH pills or tablets are concentrated substances containing 7-hydroxymitragynine, the strongest component of the kratom plant. These tablets are unregulated and may cause significant health risks. They are not regulated by the FDA or any other healthcare organization.