AKA Urges AMA to Distinguish Natural Kratom from Chemically Converted 7-OH Opioids

Why it matters

The debate over whether to regulate or ban kratom increasingly hinges on a key distinction: are policymakers targeting natural kratom leaf, or chemically synthesized 7-OH concentrates? The AKA says conflating the two harms both consumers and evidence-based policy.

The big picture

The American Medical Association adopted a policy statement at its June 2026 annual meeting expressing concern about concentrated 7-hydroxymitragynine products and supporting restrictions on their sale, particularly to minors. The AKA applauded the AMA's attention to 7-OH dangers but took issue with language that repeatedly called these products "kratom products" — a characterization the AKA says creates dangerous regulatory confusion. Natural kratom leaf contains mostly mitragynine with only trace 7-OH; many commercial 7-OH products are chemically converted to reverse that ratio, producing a pharmacological profile closer to synthetic opioids.

Key findings

• The AMA adopted a policy calling for restrictions on concentrated 7-OH products at its 2026 annual meeting
• Natural kratom leaf contains mitragynine as the dominant alkaloid; 7-OH is present only in trace amounts
• Commercial 7-OH products often reverse this ratio through chemical conversion, creating a very different substance
• An NIH-sponsored human safety study found kratom doses up to 12 grams were generally well-tolerated in healthy adults
• The AKA supports strict regulation and scheduling of chemically converted 7-OH opioid products
• Both HHS Secretary RFK Jr. and former FDA Commissioner Makary have said federal enforcement targets 7-OH, not natural kratom

What they say

"These chemically manipulated 7-OH opioids are not traditional kratom products. They are highly concentrated opioids manufactured through chemical conversion processes that fundamentally alter the natural composition of kratom," said Mac Haddow, Senior Fellow on Public Policy for the American Kratom Association.

Bottom line

The central policy battleground has shifted from kratom vs. no kratom to natural kratom leaf vs. chemically converted 7-OH opioids — and how regulators draw that line will define the future of the industry.