ASAM Conference: Johns Hopkins and Yale Researchers Find Kratom Leaf Does Not Act Like Classical Opioids — But Concentrated 7-OH Is a Different Story

Why it matters

New clinical insights from top addiction medicine researchers draw a sharp line between natural kratom leaf and concentrated 7-OH products — a distinction that could reshape both regulatory policy and clinical treatment approaches nationwide.

The big picture

At the April 2026 American Society of Addiction Medicine (ASAM) conference in San Diego, leading kratom researchers from Johns Hopkins and Yale presented emerging evidence on how kratom products function pharmacologically. Their finding that natural kratom leaf does not produce respiratory depression like classical opioids — while highly concentrated 7-OH products do — supports a regulatory distinction that some states have already enacted. California has simultaneously achieved 97% retail compliance in its crackdown, yet products remain freely available online.

Key findings

• Kirsten Smith (Johns Hopkins): Kratom leaf is "not behaving like a typical opioid in any way" — opioid activity confirmed, but no respiratory depression observed
• Yale researcher Katherine Hill: "When people are asking, 'Is it an opioid?' It's not our classical opioid"
• California seized over $5 million in kratom and 7-OH products and reached 97% retail compliance by April 2026
• Nationwide poison centers received 1,690 kratom-related calls in just the first 7 months of 2025, surpassing all of 2024
• OC addiction physician: 7-OH withdrawal is harder to manage than fentanyl withdrawal; standard opioid detox protocols do not work

What they say

"There's two things to remember with kratom: A. Yes, there's opioid activity. B. Is this acting like a typical opioid? No. And when I say 'it,' I mean any of the alkaloids within kratom." — Kirsten Smith, Johns Hopkins University School of Medicine

Bottom line

Leading addiction researchers now broadly agree that natural kratom leaf and concentrated 7-OH products present fundamentally different pharmacological risk profiles — and that effective policy must treat them differently.