Clinicians Report Rising Kratom and 7-OH Dependence, Adapt Opioid Treatment Protocols

Why it matters

Healthcare providers are increasingly encountering patients dependent on kratom and its synthetic derivative 7-OH, yet formal treatment protocols are still being developed. Understanding how clinicians are adapting opioid use disorder treatments to address kratom dependence is essential for patients, families, and healthcare systems.

The big picture

Kratom and 7-OH have moved from niche herbal supplement to a growing clinical concern. CDC data shows kratom-related poison control calls were substantially higher in 2025 than a decade earlier. The treatment community is adapting by applying opioid use disorder frameworks, but evidence specific to concentrated 7-OH products remains limited. Deaths attributable to 7-OH are difficult to assess because laboratory testing has not fully caught up to detecting these substances.

Key findings

• Clinicians report a significant increase in patients seeking help for kratom and 7-OH dependence, with one treatment director noting an even bigger surge in the past six months
• Withdrawal symptoms from kratom and 7-OH closely resemble opioid withdrawal, prompting use of similar treatment frameworks
• Treatment begins by identifying root reasons for use — pain management, opioid withdrawal management, or mental health conditions
• Medications for opioid use disorder (MOUD) including methadone, buprenorphine, and naltrexone are being used or explored for kratom dependence
• Long-acting buprenorphine formulations (e.g., Sublocade) are being explored, though evidence specific to 7-OH remains limited

What they say

"We have grown to understand that these products work very similar to opioids in the body. And when they try to stop or cut down on using them, often withdrawal symptoms are very similar to opioid withdrawal symptoms," said Jonathan Paolini, nurse practitioner and director of medical operations with Crossroads Treatment Centers.

Bottom line

As kratom and 7-OH dependence rises, clinicians are adapting opioid treatment protocols — including methadone and buprenorphine — to manage withdrawal, but evidence-based guidelines specific to these substances are still emerging.