Hawaii Department of Health Issues Official Warning: 7-OH Is 10x More Potent Than Morphine and Poses Overdose Risk

Why it matters

A state health department issuing an official public warning about 7-OH signals escalating governmental concern and provides healthcare providers with actionable guidance—including that naloxone (Narcan) can reverse a 7-OH overdose.

The big picture

As 7-OH products proliferate in smoke shops, vape stores, and convenience stores nationwide, state health agencies are increasingly filling the void left by the absence of federal scheduling. The DEA is reviewing the FDA's July 2025 recommendation to classify 7-OH as a Schedule I controlled substance. Hawaii's official warning follows the state's first confirmed 7-OH-related death.

Key findings

• 7-OH (7-hydroxymitragynine) is estimated to be 10 times more potent than morphine; synthetic kratom extract MGM-15 poses similar risks
• Products are sold as gummies, tablets, drink shots, and flavored items in smoke shops and online, often in formats that appeal to youth
• 7-OH can cause addiction, respiratory depression, sedation, and dangerous interactions with alcohol or other drugs
• The FDA has begun enforcement actions against concentrated 7-OH products and warns that no approved drugs contain 7-OH
• Naloxone (Narcan) can reverse a 7-OH overdose; emergency services should always be called if overdose is suspected

What they say

"7-OH is an emerging public health threat," said DOH Director Dr. Kenneth Fink. "Retail products to which 7-OH has been added are being marketed in ways that may mislead consumers into believing they are natural or safe. In reality, 7-OH acts on opioid receptors in the brain and may carry many of the same risks associated with other opioid products."

Bottom line

Hawaii's health department has officially classified 7-OH as an opioid-like public health threat and urges parents, youth, and clinicians to treat these widely available products with the same caution as prescription opioids.