Clinicians Scramble to Develop Kratom and 7-OH Addiction Treatment Protocols as Patient Caseloads Surge

Why it matters

As millions of Americans use kratom and its synthetic derivative 7-OH, treatment centers report rapidly rising caseloads — but no FDA-approved treatment exists for kratom use disorder. Physicians are adapting opioid protocols on the fly.

The big picture

Kratom has been used by an estimated 1 to 20 million Americans, and the advent of synthetic 7-OH has dramatically raised addiction severity. With 14,449 poison control reports since 2015 and record highs in 2025, the healthcare system is now confronting a wave of patients seeking detox and treatment for kratom dependence — without standard clinical guidelines.

Key findings

• Crossroads Treatment Centers report major increase in kratom and 7-OH patients seeking help in the past six months
• 7-OH produces opioid-like toxicity — respiratory depression and potentially fatal overdose — unlike traditional kratom
• Mitragynine pseudoindoxyl, a third-generation derivative, is reportedly even more potent than 7-OH
• Withdrawal symptoms closely mirror opioid withdrawal; kratom use disorder is not yet an official diagnosis, complicating insurance coverage
• Treatment options include buprenorphine (Suboxone), methadone, and naltrexone (Vivitrol); Sublocade injection is favored
• Clinicians urge determining root cause of use (pain, anxiety, opioid withdrawal) before initiating treatment

What they say

Dr. Jeanmarie Perrone of the Penn Center for Addiction Medicine and Policy said: "Just like oxycodone or other opioids, once people who may be vulnerable to addiction get exposed, then the cat's out of the bag and you really have to do a lot of work to undo that brain sensation of the positive euphoria of these drugs."

Bottom line

**Opioid treatment medications like buprenorphine and methadone are the best current options for kratom use disorder, but the absence of standard protocols leaves clinicians guessing.**