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.