Michigan Addiction Doctor: 7-OH Crisis Is Real, But Kratom Ban Ignores Underlying Drivers of Substance Use

Why it matters

A frontline addiction physician provides rare clinical testimony on the distinct harms of 7-OH versus natural kratom — a distinction policymakers are frequently collapsing — while also highlighting the systemic treatment failures that leave patients vulnerable to these products.

The big picture

Physicians treating kratom and 7-OH addiction are increasingly speaking out as state legislatures debate broad bans. The clinical picture they describe is nuanced: 7-OH products — particularly synthetic or concentrated forms — behave like opioids and have caused deaths, while natural leaf kratom is viewed by some patients as a harm-reduction tool. Michigan's proposed ban covers both, prompting clinicians to argue the policy does not reflect the medical reality on the ground.

Key findings

• Dr. Eliza Hutchinson, a University of Michigan family and addiction medicine physician, describes treating a growing wave of 7-OH-dependent patients in her community health center\nBuprenorphine — the same medication used for opioid use disorder — successfully treats 7-OH dependence\nA father previously in opioid recovery died from a 7-OH overdose after a vape shop advertised it as an energy product\nA single mother spent $150 per day on 7-OH before stabilizing on buprenorphine\nSome patients use natural leaf kratom as a safer alternative to street fentanyl or to manage pain without insurance coverage\nDr. Hutchinson warns that kratom bans will increase urgency for addiction treatment, which Michigan's healthcare system is ill-equipped to handle

What they say

"Without a doubt, swift action is needed," writes Dr. Hutchinson. "But not just on kratom, 7-OH, or the substance of the moment. The problem is much larger... Let us not allow the current focus on these products to distract us from the underlying threats that fuel our substance use epidemic."

Bottom line

A Michigan addiction doctor treats 7-OH overdoses daily with buprenorphine, and warns that banning kratom without expanding addiction treatment ignores the systemic causes driving patients to these products in the first place.