Missouri DHSS: 7-OH Hits All Opioid Receptors—AG Files Suit, Calls It a Legal Path to Drug Profits

Why it matters

Missouri's attorney general is suing kratom product manufacturers while the state has no scheduling law covering 7-OH—creating a legal vacuum that prosecutorial creativity alone cannot fill. Ohio's new May 19 framework for regulating all synthetic kratom derivatives is being watched as a potential national model.

The big picture

Missouri saw over 2,000 fatal overdoses in 2022, declining to 1,450 in 2024, largely due to fentanyl enforcement. But the synthetic drug market continues evolving. 7-OH is currently unscheduled in Missouri. Ohio's new rules effective May 19 ban all kratom derivatives except natural dried leaves or powder—a bath-salts-style analog ban that could become a blueprint for other states.

Key findings

• Missouri DHSS Chief Medical Officer Dr. Heidi Miller confirms 7-OH acts as an opioid: 'It hits our opioid receptors. People can overdose on it.'
• Kratom-related poison control calls nationally rose 1,200% from 2015 to 2025, per the National Poison Data System.
• In 2021, 1.7 million Americans reported using kratom; 772,000 reported daily use.
• Missouri AG Catherine Hanaway filed suit against kratom product-makers but says direct scheduling charges are not possible under current law.
• Kirksville, MO became one of the first Missouri cities to regulate kratom, banning synthetic additives and restricting sales to adults 21+.
• Ohio's May 19 framework—allowing only natural dried kratom while banning all synthetic derivatives—may serve as a national blueprint.

What they say

"The people who want to make money off drugs have found now a legal path to do it that's very profitable," said Missouri AG Catherine Hanaway. "What we have alleged that they are doing is engaging in illegal advertising, claiming that their product is not addictive and is not intoxicating."

Bottom line

Missouri's AG is using consumer protection law—not drug law—to fight 7-OH manufacturers, exposing a legal vacuum that only scheduling can close.