New York State Releases Comprehensive Kratom and 7-OH Clinical Guidance for Providers

Why it matters

New York's Office of Addiction Services and Supports (OASAS) has published comprehensive clinical guidance on kratom and 7-OH — one of the most detailed state-level resources available — to help clinicians identify, treat, and understand kratom use disorder.

The big picture

As kratom-related calls to poison centers surged 1,200% between 2015 and 2025, states are increasingly stepping in with their own guidance in the absence of federal regulation. New York already bans kratom sales to those under 21 and requires ingredient disclosure and addiction warnings on labels. The OASAS guidance acknowledges both the therapeutic motivations behind kratom use and the real risks of dependence, covering everything from detection challenges to buprenorphine-based treatment.

Key findings

• New York State bans kratom sales to people under 21 and requires products to list all ingredients and carry addiction warnings, but has not set product quality standards
• 7-OH products commercially sold in the U.S. are laboratory-made and chemically distinct from kratom plant products, producing more intense opioid effects
• Standard drug screening tests cannot detect kratom or its metabolites; specialized laboratory testing exists but does not produce immediate results
• A 2026 study using NSDUH 2021-2023 data found higher kratom use odds among men, adults 35-49, and those with prior prescription pain reliever use
• Buprenorphine has been used off-label to treat kratom use disorder, though it has not been well-studied in clinical trials for this indication

What they say

The OASAS guidance states: "Since 7-OH is more potent than kratom, consumption of 7-OH products may lead to a more intense activation of the opioid receptors and more pronounced opioid-like effects. These effects may be comparable to those experienced after using an opioid medication."

Bottom line

New York OASAS published detailed clinical guidance on kratom and 7-OH — covering diagnosis, treatment options, and legal status — giving healthcare providers a state-backed resource to address the growing kratom use disorder challenge.