Opinion: DEA 7-OH Action Is Welcome But Incomplete -- Kratom Itself Needs Federal Regulation

Why it matters

Andrew Kolodny, one of the U.S.'s most prominent addiction medicine physicians, argues the DEA's 7-OH scheduling is too narrow -- leaving ordinary kratom, which he considers addictive, fully legal in most states. The argument challenges the industry narrative that problem products are limited to synthetic 7-OH.

The big picture

The kratom industry has lobbied to frame synthetic 7-OH as the problematic outlier while positioning natural leaf kratom as safe. Kolodny's piece challenges that framing, pointing to data showing kratom-related hospitalizations and poisonings rose 1,200 percent over the past decade -- well before 7-OH products entered the market two years ago. The debate is central to ongoing federal and state policy decisions.

Key findings

• Kratom poisonings and hospitalizations have risen 1,200 percent over the past decade, predating the emergence of 7-OH products by years
• Kolodny argues that ordinary kratom leaf is itself opioid-like and addictive, not merely the synthetic concentrated products
• Patients hospitalized for unrelated conditions can enter severe opioid withdrawal after undisclosed kratom use -- which standard drug screens do not detect
• The DEA's 7-OH scheduling will not affect plain leaf kratom powder, capsules, or standard extracts sold in most states
• The kratom industry has funded lobbying campaigns to distinguish natural kratom from synthetic 7-OH and preserve the former's legal status

What they say

"I have treated patients who were hospitalized for an unrelated condition, tested negative for opioids on admission and then, within days, were in severe opioid withdrawal -- sweating, vomiting, in agonizing pain. Medical staff are stunned every time; kratom doesn't register on standard drug screens," wrote Dr. Andrew Kolodny in the Washington Post.

Bottom line

A leading addiction medicine physician argues the DEA's 7-OH action is a first step but leaves millions exposed to natural kratom's opioid-like dependence potential -- and calls for broader federal regulation.