Pennsylvania Addiction Physicians and State Health Officials Sound Alarm Over 7-OH Gas Station Drug

Why it matters

Pennsylvania is the latest major state where clinical practitioners are documenting a visible uptick in 7-OH dependency, backing FDA and state health warnings with firsthand patient data — and offering a template for how addiction medicine physicians can respond.

The big picture

The FDA has called 7-OH a potential driver of the next opioid epidemic and recommended scheduling it as a controlled substance. Pennsylvania's experience — with rapidly rising poison control calls, a first confirmed mitragynine death in Carbon County in January 2026, and UPMC addiction physicians seeing more patients — illustrates how the crisis is reaching mid-size cities and rural areas beyond major metros.

Key findings

• The Pennsylvania Department of Health issued a health advisory in October 2025 warning of increased kratom and 7-OH calls to poison control centers; 7-OH-specific calls began appearing in 2025
• Between 2022 and June 2025, 81 individuals reported significant illness from kratom or 7-OH, with Allegheny, Montgomery, and Philadelphia counties most affected
• On January 20, 2026, Carbon County coroner reported the first confirmed mitragynine-related death in the county, calling kratom "readily accessible" and fatal
• UPMC addiction medicine specialist Dr. Greg Swartzentruber said concentrated 7-OH sold at gas stations is "about 40 times more potent at the opioid receptor" than the parent compound mitragynine
• The FDA has characterized 7-OH as 13 times more potent than morphine; Pennsylvania House Bill 2158 would schedule synthetic kratom and 7-OH as Schedule I controlled substances

What they say

"The problem with the 7-OH you can get at the gas station is it's purified, right? It's only 7-OH, and 7-OH is about 40 times more potent at the opioid receptor than mitragynine, than the parent compound," said Dr. Greg Swartzentruber, UPMC addiction medicine specialist.

Bottom line

Pennsylvania's first confirmed mitragynine death, rising poison control calls, and UPMC clinical data together make a compelling case that the 7-OH gas station drug crisis has moved well beyond coastal hotspots into mainstream American communities.