University of Michigan Physicians Sound Alarm: 7-OH Addiction Filling Treatment Programs at Rapidly Growing Rate

Why it matters

Addiction specialists at the University of Michigan report seeing a rapid surge in patients — including people in long-term opioid recovery — developing severe 7-OH addictions after purchasing the products legally at gas stations and smoke shops.

The big picture

7-OH (7-hydroxymitragynine), marketed as a kratom derivative, is a synthetic opioid up to 10 times more potent than kratom primary alkaloid mitragynine. Unlike street drugs, it can be purchased with a credit card and is widely available at convenience stores in most states. Physicians at U-M are now treating 7-OH addiction with buprenorphine, using the same protocols as for fentanyl or heroin addiction.

Key findings

• 7-OH is described as up to 10 times more potent and addictive than mitragynine, kratom primary alkaloid
• Kratom and 7-OH poison control calls in the first 6 months of 2025 exceeded all such calls in all of 2024
• At one Michigan residential treatment facility, 7-OH addiction now accounts for nearly one-third of patients
• Buprenorphine (Suboxone/Sublocade) has proven effective in treating 7-OH addiction, using the same protocols as for fentanyl and heroin
• Patients — including people in long-term opioid recovery — were misled by marketing calling 7-OH a natural kratom derivative
• U-M is developing clinician education resources on 7-OH to help providers recognize and treat addiction

What they say

"This is a wolf in sheep clothes," said Dr. Vita McCabe, director of U-M Addiction Treatment Services. "What most people do not understand is that they may develop a kratom use disorder, which is a form of an opioid use disorder, that has the same symptoms, side effects, and treatment as all opioid use disorders. We do not sell oxycodone, heroin or fentanyl in gas stations for people to self-administer."

Bottom line

University of Michigan addiction physicians are reporting a rapid surge in severe 7-OH dependency — including among recovering opioid addicts — with buprenorphine emerging as an effective treatment for what is, in clinical terms, an opioid use disorder.