Kratom and 7-OH: Differences, effects, and treatment

Kratom is a plant-based substance that’s easy to find online, in stores, and at smoke shops. Because it’s natural and legal in many places, it’s often seen as a safer alternative for pain relief or opioid withdrawal. But “natural” doesn’t always mean risk-free.

Many people turn to kratom or 7-OH products looking for relief, especially when other options feel out of reach. But the truth is, these products can quickly lead to dependence, and quitting can bring its own set of withdrawal symptoms. Some versions are even more concentrated than what’s found in the kratom plant itself, making the risk of misuse and intense withdrawal even higher.

We know that recovery isn’t always a straight line. That’s why getting the facts without judgment can be a helpful tool on your path. In this article, we’ll walk you through the relationship between kratom and why concentrated 7-OH products carry some risks you should be aware of. 

The relationship between kratom vs. 7-OH

Kratom is a plant that contains many different compounds. One of its most powerful is called 7-hydroxymitragynine, or 7-OH for short. This compound is what gives kratom its strongest opioid-like effects.

In raw kratom leaves, 7-OH only shows up in very small amounts. Most of the 7-OH your body absorbs is actually created after you take kratom, during digestion. Your body naturally converts other compounds in the plant into 7-OH.

Why does that matter? Because 7-OH acts on the same brain receptors as opioids like morphine. That’s why kratom can bring short-term relief for pain or withdrawal. But this is also why it can be habit-forming. Products that isolate or boost 7-OH levels hit much harder than whole-leaf kratom, and that increased strength also raises the risk of dependence, withdrawal symptoms, and long-term harm.

What is kratom?

Kratom has been called everything from a natural painkiller to a dangerous drug, but the reality is more complicated. Kratom comes from the leaves of the Mitragyna speciosa tree, native to Southeast Asia. People there have used it for generations to manage pain, boost energy during long workdays, or find calm when stressed.

In the U.S., kratom use looks different. Many people discover it while searching for alternatives to prescription painkillers or trying to manage withdrawal from other opioids. Research shows kratom use is significantly higher among people dealing with opioid dependence and those using other substances. This tracks with findings that show that many people using kratom aren’t looking to “get high.” Instead, they’re looking to cope and self-treat.

For many, kratom isn’t a recreational choice. It can feel like a last resort when they don’t have access to affordable care without stigma or judgment attached. In those moments, kratom can seem like the only available option to them, giving them something that feels “natural,” “legal,” and within reach.

Kratom’s effects depend on the dose. At lower doses, it acts more like a stimulant. At higher doses, it works more like an opioid, which is why some people turn to it for pain relief or to ease withdrawal symptoms.

What is 7-OH?

7-OH (or 7-hydroxymitragynine) is kratom’s most potent compound and the one responsible for most of its opioid-like effects. In traditional kratom leaves, 7-OH makes up only a tiny amount of the active compound, typically less than 2%.

However, in many commercial products, that balance is changed. Manufacturers may extract and concentrate 7-OH, or even create synthetic versions of it. This turns it into something much stronger than the original plant. That extra strength can increase the risk of dependence and make withdrawal symptoms more intense.

These concentrated 7-OH products are often marketed as “enhanced kratom” or “extra strength,” but they’re very different from traditional kratom. One study tested eight products marketed as kratom and found that seven of them contained 7-OH levels two to six times higher than what naturally occurs in kratom leaves. Some products are purely synthetic 7-OH with no actual kratom plant material at all.

You can find concentrated 7-OH in tablets, gummies, liquid shots, and powders sold in places like gas stations or convenience stores. The packaging often looks similar to regular kratom products, making it easy to assume you’re buying traditional kratom when you’re actually getting something much stronger. 

Kratom vs. 7-OH: what’s the difference?

7-OH is a compound found naturally in kratom leaves in very small amounts. While kratom contains many different compounds, 7-OH is the most potent one. To make stronger products, some manufacturers extract 7-OH from kratom or create synthetic versions in a lab.

Here’s a breakdown of the differences between kratom and 7-OH:

Kratom vs 7-OH: side effects 

Kratom and 7-OH share similar side effects. However, the effects of 7-OH are much more intense because it’s concentrated and acts directly on opioid receptors.

Side effects of kratom 

Kratom might seem like a natural alternative, but it’s not without risks or side effects. Some are mild, while others are more serious with heavy or long-term use. 

Common side effects:

• Nausea
• Constipation
• Dry mouth
• Dizziness
• Drowsiness (especially at higher doses)
• Sweating
• Increased urination
• Itching
  

Less common but more serious (typically with heavy or long-term use):

• Elevated heart rate
• High blood pressure
• Liver injury (rare but documented)
• Physical dependence and withdrawal (irritability, cravings, restlessness)

Side effects of 7-OH 

7-OH can cause a variety of side effects that range from mild to serious or potentially life-threatening. According to a health advisory by America’s Poison Centers, 35% of the people who reported 7-OH exposure in 2025 experienced serious side effects, and 67% had to be treated in a healthcare setting. Tragically, the Los Angeles County Department of Public Health also reported three fatal overdoses tied to a lethal combination of 7-OH and alcohol.

Knowing the warning signs and serious side effects of 7-OH can help you seek out help immediately. Potential symptoms and side effects of 7-OH include: 

• Confusion
• Difficulty breathing 
• Dizziness 
• Drowsiness 
• High blood pressure
• Liver toxicity (liver damage) 
• Losing consciousness (fainting) 
• Nausea
• Respiratory depression (slow, shallow breathing) 
• Seizures 
• Vomiting 
• Withdrawal symptoms, which can include:
  • Cravings 
  • Diarrhea 
  • Hot flashes 
  • Runny nose 
  • Tremors (trembling) 
  • Watery eyes 

The more often someone uses 7-OH (or the stronger the dose), the more likely they are to build a tolerance. This means the body starts needing more of it to feel the same effects, which can raise the risk of overdose or dependence. And because 7-OH is not currently regulated, it can be difficult to tell just how potent a product containing this compound may be. 

It’s worth remembering: just because something comes from a plant doesn’t mean it’s automatically safe. While kratom itself comes from a plant, many products sold in stores or online aren’t just the raw leaf. They often contain concentrated extracts or other added substances. These versions can have much higher levels of 7-hydroxymitragynine (7-OH), which significantly increases the risk of unpredictable effects, dependence, and harm.

Why do people use 7-OH? 

There are many reasons people turn to 7-OH or kratom products. Here are some of the most common:

• Pain management: Pain relief is often the most common reason why people use kratom. While studies on rodents have shown that 7-OH can be an effective pain reliever, there haven’t been any controlled studies focused on humans. So, researchers still don’t fully understand how well it works or what the long-term effects might be.
• Mood disorders: Some individuals use kratom to ease anxiety or improve mood. However, withdrawal from 7-OH can cause mood swings, irritability, restlessness, and even feelings of sadness or anger.
• Opioid withdrawal: Kratom is not a controlled substance, and it isn’t fully regulated. While federal agencies have issued warnings about the dangers of this compound, some people attempt to use it to ease the symptoms of opioid withdrawal. What makes this even more dangerous is the potential for misuse since it’s often accessed at higher concentrations. Because its potency and purity aren’t standardized, the effects can be unpredictable, increasing the risk of dependence, serious side effects, and even overdose. 
  

While there’s growing interest in kratom and 7-OH, there’s still a lot we don’t know. Large human studies haven’t been done, and the FDA hasn’t approved 7-OH for any medical use. There’s no standardized dosage, and product labeling can be inconsistent or misleading. That’s why it’s so important to approach 7-OH with caution and get professional guidance if you need it.

Why 7-OH in kratom deserves more attention

You might think you’re taking a natural herbal supplement, but if your kratom product contains concentrated 7-OH, it’s working more like a prescription opioid than a plant remedy.

The problem is manufacturers don’t always list how much 7-OH is in their products. “Enhanced” or “extra strength” kratom usually means concentrated 7-OH has been added, but you won’t always see that spelled out on the label.

If you’ve noticed you need more kratom to get the same effect, or if quitting has been harder than expected, concentrated 7-OH is likely why. Even regular use can lead to tolerance, dependence, and withdrawal over time. 

At QuickMD, we offer $19 online counseling and same-day virtual visits. Our Medication-Assisted Treatment (MAT) program offers affordable, judgment-free care and thoughtful guidance to help you take control of your health.

Is 7-OH dangerous? Risks of high-potency kratom products

In its concentrated form, 7-OH stops behaving like a plant-based supplement and starts working on your brain the same way opioids like morphine or heroin do. This raises both its abuse potential and the risk of:

• Physical dependence that happens faster than with traditional kratom
• Intense withdrawal symptoms when you stop or cut back
• Accidental overdose, especially when combined with alcohol or other substances
• Slowed or difficult breathing at high doses
  

Withdrawal can catch people off guard, especially when the product isn’t traditional whole-leaf kratom. Many kratom products today contain concentrated or synthetic 7-OH in amounts far higher than what naturally occurs in the plant. That higher potency can lead to quicker dependence, stronger cravings, and tougher withdrawal symptoms when you try to stop. That’s not because of any failing or “lack of willpower.” In reality, it’s just the way these products are made.

On top of that, quality can be a serious concern. Some kratom products have tested positive for unsafe levels of heavy metals like lead. If you’re dealing with lingering fatigue, brain fog, or physical symptoms that don’t make sense, it may not be just the kratom. Those symptoms could be due to contamination. 

Kratom dependence and withdrawal: How QuickMD can help

Not sure if kratom or 7-OH is a concern? You’re not alone, and you don’t have to figure it out by yourself. At your next visit, ask your QuickMD provider about support for kratom or 7-OH use. Your questions deserve honest answers and support.