What Professionals Working with Children and Families Need to Know
Why This Matters
A growing number of products marketed as 7-OH or 7-hydroxymitragynine are being sold in vape shops, smoke shops, convenience stores and online. Although 7-OH is related to kratom, it is not the same as traditional kratom products.
These highly concentrated products have raised significant public health concerns because of their opioid-like effects and increased risk of addiction, overdose and withdrawal.
Professionals who work with youth and families should understand the differences and be prepared to educate parents, recognize warning signs and connect individuals with appropriate support.
What Is 7-OH?
7-Hydroxymitragynine (7-OH) is a naturally occurring compound found in very small amounts in the kratom plant.
Today's concern is not the small amount naturally found in kratom leaves. Instead, manufacturers are producing concentrated 7-OH products that contain much higher levels of this opioid-active compound.
These products are commonly sold as:
- Tablets
- Gummies
- Capsules
- Powder
- Drink shots
- Other concentrated products
They are often marketed as "natural," "legal" or "plant-based," which can create a false perception that they are safe.
Kratom vs. 7-OH
Traditional Kratom
- Plant leaves or powder
- Contains many naturally occurring compounds
- Only a trace amount of naturally occurring 7-OH
- Can still cause dependence and other health risks
Concentrated 7-OH Products
- Manufactured to contain much higher amounts of 7-OH
- More potent than traditional kratom
- Greater potential for addiction and withdrawal
- May increase the risk of overdose and other serious health effects
Why Are Health Experts Concerned?
7-OH acts on the same opioid receptors in the brain that are affected by prescription opioids and other opioids.
Potential risks include:
- Rapid development of tolerance
- Physical dependence
- Opioid-like withdrawal symptoms
- Respiratory depression
- Impaired thinking and judgment
- Increased overdose risk, especially when combined with alcohol or other drugs
In July 2025, the U.S. Food and Drug Administration (FDA) announced actions to restrict concentrated 7-OH products because of concerns about abuse, addiction and serious health risks.
Questions to Ask
When someone reports using "kratom," ask follow-up questions.
Consider asking:
- What type of product are you using?
- Is it powder, capsules, gummies or tablets?
- Does the package mention "7-OH" or "7-hydroxymitragynine"?
- Where was it purchased?
- How often is it used?
- Has the amount increased over time?
- Have there been withdrawal symptoms when stopping?
The answers may significantly change your assessment of risk.
Signs Someone May Be Using 7-OH
Possible warning signs include:
- Drowsiness or excessive sleepiness
- Pinpoint pupils
- Mood changes or irritability
- Nausea or constipation
- Frequent purchases from vape or smoke shops
- Declining school or work performance
- Secretive behavior
- Increasing tolerance or needing larger amounts
Withdrawal Symptoms
Individuals who have become dependent may experience:
- Anxiety
- Restlessness
- Trouble sleeping
- Sweating
- Muscle aches
- Nausea or vomiting
- Diarrhea
- Cravings
- Irritability
Withdrawal can resemble opioid withdrawal and should be evaluated by a healthcare professional.
How Professionals Can Help
Professionals can make a difference by:
- Providing accurate, nonjudgmental information.
- Helping families understand that "natural" does not always mean safe.
- Screening for substance use when concerns arise.
- Encouraging early conversations with youth.
- Connecting individuals and families with treatment and behavioral health resources.
Connect Families to Support
If you are concerned about a child's or family's substance use, encourage them to seek help early.
North Dakota's Behavioral Health Directory can help connect families with prevention, treatment and recovery services available in their community.