Parents plead for synthetic kratom ban as powerful opioid hooks kids

Call the Substance Abuse and Mental Health Services Administration's free hotline 24 hours a day for resources and treatment for addiction issues at 1-800-662-HELP (4357). Narcan can reverse a 7-OH overdose.

Like many 18-year-olds, Jeremy Rivers had been dealing with social anxiety for years by the time he got to the end of high school. But his problems melted away this June when he tried his first 7-OH pill.

“My anxiety and all my problems went away, and I just felt really good,” said Rivers, who is using a pseudonym in accordance with Hearst’s ethics policy. “I felt really amazing, euphoric. I felt like I was in a warm blanket.”

7-OH, which is short for 7-hydroxymitragynine, is a powerful opioid related to the drug kratom that’s often sold in candy-flavored pills. Rivers first noticed 7-OH at a gas station five minutes away from his family’s Bay Area house and bought it out of curiosity. Immediately hooked, he returned the following day for more. Within three months, he had spent over $5,000 on 7-OH, as he quickly developed a tolerance and had to take more and more to get the relief he was looking for, and was in a deep stage of addiction. He had gotten accepted into a state university in California, but on the day in September he was supposed to start his freshman year, his parents dropped him off at rehab instead of a dorm.

7-OH has earned the moniker “gas station heroin” because it’s an opiate so powerful that one study estimated it was 14 to 22 times stronger than morphine. Yet it’s sold openly across the country with no age restrictions. In the two years since 7-OH has become available in the U.S., it has quickly grown to a blockbuster seller — and experts are concerned it could cause the next opioid epidemic.

“It’s just a matter of time until people start dying,” said Matthew Lowe, the executive director of the Global Kratom Coalition, which is calling for a ban on synthetic kratom like 7-OH. Lowe said Americans are spending an estimated $9 billion every year on 7-OH; that means Americans are spending more money on 7-OH than on hard seltzer. “The first step is addiction, and then addiction turns into overconsumption and overconsumption turns into death.”

Authorities in LA have linked a spate of deaths this summer to 7-OH, with six people dying from mixing the drug with other substances like alcohol. All of the deaths were of people under the age of 39, including a 19-year-old, and all of the deceased were otherwise healthy individuals.

Regulators are now rushing to act. The Food and Drug Administration recommended in July that the drug be made illegal, with FDA Commissioner Marty Makary warning: “We need regulation and public education to prevent another wave of the opioid epidemic.” Florida banned 7-OH in August; in September, the California Department of Public Health launched a crackdown on the drug, seizing millions of dollars’ worth of the products. California’s surprise actions have yet to actually stop most sales; after CDPH launched its operation, SFGATE found the drug still being sold at 10 stores in the Bay Area. 

Rivers’ mother, Mary (who is also using a pseudonym for anonymity in accordance with Hearst’s ethics policy), said trying to keep her sons away from 7-OH has made her feel “so incredibly helpless as a parent.” Jeremy’s 16-year-old brother also started using the drug when Jeremy did. 

“It’s shocking that it’s so readily available. It’s just sitting on a store shelf less than a mile from our house. And anybody at any age can go and buy it,” Mary said.

What is 7-OH?

7-OH was first discovered in kratom, a naturally occurring drug derived from the leaves of a tropical tree closely related to coffee. Kratom has been used for centuries in Southeast Asia as a pain reliever and mood enhancer, and it has become popular in the United States over the past decade, especially as a possible way to reduce dependence on other pharmaceutical opioids. 

Natural kratom products, which are commonly consumed as a powder or a pill, contain dozens of active chemicals with varying effects, including trace amounts of 7-OH. Kratom companies eventually realized that 7-OH was a potent drug by itself and could be synthetically produced, so in late 2023, companies started releasing stand-alone 7-OH products, according to Lowe of the Global Kratom Coalition.

People who use 7-OH describe it as delivering strong feelings of pain relief, sedation and euphoria. Users quickly build up a tolerance and need to take more and more 7-OH to feel the same high, or risk going through severe withdrawal symptoms if they stop — a cycle similar to other opioids.

7-OH comes in pills, drinks and even vape cartridges, and it’s not cheap, with a single 15 milligram dose of 7-OH costing between $5 and $10 and packages selling for over $50 at Bay Area smoke shops. It is frequently sold in colorful packaging with names that reference other drugs, like “Perks” (a nod to Percocet), “Sippin Syrup” (a reference to promethazine cough syrup) and “Roxy” (a reference to the powerful opioid Roxicodone). The Cheech and Chong company was selling 7-OH as chewable tablets called “Kosmic Ludes,” an apparent reference to Quaalude, a popular sedative sold in the 1960s and 1970s. The company’s marketing language described them as “better than their namesake from 50 years back.” Brooke Mangum, an executive at the Cheech and Chong Corporation, said in an emailed statement that the product’s name was not a reference to quaaludes and said the company stopped selling 7-OH in January 2025 “out of an abundance of caution.”

Yet consumers appear eager to buy 7-OH. Jeff Smith, the national policy director for Holistic Alternative Recovery Trust, a nonprofit that represents producers of the drug, said in an email to SFGATE that the group’s manufacturers have shipped “well over a billion servings” and that they estimate 1 to 2 million unique individuals have consumed the products.

Other industry groups representing 7-OH sellers, like 7-Hydroxy Outreach for Public Education, say it is a new tool to combat opioid addiction and chronic pain, and say it should be regulated instead of outright prohibited. Drug reform advocates like Students for Sensible Drug Policy and Doctors for Drug Policy Reform are also against prohibition, calling it a rush into a new drug war that will only harm people by pushing them into less safe drugs. 

The one thing nearly everyone agrees on is that the status quo is dangerous, with a powerful opiate widely available to youth like Rivers.

‘Oh, you should try this’

Tom Miller had been using natural kratom products for six years before he tried 7-OH. The 35-year-old started using kratom for pain relief while working in the oil fields of North Dakota, and he soon became a daily user. This January, he was shopping for kratom at a smoke shop in Torrance when the salesperson recommended a new little pill called 7-OH.

“The guy was like, ‘Oh, you should try this.’ I asked what it was, and he said it was kratom,” said Miller, who is using a pseudonym in accordance with Hearst’s ethics policy. “It was in a tiny little tablet and was extremely convenient. It worked great. I could take a tiny tablet and be on my way. I noticed quickly that it was a lot stronger and more effective than kratom.”

At first, he was taking 15 milligram pills, but within days, he noticed he needed to take an entire package of tablets and consume 200 milligrams at a time “just to chase that high again.” Eventually, he was talking 2,000 milligrams a day. He spent $10,000 on the drug within just six months. 

Miller had become one of the thousands of people across the country addicted to this powerful new drug. The FDA has described 7-OH as having “significant addiction potential” in a July report, although the agency has not estimated how many Americans are addicted to 7-OH. 

Other harmful effects are also becoming more apparent. America’s Poison Centers, a nonprofit that collects data on all of America’s poison control hotlines, has seen a sharp increase in reports of exposure cases related to kratom, with 165 reports related specifically to 7-OH, according to an August report from the organization. Symptoms of 7-OH use include nausea, confusion, rapid heart rate, sleepiness or loss of consciousness, and seizures, the poison centers said. 

There is also an apparent risk of death. Opioids can disrupt someone’s breathing rhythm through their activation of opioid receptors in the brain, and a fatal opioid overdose occurs when breathing is slowed so significantly that the brain becomes starved of oxygen. 7-OH is such a new drug that its precise effects are not clear, but a recent study on rodents showed 7-OH caused “significant respiratory depression.” There are also reports that 7-OH can cause severe respiratory depression when combined with other central nervous system depressants, like benzodiazepines and alcohol.

Medical experts have said that Narcan, a drug used to reverse overdoses of other opioids like fentanyl, can be an effective treatment in the case of an 7-OH overdose. But in the five deaths for which LA authorities included 7-OH as a cause, multiple drugs were involved: a 21-year-old who died in April, a 24-year-old who died in June, a 33-year-old who died in July, a 38-year-old who died in July, and a 39-year-old who died in July. The death of a 19-year-old in June was also linked to 7-OH according to the LA Public Health Department, although the medical examiner report only lists “multiple drug toxicity.”

‘It freaked me the f—k out’

Miller first tried to quit 7-OH by himself, cutting himself off cold turkey. For the first 24 hours, he just felt a bit depleted, but then he was suddenly getting cold sweats, shaking and experiencing extreme restless leg syndrome that eventually spread to his entire body.

“I was shaking, like pounding my head against the pillow hitting the wall. I could not escape it. It was f—king terrible. It freaked me the f—k out,” Miller said.  

He took an entire week off his job as an account manager at a major shipping company to fully get clean, but then a few weeks later, he relapsed and was soon taking heavy doses of 7-OH again. He decided to get professional help, but he was turned away from numerous rehab centers that he said told him they didn’t know how to treat 7-OH. Then he found QuickMD, a private telemedicine platform that offers addiction treatment. He said QuickMD gave him a dose of suboxone, a common treatment for opioid use disorder, and he was able to quit 7-OH with much less severe withdrawals.

QuickMD has been treating 7-OH addiction for a year and has seen a “dramatic surge” in 7-OH addiction cases in the past six months, with the number of cases increasing almost tenfold over that period, according to Dr. Robert Stern, QuickMD’s chief medical officer.

Mary, the mother of the Bay Area 18-year-old facing 7-OH addiction, said her son spent 17 days at an in-patient rehab this September, but then her health insurance company denied payment for the treatment, saying 7-OH addiction was not a valid reason for in-patient rehab. She watched her 16-year-old son go through withdrawals at home.

“Because this drug is so new, and unregulated, and nobody knows about it, the insurance company won’t cover the rehab,” Mary said.

State and federal authorities have begun taking action to shut down sales of 7-OH. The FDA recommended in July that 7-OH be made a Schedule I drug, the most restricted and illegal class of drugs, while keeping natural kratom unscheduled. That recommendation will take months, or even years, before it could possibly go into effect. 

State lawmakers have also tried to take action. Assemblymember Jasmeet Bains, a Democrat representing most of Kern County in the Central Valley, introduced a measure this year that would make 7-OH products illegal in California. The bill failed to pass this year but could be considered next year, although Bains said in an email to SFGATE that state regulators should immediately take emergency action to “go after the products that look like candy and are clearly being sold to children.” She blamed federal regulators for being “asleep at the wheel as these products have grown in popularity.”

“I have spent my career as a physician on the front lines of the fight against the fentanyl epidemic. I know what it takes to stop an emerging drug threat from becoming an epidemic,” Bains said in an email to SFGATE.

The 7-OH industry has mobilized to fight any ban on the products. Jackie Subeck, the founder of 7-Hope Alliance, a nonprofit group that represents people who use 7-OH, as well as producers of the drug, said the drug should be restricted to only adults and not marketed to children.

“This is exactly why we believe regulation is better than prohibition,” Subeck said in an email to SFGATE. “Regulation can put strong age-gating requirements in place, require ID checks, mandate child-resistant packaging, and create strict rules on advertising. Prohibition, on the other hand, doesn’t stop access; it only drives products underground, where there are no safeguards.”

Subeck added that the drug is used to manage opioid addiction, alcohol addiction, chronic pain, and benzodiazepine addiction. Subeck said personal anecdotes from 7-OH users “depict a story of hope and healing, not abuse, overdose, and death.”

The 7-OH industry also has earned defenders from a broad coalition of drug policy reform advocates and conservative groups, who say banning the drug will only push people into more dangerous and less safe opioids. Dr. Bryon Adinoff, the president of Doctors for Drug Policy Reform, said the current 7-OH situation is unsafe because there are no product standards and children have access, but he said the drug should not be banned entirely. 

“We are in a whack-a-mole situation, as new drugs are formulated and being developed all the time,” Adinoff said. “We’re not going to be able to ban our way out of this. We have to come up with other more enlightened approaches than just saying, ‘Oh we’re making this against the law.’”

Miller, the 35-year-old who has struggled with 7-OH addiction, thinks the drug should be tightly regulated but not outright banned. But Jeremy, the 18-year-old, and his mother, Mary, think it should be immediately taken off shelves. Mary said she’s gone to local Bay Area gas stations with photos of her sons so she could urge the clerks to not sell 7-OH to them. Her older son has already relapsed once since leaving rehab, and her husband is now considering moving with him to a state that has banned the drug. 

Jeremy said the easy access of 7-OH everywhere he goes is making it even harder to quit.

“You can just go down to the gas station or any smoke shop in any city you can find it. You can find it at gas stations,” he said. “The fact that it’s not banned, I don’t even know how it’s allowed to be sold. It’s crazy.”