Addiction treatment centers across the country say more patients are arriving dependent on kratom products, especially concentrated 7-OH, and that their withdrawal is growing more severe. At the telehealth addiction clinic Boulder Care, people reporting kratom use made up 3% of new patients in September 2025, 8% in July 2026, and 14% in August, STAT reported on Monday. These figures come from clinics, not national surveillance data.
For families, the change is concrete. A product bought at a gas station counter for energy or pain relief can lead to withdrawal that some clinicians now manage with the same tools used for opioid withdrawal. Many patients, providers say, did not understand what they were taking.
Clinics Describe a Sharp Rise in Demand
At two Recovery Centers of America inpatient clinics in Massachusetts, medical director Myles Jen Kin said admissions for kratom use last year typically numbered no more than one a week, with mild withdrawal. The same clinics now see 10 to 20 people a week who are dependent on kratom or 7-OH, or who use the products as part of a larger substance use problem.
"We're basically treating it as if it's fentanyl or oxycodone or heroin," Jen Kin told STAT.
Similar reports come from other regions. Phil Smyth, executive director of Milestone Treatment Center, which has clinics in New Jersey, Virginia, and Texas, said many patients began using 7-OH to ease pain and "didn't know really what it was." At Caron Treatment Centers in Pennsylvania, physician Steve Klein described patients moving down what he called a "potency rabbit hole," including some in remission from opioid use disorder who quickly relapsed after trying kratom. Last month, nearly a third of Boulder Care's new patients starting buprenorphine reported current kratom or 7-OH use.
Ayesha Appa, Boulder Care's head of medical affairs, suggested that state laws removing access to these products may be pushing people into withdrawal. "I think we're really seeing and feeling what happens when people lose access and need to seek care in unprecedented numbers," she said.
Concentrated 7-OH Is Not the Same as Kratom Leaf
The difference between products explains much of the concern. Traditional kratom is a powder made from the dried leaves of a Southeast Asian tree. The compound 7-hydroxymitragynine, or 7-OH, makes up less than 2% of the leaf's alkaloids, but many newer tablets, gummies, and shots contain it in concentrated form, likely produced by chemically converting the leaf's main alkaloid, according to an FDA scientific assessment.
Unlike that main alkaloid, mitragynine, 7-OH acts directly on the brain's opioid receptors. The FDA said 7-OH produces respiratory depression, physical dependence, and withdrawal symptoms characteristic of classical opioids, and in animal studies it depressed breathing with more than three times the potency of morphine. Products containing 7-OH are often misleadingly marketed as kratom, and testing has found some kratom-related products contain compounds not listed on the label, STAT reported.
MedicalDaily previously reported on the federal scheduling gap, in which three synthetic kratom opioids became Schedule I while concentrated 7-OH products remained unscheduled. That coverage focused on what is legal to sell. The new development is the treatment burden. The DEA has proposed an effective ban on 7-OH above a set threshold, but the rule has not been finalized, while numerous states have enacted their own restrictions.
Evidence Gaps Clinicians Are Working Around
Existing research on kratom has generally found withdrawal to be mild. Clinicians now describe symptoms that resemble opioid withdrawal, including agitation, sweating, anxiety, diarrhea, irritability, and trouble sleeping or eating. Early case reports suggest buprenorphine, alone or combined with naloxone, and methadone can help, but no large clinical trials have tested these approaches for 7-OH dependence.
The treatment numbers also have limits. Katherine Hill, an epidemiology doctoral candidate at Yale School of Public Health who has studied kratom, told STAT that clinic reports may reflect sampling bias, because people who stop on their own never appear in treatment data. For national context, federal survey data show that the number of people who had ever tried kratom rose from about 4 million to 5 million between 2019 and 2023, according to a CDC report. Over the past decade, reports to U.S. poison centers about kratom exposure rose from 258 to 3,434, and 79% of kratom-related deaths reported to the CDC during that period involved other substances, mainly other opioids, STAT reported.
Guidance for Families and Regular Users
People most likely to struggle include daily users of concentrated 7-OH shots or tablets, people who began using kratom to manage pain or anxiety, and people with a history of opioid or alcohol use disorder. Those living in states that recently restricted sales may face a sudden loss of supply.
Anyone who uses these products regularly and wants to stop should talk with a clinician first rather than quitting abruptly. Be specific about the product name, how often you use it, and how much, since treatment depends on the level of dependence. Telehealth addiction programs and local clinics can prescribe buprenorphine, which is often covered by Medicaid and many private plans.
The free, confidential SAMHSA National Helpline at 1-800-662-4357 and FindTreatment.gov can help locate care. Call Poison Control at 1-800-222-1222 with questions about a possible exposure. Slow or stopped breathing, blue lips, unresponsiveness, or pinpoint pupils can signal an overdose. Call 911 and give naloxone if it is available.
The DEA's decision on 7-OH scheduling and additional state actions will shape how many more people face sudden withdrawal. MedicalDaily will continue tracking treatment demand as new clinical and surveillance data emerge.
Key Questions Answered
What is new in this report? Addiction clinics told STAT they are seeing sharp increases in patients dependent on kratom and 7-OH. At Boulder Care, the share of new patients reporting kratom use rose from 3% to 14% in about a year.
How is 7-OH different from kratom? 7-OH is a trace compound in the kratom leaf that acts directly on opioid receptors. Concentrated products contain far more of it than the natural leaf.
What does withdrawal feel like? Clinicians describe agitation, sweating, anxiety, diarrhea, irritability, and trouble sleeping or eating.
How is it treated? Some clinics use opioid use disorder medications such as buprenorphine or methadone. Evidence comes mainly from case reports.
Should I stop using kratom right away? Talk with a clinician first, especially if you use concentrated 7-OH daily.
Where can I find help? Call the SAMHSA Helpline at 1-800-662-4357 or search FindTreatment.gov. Call 911 for signs of overdose.
Published by Medicaldaily.com
