The products, which contain high levels of 7-hydroxymitragynine, a psychoactive compound found naturally in kratom in very small amounts, have generated sharply divergent accounts from users. Some describe them as life-changing relief for chronic pain or a bridge away from opioids. Others describe rapid addiction, debilitating withdrawal and a sense that the products were far more potent than they expected.

Tyler, a 38-year-old who asked that only his first name be used because of the stigma surrounding drug use, said he used kratom leaf powders to stop using opioids in his early 20s and stayed off them for a decade. In early 2025, he tried 7-OH tablets he found at a gas station, attracted by the convenience and the fact that the powders had been hard on his stomach. The effect, he said, felt like an opioid.

"It felt like a kind of a miracle," he said.

Within months, Tyler said he was taking 300 to 400 milligrams of 7-OH a day, roughly ten times the dose used by another person interviewed for this story. He tried to stop several times, but the withdrawal was overwhelming. "Imagine having the flu, the worst flu you've had, multiply that by at least three times," he said. "And then just know that all you gotta do is take one pill, and it's gone in seconds."

Tyler eventually entered a rapid detox program in Michigan in March, where he was sedated through the withdrawal. He has not used kratom or 7-OH since, but said recovering his energy has taken months, far longer than his recovery from opioids.

Brian, 41, who also asked that only his first name be used, said he quit opioids in 2016 but found kratom at a gas station in 2022. He said the product was displayed next to the register and looked like an energy shot. Within minutes of taking it, he said, he felt exactly as he had on opioids. He later moved to 7-OH tablets after a smoke shop clerk offered him a sample, describing it as a lower-dose version of kratom.

"Once I found these little tiny tablets — that I had to take one and it felt like I had taken an Oxycontin — you know, that was it," Brian said. "It was game over."

At his peak, Brian said he was using 1,200 milligrams of 7-OH a day and spending about $150 daily. He stopped cold turkey in April 2026 and described the withdrawal as a nightmare of fear, anxiety, gastrointestinal problems and a loss of desire to leave his house.

Not all users report harm. Angela Wilson, 44, of Delaware, said 7-OH has helped her manage severe chronic pain from endometriosis and long-standing depression. She said she takes 32 to 40 milligrams a day in three doses and has done so for about a year and a half. Kratom powders made her anxious and shaky, she said, but 7-OH does not.

"It's been truly life-changing for my family situation, my personal life," Wilson said. She does not have health insurance and said losing access to the product would be devastating. "We're not really sure, you know, what I'm gonna do when it's not available," she said.

The federal government has not targeted traditional botanical kratom, which comes from a tree in the coffee family and is sold as powder, capsules and pills. But the path to restricting 7-OH products has been uneven. In August, the Drug Enforcement Administration used emergency authority to place three semi-synthetic opioids derived from 7-OH and related compounds — MGM-15, MGM-16 and mitragynine pseudoindoxyl, or MGPI — on the most restrictive schedule of the Controlled Substances Act, alongside heroin and LSD.

The move drew backlash from kratom advocates who feared it would sweep in natural kratom products containing trace amounts of MGPI. The American Kratom Association filed a federal lawsuit against the DEA on Aug. 26, asking the agency to ensure that natural kratom products with trace MGPI would remain legal.

On Oct. 9, the Department of Health and Human Services issued a new recommendation on 7-OH and MGPI, and the DEA changed course. The agencies now plan to restrict a narrower set of products — those with higher concentrations of 7-OH or MGPI — while leaving natural kratom products alone.

Estimates of how many people use kratom and 7-OH vary widely. Some research suggests more than 5 million people in the U.S. have used kratom in their lifetime, while David Epstein, a senior investigator at the National Institute on Drug Abuse, said he has seen estimates as high as 15 million. Those figures generally do not distinguish between whole-leaf kratom and concentrated products like 7-OH.

A recent report drawing on data from 53 U.S. poison control centers found that calls related to kratom rose about 1,200% between 2015 and 2025. The report documented 233 deaths associated with kratom during that period, with 79% involving multiple substances. But Chris Holstege, a physician and professor of emergency medicine and pediatrics at the University of Virginia School of Medicine who co-authored the report, noted that 62% of the calls involved people using kratom without other drugs.

Holstege said he and his colleagues were stunned by the increase. He also questioned the marketing of the products. "I find it a little hard to believe that all the shops that are popping up around my campus right now are trying to advertise to people who are addicted to opioids," he said. "So the question is, what else are they advertising this product for?"

He added that he has a growing list of patients in addiction clinics who are dependent on the products and experiencing withdrawal.

Epstein said his ongoing research suggests the risk of dependence may be higher with 7-OH products than with whole-leaf kratom. Some users, he said, find that the products work well for a few days but then require constant use to avoid withdrawal, including waking in the middle of the night to take more. Others, he said, are satisfied with the effects and do not report problems.

The National Institute on Drug Abuse says on its website that early studies suggest kratom and kratom compounds warrant further study as experimental treatments for substance use disorders, specifically opioid use disorder.

For Tyler, the question of access is settled. He said he could not have stopped without the detox program. "There's no chance," he said. "It's just too addictive and too accessible."