The Missouri Department of Health and Senior Services (DHSS) has issued an advisory regarding 7-hydroxymitragynine, also known as 7-hydroxy and 7-OH.
It’s an extract of the kratom plant and it’s being marketed as a “natural remedy” for pain relief and brain stimulation. But 164 people in Missouri have died from using Kratom products since 2019, including those containing 7-OH.
Dr. Heidi Miller, Chief Medical Officer for DHSS compares 7-OH to an opioid, saying it can be up to 13 times stronger than morphine.
“Nationally, we have seen patients who have died from overdose have had kratom-type substances in their blood,” she told Missourinet. “Unfortunately, it’s very hard to distinguish between whether or not someone has taken the kratom leaf versus this concentrated 7-OH substance.”
Miller also said the Missouri Poison Center has seen a rise in 7-OH reported cases.
“You know, two years ago, we only had about 19 reports, and then the year after that (2024), we had 25 reports. And this year, 2025 – the year isn’t even done – and we already have 47 reports.”
Miller said 7-OH is unregulated, and products containing the compound can easily be purchased online or at convenience stores, without age restrictions.
“Seven-hydroxy products are sold as, like, little energy shots or powders that can be mixed into drinks,” she said. “There are also versions that can be dissolved in the mouth. There are versions that can be inhaled. There are gummies.”
Symptoms of 7-OH exposure may include:
- Nausea, vomiting and gastrointestinal distress.
- Anxiety, agitation, confusion and insomnia.
- Rapid heart rate, high blood pressure and trouble breathing.
- Seizures, unconsciousness and withdrawal symptoms.
- Risk of overdose, especially when combined with alcohol or other sedatives.
Miller said anyone experiencing symptoms or is suspected of overdosing should call 911, and to administer naloxone (Narcan) if any is available.
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