What is kratom 7-OH? Why RFK and health officials are cracking down

U.S. health officials are cracking down on 7-OH, an opioid-related ingredient that’s been increasingly sold at gas stations and convenience stores. 

Last week, the Food and Drug Administration said it’s recommending that products containing 7-OH – a component of kratom – be added to the list of Schedule I narcotics, the federal government’s most restrictive list of illegal drugs, which includes LSD and heroin. Health experts say it’s a dangerously concentrated, synthetic form of the original ingredient.

What is kratom? 

The backstory:

Kratom is a plant native to Southeast Asia that has gained popularity in the U.S. as an unapproved treatment for pain, anxiety and drug dependence.

RELATED: FDA warns of 'gas station heroin' risk to youth

Federal regulators have been scrutinizing kratom for about a decade after reports of addiction, injury and overdose. But users and distributors have long opposed efforts to regulate it, saying kratom could be a safer alternative to opioid painkillers that sparked the ongoing drug addiction epidemic.

Nearly a decade ago, the federal government came close to banning kratom.

In 2016, the DEA announced plans to add it to the government’s most restrictive schedule 1, reserved for drugs that have no medical use and a high potential for abuse. But the plan stalled after a flood of public complaints, including a letter signed by more than 60 members of Congress.

The FDA then began studying the ingredient, concluding in 2018 that kratom contains many of the same chemicals as opioids, the addictive class of drugs that includes painkillers like OxyContin as well as heroin and fentanyl.

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Since then, FDA regulators have continued to issue warnings about cases of injury, addiction and death with kratom supplements, which are usually sold in capsules or powders.

An industry group, the American Kratom Association, has lobbied Congress for years against restrictions on the plant. Legislation supported by the group would prohibit the FDA from regulating kratom more strictly than food and dietary supplements.

The FDA recommendation to make 7-OH illegal "is not focused on natural kratom leaf products," according to the U.S. Department of Health and Human Services.

What is 7-OH? 

Dig deeper:

Regulators are scrutinizing the chemical known as 7- hydroxymitragynine, a component of kratom. Synthetic forms of 7-OH are being added to supplements available over the counter. 

What they're saying:

"7-OH is an opioid that can be more potent than morphine," said FDA Commissioner Marty Makary. "We need regulation and public education to prevent another wave of the opioid epidemic."

Makary joined Health Secretary Robert F. Kennedy for a press conference recently to stress the danger of the drug. 

In recent years, the American Kratom Association has lobbied at the state level for bills that limit synthetic 7-OH products.

The other side:

A rival group that supports the availability of 7-OH drugs criticized the government’s move, pointing to the influence of kratom suppliers.

"Big kratom trade groups have spent years blaming 7-OH for harms caused by their own unregulated products, because it threatens their market share," the Holistic Alternative Recovery Trust told The Associated Press.

Where is kratom illegal?

Local perspective:

Kratom is illegal in seven states and age-restricted in more than a dozen others, according to the Legislative Analysis and Public Policy Association. States where kratom is banned include: 

• Louisiana
• Arkansas
• Alabama
• Indiana
• Wisconsin
• Vermont
• Rhode Island

When will 7-OH be banned?

What's next:

The FDA’s recommendation will be reviewed by the Drug Enforcement Administration, which sets federal rules for high-risk drugs including prescription medicines and illicit substances. A national ban wouldn’t take effect until the agency drafts and finalizes new rules governing the ingredient.

The agency said it was releasing a report to educate about the risks of "7-OH and its distinction from the kratom plant leaf."