Addiction treatment centers across the nation are reporting an alarming increase in cases linked to kratom and its potent derivative, 7-hydroxymitragynine (7-OH). This rise is triggering concerns among healthcare professionals as they witness more individuals seeking help for dependence on these substances.
At Boulder Care, a telehealth addiction clinic, new patient admissions citing kratom usage surged dramatically from 3% in September 2025 to 14% in August 2026. Ayesha Appa, the clinic's head of medical affairs, stated, "That really is quite an explosion." This trend is symptomatic of a broader national issue as more individuals turn to kratom products, often sold in gas stations and convenience stores.
Kratom has been available in the U.S. for some time, typically marketed as a natural remedy for pain relief, mood enhancement, and increased energy. However, many users are now opting for higher concentrations of 7-OH, which can trigger more intense effects on the brain's opioid receptors, resulting in increased sedation and euphoria. Because 7-OH is only present in trace amounts in the kratom leaf, it is being isolated in more potent formulations.
Recent alerts from the Food and Drug Administration (FDA) have labeled 7-OH products as an "emerging opioid threat," prompting discussions about regulatory interventions. The Drug Enforcement Administration (DEA) is working on a proposal to prohibit 7-OH sales above certain concentrations, which could compound the current crisis as individuals face abrupt withdrawal from these products when their availability is restricted.
Clinicians have observed that many individuals seeking treatment are likely experiencing withdrawal symptoms as access to kratom and 7-OH diminishes. "I think we’re really seeing and feeling what happens when people lose access and need to seek care in unprecedented numbers," Appa remarked about the spike in admissions.
Clinical Insights on Withdrawal Patterns
In Massachusetts, data from Recovery Centers of America shows a marked increase in kratom-related admissions, with numbers jumping from a single patient per week to between 10 and 20. Myles Jen Kin, a medical director there, indicates that the severity of withdrawal symptoms is escalating, now treated similarly to opioid withdrawal from substances like fentanyl or oxycodone. “We’re basically treating it as if it’s fentanyl or oxycodone or heroin,” Jen Kin stated.
Despite the lack of comprehensive research, treatment centers are adapting to rising patient numbers facing kratom and 7-OH withdrawal. "Having kratom [patients] without any research, it’s just another day for us," Jen Kin expressed, highlighting the general state of addiction care often spiraling in a reactive fashion.
Demographic Trends Among Users
Clinicians are noting two main demographics among those dependent on kratom: individuals who are new to substance use and treatment, and those returning after prior experiences with substance use disorders. Many patients report turning to kratom to self-medicate for energy, anxiety relief, or chronic pain management. Some individuals use it as a coping mechanism during recovery from more traditional opioid or alcohol dependencies, sometimes escalating their use to 7-OH.
Kratom is sold in various formats, including powders, pills, teas, gummies, and liquid shots. Unfortunately, claims regarding purity and composition can often be misleading. Many kratom products contain other undisclosed substances like caffeine or CBD, complicating users' understanding of what they’re consuming.
Federal surveys show that lifetime usage of kratom products rose from around 4 million to 5 million between 2019 and 2023, with reports to poison centers increasing exponentially over the years. Although not typically lethal like fentanyl, kratom-related incidents have surged, warranting greater scrutiny from health professionals.
Phil Smyth, director of Milestone Treatment Center, noted that patients frequently express confusion about kratom's risks. "The common story I get from a lot of these clients is that they didn’t know really what it was," he said, pointing to the rapid development of dependence and withdrawal symptoms among users.
Responses from Treatment Centers
Clinicians acknowledge that while traditional research indicates mild withdrawal symptoms, many describe the experience as akin to that of opioid withdrawal, with symptoms including agitation, anxiety, and gastrointestinal distress. Ken Jin, a physician, noted that unidentified dependence often leads to irritability and difficulty sleeping for users attempting to quit.
Many treatment programs have begun incorporating medications typically used for opioid use disorder, such as buprenorphine and methadone, to assist patients facing kratom or 7-OH dependency. Boulder Care reported that nearly a third of its new patients starting buprenorphine have histories of kratom or 7-OH use.
It's important to consider that anecdotal reports may not tell the full story, as individuals capable of managing withdrawal without treatment may avoid seeking help. There are online communities providing support for those attempting to quit kratom and 7-OH, sharing strategies and personal experiences regarding tapering off these substances.
As discussion continues surrounding kratom and its derivative 7-OH, the growing evidence of addiction treatment needs calls for intensified research and healthcare responses tailored to this new wave of substance use challenges. The complexities surrounding kratom reveal an urgent need for further investigation into its safety, potential for addiction, and effective treatment protocols.
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.