The Texas Department of State Health Services (DSHS) has issued a warning about the use of products containing 7-hydroxymitragynine (7-OH), an opioid-like substance found in the kratom plant. According to DSHS, high concentrations of 7-OH can cause significant health issues and carry a risk for dependence or abuse.
As of August 27, the Texas Poison Center Network recorded 192 cases of exposure involving kratom or other products with 7-OH so far in 2025. This is a notable increase compared to 107 cases reported in all of 2024 and 122 in all of 2023. Of this year’s reports, 19 involved concentrated forms of 7-OH, with most incidents occurring in July and August. Among those exposed to concentrated products, 11 required treatment at healthcare facilities.
“Kratom is a tropical tree native to Southeast Asia. Kratom and 7-OH products are sometimes marketed as natural remedies for pain, anxiety, or to help with opioid withdrawal. Kratom products typically contain low 7-OH concentrations (less than 2% total content or less). However, semi-synthetic or synthetic 7-OH products have concentrations up to 98% 7-OH and are now more readily available. Concentrated 7-OH is often added to kratom products. Because of its opioid-like characteristics, there is significant potential for abuse of 7-OH at concentrated levels. In studies, 7-OH shows up to 13 times the potency of morphine, an opioid pain-relieving medication. Products containing concentrated 7-OH are sold as pills, gummies, candies, and imitation ice cream cones at gas stations, smoke shops, and online,” according to DSHS.
In July 2025, the U.S. Food and Drug Administration announced steps intended to restrict access to these substances because of their strong opioid-like effects. Neither kratom nor any product containing concentrated or synthetic forms of its active ingredients has FDA approval for medical use.
Reported symptoms after using products with high levels of 7-OH include nausea and vomiting, agitation, confusion, sweating, rapid heart rate and blood pressure changes, trouble breathing, sleepiness or loss of consciousness, seizures, and respiratory depression.
Healthcare providers are advised by DSHS: “Provide general emergency and critical care medical support as warranted. Administer naloxone for reversal of respiratory depression. Observe and manage symptoms of opioid use disorder following use of kratom or 7-OH products. Contact the Texas Poison Center Network at 1-800-222-1222 for any questions about medical management.”
For members of the public concerned about possible exposure or adverse reactions from these substances: “Avoid all products containing 7-OH, including products that claim to treat a health ailment… Consult a doctor or pharmacist before using any supplements… Talk to a health care provider if help is needed with opioid addiction…” The department urges anyone experiencing serious symptoms after using such substances to seek immediate medical attention by calling emergency services.
Questions regarding adverse reactions should be directed to the Texas Poison Center Network at their hotline number.
