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At least six residents in Los Angeles have recently died from overdoses involving synthetic 7-OH, a compound typically found at low levels in the natural kratom plant.
A synthetic derivative of the kratom plant is killing people in Los Angeles. Over the weekend, local health officials reported three new overdose deaths tied to the opioid-like compound 7-hydroxymitragynine, or 7-OH.
What is Kratom?
Kratom is the name given to the leaves of the tree Mitragyna speciosa. It contains numerous compounds that combine to provide users a stimulant-like effect at lower doses and an opioid-like effect at higher doses.
Kratom proponents have long argued that the drug, usually sold as an herbal or dietary supplement, can be used to safely manage chronic pain or as an alternative treatment for opioid use disorder (people with this condition often take other less harmful and addictive opioids to manage their dependence). So far, though, health agencies largely haven’t agreed.
For years, the FDA has warned the public to stay away from natural kratom, arguing that these unregulated products can carry some of the same serious health risks as other opioids. While kratom is not a controlled substance, no legal use of it exists in the U.S., including as a dietary supplement, and some states have outright banned it.
Whatever the potential risks of natural kratom are, however, they seem to pale in comparison to synthetic 7-OH products. Though it can depend on the exact variety, the leaves of the kratom plant typically contain only a small percentage of 7-OH (less than 2% of the total alkaloid content).
But synthetic products are often concentrated in 7-OH, with levels two- to sixfold higher than would be expected from natural kratom products, according to a recent FDA report. Compared to mitragynine—the main alkaloid compound in kratom—7-OH also appears to be more chemically similar to other opioids. As such, these synthetic products can reliably cause the same symptoms caused by a classical opioid overdose, including severe respiratory depression (shallow or slowed breathing) and death.
Particularly when used with alcohol, medications, and/or illicit drugs, 7-OH can cause severe respiratory depression and death. Importantly, these products are unregulated and may contain unknown concentrations of 7-OH, increasing the risk of unintentional overdose.
Earlier this summer, the FDA announced that it would be taking action to curb synthetic 7-OH use.
The warning letters to firms for illegal marketing of concentrated 7-OH products and posted product images, saying, “7-OH is not lawful in dietary supplements and cannot be lawfully added to conventional foods. Additionally, there are no FDA-approved drugs containing 7-OH, and it is illegal to market any drugs containing 7-OH. Consumers who use 7-OH products are exposing themselves to products that have not been proven safe or effective for any use.”
“The safest thing to do is avoid using 7-OH and kratom-related products all together. To prevent overdose, never use alone; avoid mixing 7-OH with other drugs and alcohol; carry naloxone to reverse the effects of opioids, including 7-OH; and make sure someone in the group can administer naloxone to save a life, if needed.”