Who uses kratom
More people than you might expect — and for a wide range of reasons.
Kratom is a plant from Southeast Asia sold legally at gas stations, smoke shops, and online across the US. People use it for pain, anxiety, depression, low energy, and increasingly to try to manage opioid withdrawal on their own. For many, daily use crept up over time — and stopping became harder than expected.
Kratom users come from a wide range of backgrounds. Many started using it for pain, anxiety, low energy, or to manage opioid withdrawal on their own. Dependence happened gradually, and stopping is genuinely difficult.
What is 7-OH
7-OH is not kratom. It is significantly more potent.
Since late 2023, a surge of products sold as "7-OH," "7-Hydro," or "legal morphine" have flooded gas stations, vape shops, and online vendors. These are not the same as traditional kratom powder.
7-hydroxymitragynine (7-OH) is a compound that occurs in trace amounts in natural kratom leaves — less than 2% of total alkaloids. The products now widely sold as "7-OH" are semi-synthetic: manufactured in laboratories by chemically converting kratom's primary alkaloid, mitragynine, into concentrated 7-OH.
7-OH is substantially more potent than natural kratom. Research has found 7-OH to have greater binding affinity to opioid receptors than morphine. The FDA formally recommended the DEA classify 7-OH as a controlled substance in July 2025. Products are sold with little to no accurate labeling. Physical dependence and withdrawal develop rapidly with regular use.
The American Kratom Association — which advocates for kratom — has itself warned that products with 7-OH levels above 2% of total alkaloids are "no longer kratom" and should not be labeled as such. If you are using 7-OH products, you are using a concentrated semi-synthetic opioid-like compound, not an herbal supplement.
Withdrawal
Kratom and 7-OH withdrawal is real — and often severe.
Kratom and 7-OH act on the same opioid receptors in the brain as prescription opioids. When regular use stops, the withdrawal pattern closely resembles opioid withdrawal:
Common kratom and 7-OH withdrawal symptoms
Muscle aches and cramps · Severe anxiety and irritability · Insomnia · Nausea, vomiting, diarrhea · Sweating and chills · Intense cravings · Depression · Inability to feel pleasure
Withdrawal typically begins within 12–24 hours of the last dose and can last days to weeks depending on how much and how long you've been using. Many people try to taper on their own and find it extremely difficult. This is not a willpower problem — it is a physiological response to opioid receptor dependence.
Treatment
Buprenorphine can work. Here's what the evidence shows.
There are currently no FDA-approved medications specifically for kratom use disorder. However, multiple published case reports and case series in peer-reviewed medical journals document successful treatment of kratom and 7-OH dependence with buprenorphine-naloxone (Suboxone) — the same medication used for opioid use disorder.
Treatment is handled on a case-by-case basis by your physician. The appropriate dose of buprenorphine appears to correlate with the amount of kratom used — patients using higher daily amounts typically require higher starting doses.
Case series — Wake Forest School of Medicine (2021)
A systematic review and case series found a strong correlation between daily kratom dose and the buprenorphine-naloxone dose needed for effective treatment. Patients using under 20g of kratom daily were successfully initiated on lower doses; patients using over 40g daily required higher doses.
Long-term case series — Ideal Option clinics (2022)
A case series of patients maintained on buprenorphine for kratom use disorder found significant improvement in withdrawal symptoms, pain, anxiety, and depression. This was the largest published case series at the time of publication.
Case report — Cleveland Clinic
A patient with a history of opioid dependence who transitioned to kratom was successfully treated with buprenorphine-naloxone, with resolution of withdrawal symptoms and sustained abstinence from kratom.
Honest caveat: The clinical evidence for buprenorphine in kratom dependence consists of case reports and case series — not large clinical trials. No randomized controlled trials have been published to date, and there are no FDA-approved treatments for kratom use disorder. A scientific expert forum has advised that buprenorphine should be used on a case-by-case basis, especially in patients with no prior history of opioid use. Your physician will evaluate your specific history and make a clinical judgment about whether buprenorphine is appropriate for you.
Our approach
What a visit looks like.
Your first visit is a real medical evaluation — not a checkbox intake form. Your physician will review your history with kratom or 7-OH use, any prior treatment, your overall health, and any other medications. If buprenorphine is clinically appropriate, a prescription is sent to your pharmacy the same day.
Call or text to book
Same-day visits often available. No referral required.
Medical evaluation via telehealth
Your history, your use, your health picture. The physician determines whether buprenorphine is appropriate for your situation.
Prescription sent same day
To the pharmacy of your choice, if buprenorphine treatment is appropriate.
Ongoing care
Same physician, ongoing relationship. Treatment duration depends on your individual needs.
MyStreetHealth is a physician-led independent practice. You see the same doctor every visit. No rotating providers, no judgment, no waiting lists.
$200 per month for most patients. No insurance required. Most patients are seen once a month once stable on medication.