The Missouri Department of Health and Senior Services (DHSS) has issued a statewide health advisory warning Missourians about the serious health risks associated with 7-hydroxymitragynine (7-OH), a potent psychoactive compound increasingly found in unregulated consumer products.
7-OH, a synthetic derivative of the kratom plant, is being sold in Missouri in forms such as gummies, candies, powders and liquid shots—often in stores and online. While kratom itself is a natural botanical, isolated 7-OH is far more potent—up to 13 times stronger than morphine at opioid receptors—and has not been tested for safety in humans.
“Products containing 7-OH are being marketed as natural remedies, but they carry serious risks including addiction, overdose and even death,” said Dr. Heidi Miller, Chief Medical Officer at DHSS. “We are seeing a rise in emergency room visits and poison control calls related to these products.”
From January through September 2025, the Missouri Poison Center received 47 reports of exposures involving kratom or 7-OH—nearly double the number from 2024. Three of those cases involved isolated 7-OH, with at least one requiring hospital evaluation.
Symptoms of 7-OH exposure may include:
• Nausea, vomiting and gastrointestinal distress.
• Anxiety, agitation, confusion and insomnia.
• Rapid heart rate, high blood pressure and trouble breathing.
• Seizures, unconsciousness and withdrawal symptoms.
• Risk of overdose, especially when combined with alcohol or other sedatives.
The U.S. Food and Drug Administration (FDA) recently announced steps to restrict access to 7-OH products due to their opioid-like effects and lack of approved medical use.
DHSS urges Missourians to avoid products containing 7-OH until further safety data is available. Anyone experiencing symptoms or suspecting an overdose should call 911 and administer naloxone if available.
For more information, visit Health.Mo.Gov/Kratom or contact the Missouri Poison Center at 1-800-222-1222.
