Kratom-Related Dependence Is Rising Across the United States

Kratom use has become increasingly visible in addiction treatment settings across the United States, with clinicians reporting a notable rise in patients experiencing dependence on kratom and products containing concentrated 7-hydroxymitragynine, commonly known as 7-OH.

Kratom is derived from the leaves of a tree native to Southeast Asia. For years, products containing kratom have been available in the United States in forms such as powders, capsules, tablets and teas. They have commonly been promoted for purposes ranging from relaxation and mood enhancement to increased energy and pain relief.

However, healthcare professionals are now reporting concerns about newer and more concentrated products, particularly those containing high levels of 7-OH.

Treatment providers report a sharp increase

Figures shared by Boulder Care, a telehealth addiction treatment provider, indicate a substantial increase in the number of new patients reporting kratom use.

According to company data reported by STAT, approximately 3% of new Boulder Care patients reported using kratom products in September 2025. That figure increased to 8% by July 2026 and reached 14% in August.

Dr. Ayesha Appa, head of medical affairs at Boulder Care, described the increase as significant.

The experience of other treatment organizations also suggests that kratom-related dependence is becoming more common in some clinical settings.

At two inpatient facilities operated by Recovery Centers of America in Massachusetts, clinicians previously reported seeing relatively few patients seeking treatment for kratom-related problems. Last year, admissions involving kratom generally numbered no more than one patient per week at those locations.

According to Dr. Myles Jen Kin, a medical director for the organization, the situation has changed considerably. The facilities are now seeing approximately 10 to 20 patients each week who are dependent on kratom or 7-OH, or who are using these substances alongside other drugs.

These figures come from individual treatment organizations and should not be interpreted as a nationwide estimate of kratom dependence. Nevertheless, they illustrate the growing concern among some addiction specialists.

What is 7-OH?

One of the major concerns surrounding newer kratom products involves 7-hydroxymitragynine, or 7-OH.

Kratom naturally contains several chemical compounds. Mitragynine is generally considered its primary active component, while naturally occurring 7-OH is present only in relatively small amounts.

Concentrated 7-OH products can contain substantially higher levels of the compound.

Unlike many of the naturally occurring compounds in kratom, 7-OH has activity at opioid receptors. This can produce effects associated with opioid-type substances, including sedation and euphoria.

The growing availability of concentrated products has raised questions about how consumers understand what they are purchasing.

Some products containing substantial amounts of 7-OH may be marketed using terminology associated with traditional kratom. Reports have also raised concerns about differences between product labels and their actual contents.

For consumers, this can make it difficult to determine exactly what a particular product contains or how potent it may be.

Dependence can develop unexpectedly

Healthcare professionals quoted in the reporting have described a pattern in which some people initially view kratom as a relatively low-risk wellness product.

Because kratom products can be sold over the counter in some parts of the country, consumers may assume that they carry few serious risks.

Dr. Steve Klein of Caron Treatment Centers in Pennsylvania told STAT that some patients begin using kratom without expecting to develop a substance-use problem. Over time, however, some individuals move toward increasingly potent products.

This progression can involve seeking products with stronger effects or higher concentrations of active compounds.

People with a previous history of opioid use disorder may face particular concerns. Clinicians have reported cases in which individuals in recovery returned to problematic substance use after beginning to use kratom or concentrated 7-OH products.

That does not mean every person who uses kratom will develop dependence. Individual responses can differ considerably depending on factors such as frequency of use, product strength, other substances being taken and personal medical history.

Withdrawal may be difficult for some users

Another issue receiving attention from addiction specialists is withdrawal.

According to clinicians cited by STAT, people who regularly use kratom or 7-OH can experience symptoms after stopping. Reported symptoms may include anxiety, agitation, sweating and gastrointestinal problems such as diarrhea.

The severity and duration of withdrawal can vary between individuals.

Some people may also use kratom or 7-OH alongside other substances, which can make it more difficult for healthcare professionals to determine which substance is responsible for particular symptoms.

Boulder Care has reported an especially notable connection between kratom use and patients receiving treatment with buprenorphine.

In August 2026, nearly one-third of new Boulder Care patients beginning buprenorphine treatment reported current use of kratom or 7-OH, according to figures cited by STAT.

Buprenorphine is a medication used in the treatment of opioid use disorder and opioid withdrawal. Its use in people reporting kratom or 7-OH consumption highlights the overlap that clinicians are seeing between these products and opioid-related treatment.

Regulations differ across the country

The legal status and regulation of kratom and 7-OH products vary between jurisdictions.

The U.S. Food and Drug Administration has raised concerns about 7-OH and has described it as an emerging opioid threat.

Federal regulatory action is also being considered. According to the reporting published by STAT, the Drug Enforcement Administration has proposed a rule that would restrict 7-OH above a specified concentration. The proposal was not final as of September 22, 2026.

Meanwhile, individual states have introduced their own restrictions concerning kratom and 7-OH.

The changing regulatory environment may also affect people who are already using these products regularly. Dr. Appa suggested that some people could experience withdrawal after losing access to products because of restrictions.

This creates an important public health question. Limiting access to highly concentrated products may reduce exposure for some consumers, but people who have already developed dependence may need access to appropriate medical support if they suddenly stop using them.

Why product information matters

The increasing attention surrounding kratom and 7-OH also underscores the importance of understanding what is actually contained in commercially available products.

Kratom products are not necessarily identical. Concentrations of active compounds can vary, and concerns have been raised about products containing ingredients that are not accurately reflected on their labels.

Consumers may therefore encounter substantial differences between products even when packaging uses similar terminology.

Anyone experiencing symptoms after reducing or stopping kratom or 7-OH should consider discussing those symptoms with a qualified healthcare professional, particularly if use has been frequent or prolonged.

People with a history of opioid use disorder should also discuss kratom or 7-OH use openly with their treatment providers. Providing accurate information about all substances being used can help clinicians make more informed decisions about treatment.

The bigger picture

The recent reports from addiction treatment providers do not establish how common kratom dependence is among the entire U.S. population. However, they do show that some healthcare organizations are encountering more patients who report problems associated with kratom and concentrated 7-OH products.

The distinction between traditional kratom products and highly concentrated 7-OH products is also becoming increasingly important as regulators and medical professionals examine their potential risks.

For people who use these substances, understanding the possibility of dependence and withdrawal is an important part of making informed health decisions.

As regulations change and additional research becomes available, healthcare professionals will need better data to understand the prevalence of kratom-related dependence, the risks associated with different products and the most effective approaches to treatment.

Source

STAT, September 21, 2026, reporting on kratom and 7-OH use and treatment trends in the United States.

Medical Disclaimer

This article is intended for general informational and educational purposes only. It does not constitute medical advice, diagnosis or treatment. Statistics and reports from individual healthcare organizations may not represent the experience of the entire U.S. population. The effects of kratom and 7-OH can vary substantially between individuals and products. Anyone concerned about substance use, dependence or withdrawal should speak with a qualified healthcare professional. If severe or potentially life-threatening symptoms occur, seek urgent medical attention.