7-OH (7-hydroxymitragynine): general

7-OH (7-hydroxymitragynine) is a psychoactive alkaloid formed by oxidation of mitragynine [1]. It occurs naturally in kratom only as a trace or minor constituent, well under 2% of total alkaloid content [2][3]. Most of what's sold as concentrated "7-OH" product is not that trace amount: it's synthetic or heavily concentrated material, sometimes tested at more than 100 times the levels found in natural kratom and higher than what's stated on the label [2][4].

7-OH is an opioid. It's a partial agonist at the same mu-opioid receptor targeted by morphine, oxycodone, and fentanyl, and lab work puts it roughly ten times more potent there than mitragynine [5][6][4]. Animal studies confirm opioid-type effects, including respiratory depression that naloxone fully reverses, and — with repeated dosing — tolerance and withdrawal [2]. Clinical experience in people tracks the same pattern: opioid-like intoxication, respiratory depression, dependence, and withdrawal [2]. Concentrated 7-OH products have been linked to overdose and death [2].

The two things to hold onto before anything else:

There is no established safe dose. The American College of Medical Toxicology states plainly that 7-OH has no proven therapeutic benefit, that its toxic dose is unknown, and that no safe dose can be recommended [2]. A rodent study found only 2.7% of ingested 7-OH reaches circulation, but toxicologists note that limited absorption doesn't mean low risk — high doses, or taking it sublingually/buccally, can still produce a clinically significant exposure [2].

Treat it as you would any opioid. Don't combine it with alcohol, benzodiazepines, or other sedatives [2]. Naloxone has reversed 7-OH-related respiratory depression in both animal studies and human case reports [2], and withdrawal or dependence has been treated successfully with buprenorphine or methadone [2].

References

1. Chemistry and toxicity of 7-hydroxymitragynine (7-OHMG): an updated review on the oxidized derivative of mitragynine — ResearchGate
2. ACMT Position Statement: 7-Hydroxymitragynine — American College of Medical Toxicology
3. 7-Hydroxymitragynin (7-OH): An Assessment of the Scientific Data and Toxicological Concerns Around an Emerging Opioid Threat — U.S. Food and Drug Administration (FDA)
4. 7-OH: What is it? Why do people use it? What medical approaches can help? — University of Washington Addictions, Drug & Alcohol Institute
5. 7‑hydroxymitragynine is an active metabolite of mitragynine and a key mediator of its analgesic effects — Washington University in St. Louis
6. Monographs: 7-Hydroxy mitragynine — Center for Forensic Science Research and Education (CFSRE)