The legal, opioid-like high for sale at your convenience store

Bright, colorful packaging lines the shelves of corner stores around America, with labels like “Perks,” “Dopium,” and “Opia.” Each pack contains small, flat, circular pills — no bigger than an Altoid mint — each of which is made from a compound dubbed 7-OH. While its branding may suggest that it is a sort of supplement or vitamin, in reality, it is a compound more similar to morphine, fentanyl and oxycodone than any supplement.

Once ingested, a cascade of effects washes over the user. The brain is hit with a rush of dopamine, producing intense feelings of euphoria. The brain’s perception of pain can cease altogether. The signals that tell your lungs to breathe will slow, causing respiratory depression. At the extreme, the brain can stop telling the body to breathe at all. Respiratory depression is how opioids kill. But this is not an opioid. It’s 7-OH, short for the chemical compound 7-hydroxymitragynine,  and there’s a good chance you buy it at your local corner store.

For the past year, David Hampton, a 7-OH user from the San Francisco Bay area, had been walking into his local smoke shop nearly every day, picking up a daily dose of 7-OH pills for around $40 a day. 

Hampton, who, for privacy purposes, is using a pseudonym, began using 7-OH to get off of hydrocodone and Subutex, a prescription opioid and a medication designed to manage opioid withdrawal and dependence. 

“It works amazingly for pain,” Hampton said. “And when I was trying to get off prescription medications, 7-OH seemed like not only could I potentially get off them, but also have some sense of freedom, not being as reliant on a substance.”

Over the past year, these products have populated the shelves of gas stations, convenience stores, and smoke shops throughout Onondaga County, with minimal restrictions on who can purchase them. They are not tested for safety or effectiveness and are not approved by the FDA to treat any medical conditions. Despite 7-OH-specific tracking codes being added to the National Poison Data System (NPDS) in February 2025, in just three months (February to April 2025), 53 exposure cases were documented. The outcomes of which ranged from minor to major clinical events. Six of the cases involved patients under 18 years old.

Kratom’s origins

7-OH’s ancestor: Mitragyna speciosa, more commonly known as the kratom tree, is found on the other side of the Pacific.

In Southeast Asia, a leaf hangs fifty feet up on the branches of a kratom tree indigenous to Thailand, Malaysia, Myanmar and surrounding regions. Those native to these areas have used it as an herbal drug for centuries. The quality and source of kratom are almost always well-known to the consumer — regular users often have their own trees, or rely on familiar local suppliers.

It is used medicinally to treat fevers, diarrhea and general pain. Manual laborers use it on rubber plantations and rice fields, chewing the leaf for hours at a time, and relying on its low-dose stimulant effects to increase endurance and reduce stress — not unlike how coffee functions in the western workplace.

In the United States, the experience is entirely different. Kratom cannot be cultivated here. It must be purchased online, in smokeshops or convenience stores, where it has become widely available with minimal restrictions and no personal relationship with the supplier.

When consumed, mitragynine, Kratom’s most abundant alkaloid, is metabolized by the liver into 7-OH. 7-OH then binds to the mu-opioid receptors, the same ones targeted by morphine, fentanyl, oxycodone, and heroin — producing effects that are stimulant-like at lower doses and sedative, more opioid-like at higher doses.

It’s speculated, but not confirmed, that the kratom plant first arrived in the United States in the luggage of American soldiers and Southeast Asian immigrants following the Vietnam War. Whatever its origins, kratom’s American prominence became undeniable around the mid-2010s.

Kratom comes to America

Due to the lack of a proper growing environment, the cultivation of kratom trees in the United States is unsuitable and extremely rare. Americans most commonly use kratom recreationally for its euphoric effects and as an alternative for treating pain and opioid withdrawal.

Purchases are typically made online or from retail shops with no personal contact, no dose disclosure and no quality verification. This becomes concerning when you consider a 2016 study published in the Journal of Medical Toxicology, which tested eight commercial kratom capsule products and found that seven of the eight contained 7-OH at levels 109 to 520% higher than what occurs naturally in the plant—a single commercial capsule could contain more 7-OH than an entire handful of raw kratom leaves. The difference in 7-OH between kratom consumed in the west versus the east may explain why centuries of kratom use in Southeast Asia produced virtually no documented overdose deaths compared to 35 fatal-toxicologically confirmed cases in the US as of June 2024.

Despite this discrepancy, kratom has been marketed as a ‘safe’ herbal product capable of producing a ‘legal’ high. This reputation for safety, however, does not apply to the 7-OH products actually being sold around Onondaga County, which are something else entirely. These products are sold with no age verification, no dosage guidance, and no requirement that shop owners know anything about their effects. 

In natural Kratom leaf, 7-OH exists in amounts so small that it is nearly undetectable, making up no more than 0.05% of the plant's dry weight. The same cannot be said for the 7-OH products being sold at retail shops, the dose of which typically ranges from 5mg to 22mg per tablet. Even just 5mg is more 7-OH than kratom leaf could ever produce naturally through metabolism. 

Susruta Majumdar, an anesthesiology professor at Washington University Medicine in Saint Louis, has been studying the pharmacology of natural product-based Analgesics such as kratom for over ten years. Majumdar said that 7-OH pills being sold at gas stations are much more dangerous than one might assume. 

"In recent times, in gas stations, we are seeing increased 7-hydroxymitragynine present in kratom formulations,” Majumdar said. “That's worrying, because it's more, and that's the dangerous component. Somebody is artificially increasing the amount of (7-OH).”

According to the FDA's 2025 report, concentrated 7-OH products began increasing rapidly in 2022. Drug Enforcement Administration toxicology data reveal that 2022 also marks the beginning of a threefold increase in fatal overdose cases involving these compounds. 

The hidden danger

A gap exists between what 7-OH product labels disclose and what the science shows. Majumdar’s lab assistant Barnali Paul said the difference between 7-OH concentration in natural Kratom leaf and gas station product is obvious. Paul also said a lack of understanding of the difference is dangerous for consumers. 

“Seven hydroxymitragynine is also found in kratom as an alkaloid, but it's abundant at very low levels — less than 1%,” Paul said. “When you are taking the concentrated one, that will be more dangerous compared to when you are chewing the leaves ... if you take it directly as concentrated, that is nearly tenfold more potent.”

Abhisheak Sharma, a University of Florida researcher who tested commercial 7-OH products for the Tampa Bay Times, described the pills as equivalent to "legal morphine," but it might be worse than that. According to the FDA's 2025 preclinical review, 7-OH produces respiratory depression at more than three times the potency of morphine. It is, in every pharmacological sense, an opioid. And it’s available, without a prescription, at a gas station near you.

According to the FDA's 2025 scientific assessment, because 7-OH is a full mu-opioid agonist, regular use builds physical dependence similarly to morphine and heroin. Users' brains will begin to adapt to the drug and eventually form an addiction as use increases. 

“Everything you associate with opioids, that is also 7-OH. More addiction, more respiratory depression, more overdose deaths,” Majumdar said. “If (a consumer) ends up buying what he thinks is kratom but ends up with 7-hydroxymitragynine, he's taking heroin. It's a street drug. That is dangerous. That needs to be controlled.”

Defenders of 7-OH products may point to the alkaloid’s classification as a partial agonist – meaning that it does not activate the mu-opioid receptor to its maximum potential as a deadly drug like fentanyl, and is ultimately safer than classical opioids. Washington University senior scientist Batgas Varga is not sold on this point. 

Varga said the goal is to have a tenfold gap between positive and negative gaps in modern pharmacology, but these products don’t meet that criterion. 

"The fact that something is a partial agonist doesn't necessarily mean that there is a big enough gap between the positive and negative aspects that you could take it safely at home," Varga said. 

What makes this especially dangerous, according to Majumdar, is that many users may not know what they're actually taking when they buy what they believe to be kratom or other herbal supplements, a mistake that can lead to a slippery slope of high tolerance development, addiction and eventual withdrawal. 

Consumers who are in pursuit of an alternative to opioids or treatment of classical opioid withdrawal but end up instead with a 7-OH product are unknowingly making their situation worse. 

"What can happen with (some users) is they think they are probably using kratom and end up using a product which has more 7-OH — and they do not realize it," Majumdar said. 

For Hampton, he set out to stop being dependent on an opioid, not to become dependent on another. 

The cost of getting off

Hampton turned to 7-OH as a means of getting off prescription medication entirely. But he still needed something to help with the chronic pain he has experienced since surviving a car accident over 10 years ago. 

After months of research, Hampton discovered 7-OH. In February, he was taking about 250–500mg of 7-OH daily, a usage rate that cost him about $40 a day — a price he was fortunate enough to afford – to get through the day.

Months later, Hampton’s daily use had climbed to approximately 1,600 milligrams a day as the shops around him started selling bigger and bigger doses for even cheaper, including 800mg a bottle for only $50.

"There's better value in the larger doses," said Hampton. "You end up getting a larger dose because it's more cost-effective, and then you're not able to abstain from taking more of the medication that you now have readily available because you have it on your person."

Driven by a $15,000 work bonus and larger doses, Hampton’s tolerance grew to mountainous heights. He was dosing four times a day in the morning, early afternoon,  after dinner and before bed. Each dose at roughly 100 milligrams at a time

Just like Majumdar predicted would happen to frequent users of 7-OH, Hampton developed a worsening dependence on the drug, leading him down the path of withdrawal. Hampton knew something had to change when the clerk from whom he purchased 7-OH daily asked if he was okay. By then, he had been spending $100 a day for weeks to acquire his necessary dose. What followed was four days of sweating through his sheets, no sleep, full panic and a hospital trip.

"It's absolutely a nightmare. You've got to put your whole life on hold for 24, 48, 36 hours, whatever that might be,” Hampton said . "Because you did it to yourself, there's this feeling of lack of self worth. You felt dismal. There was no one else to say, 'someone else got me hooked on this.'"

Hampton had done his research before the first purchase. He had tracked down scientific papers, consulted online forums and even had products independently tested on his own dime to verify what the labels claimed was actually in the bottle. None of it warned him about what was coming.

"The labels now say it's an addictive substance, which they never said initially,"Hampton said. "’Before I put this in my body, there's a chance that I won't be able to stop taking it, or I'll need to increase my dosage over time.’ That's what should have been on the label."

The FDA does not require addiction warnings on 7-OH products because they’re not legally classified as a drug. 7-OH exists in a regulatory gray area that allows it to be sold as a supplement or botanical product with minimal disclosure requirements. The labels that Hampton first bought made no mention of dependence, tolerance or withdrawal. Why would they? It’s easier to sell a dangerous drug when you advertise it as “natural” and “supplemental.” 

A lawless product 

Unfortunately for consumers like Hampton, some 7-OH users find out about the drug’s detrimental pitfalls the hard way — by living it. But some states are trying to change. Recently, bills that aim to regulate and possibly outright ban products like 7-OH from being sold over the counter have been appearing in different states’ legislation. The question is whether legislation can move fast enough. 

Syracuse and its surrounding communities have spent more than a decade  on the front lines of the national opioid crisis. Fatal opioid overdoses  in Onondaga County climbed from 45 in 2012 to 142 in 2016, after the first wave of fentanyl in the county, before briefly declining and then surging aga into a peak of 186 deaths in 2021. That is a fourfold increase in under a decade. These epidemics leave a community to absorb consequences that policy and lack of awareness fail to prevent.

New York currently has three separate legislative responses to 7-OH, each with a different approach. The first is already a law. S8814, sponsored by Sen. Patricia Fahy, prohibits the sale of Kratom products to anyone under 21 years old, with a civil penalty of $500 per violation. However, the law does not ban concentrated 7-OH products, set limits on concentration amounts and says nothing about packaging. It’s a simple age restriction, nothing more. 

The second bill, S8925, goes further. Introduced by Sen. Christopher Ryan with Fahy as a co-sponsor, it would ban any 7-OH product exceeding 2% of total alkaloids or 1 milligram per serving, directly targeting most of the concentrated synthetic products like dopium that populate Syracuse shelves. Penalties range from $3,000 to $6,500 per violation. As of April 2026, the bill has been introduced in the Senate Consumer Protection Committee, but has not yet advanced to a floor vote in either chamber.

The third bill, S8686, also sponsored by Fahy, takes the broadest approach: a total ban on all kratom and 7-OH in any food or beverage product sold in New York. It makes no distinction between natural kratom and synthetic 7-OH and has not yet passed either. While this bill may seem like a possible solution to the 7-OH epidemic, the total ban of all Kratom products is a slippery slope that can result in the loss of scientific strides in the realm of opioid dependence research. 

“I would be opposed to a total ban on kratom products or Kratom leaves, because there is something to be said about the other alkaloids that are present for research purposes,” Majumdar said. “These are beautiful building blocks for tomorrow's drugs. If you ban Kratom, you're taking everything away from the research community.” 

That’s not the only issue a total ban will raise. Even if New York passes its strongest pending bill, the history of drug regulation suggests that outright banning certain addictive drugs does not simply make the problem disappear. Instead, new and often more harmful products being developed in anticipation of an outright ban will hit the market and replace what came before it.

A similar process happened before with the fentanyl epidemic. Starting in 2016, new fentanyl analogues appeared around every two weeks. Each time the DEA emergency-scheduled an individual fentanyl analogue, manufacturers created a new one. It took the class-wide scheduling of all fentanyl-related substances in 2018 to end the proliferation of fentanyl analogues. According to a 2021 study published in the Journal of Forensic Sciences, NFLIS reports of fentanyl-related substances dropped by approximately 50% in the following two years.

The FDA's 2025 report is already tracking the likely successor to 7-OH, should it be banned. Mitragynine pseudoindoxyl, a related compound that can be synthesized from the same kratom extracts used to make 7-OH, is even more potent and not yet scheduled. If 7-OH is regulated off the shelves of Syracuse smoke shops, the product that replaces it could be far more dangerous than the one it replaced. 

The takeaway here is clear: scheduling a single compound invites analogue creation. Scheduling a class disrupts it. Majumdar, who has been in contact with Missouri lawmakers about legislative language, put it plainly. "I think some sort of regulation of 7-OH is what I'm telling them," he said. "If it's present at natural levels, that's probably okay. But anything unnatural, those are things we need to keep an eye on."

Onondaga County has survived waves of prescription pills, heroin and fentanyl. With each wave came a new product and set of victims. According to a report from the Onondaga County Health Department, opioid-related deaths climbed from 45 in 2012 to a peak of 186 in 2021, a more than fourfold increase in less than a decade. By 2023, that number had fallen to 156, which local health officials cautiously attribute to expanded naloxone access and reduced stigma around treatment. 

Despite the FDA saying that it is more potent than morphine, 7-OH still sits on the shelves of certain convenience stores, smoke shops and gas stations; right next to the lottery tickets, packs of gum and mere blocks away from colleges and elementary schools alike. 

The law is moving, but it’s unclear whether it is doing so fast enough or effectively.  What is not in question is that the product is available for purchase to anyone who stops outside of a shop that sells 7-OH, who sees bright packaging, who sees words like “supplement,” who decides to try it out, not knowing what they are getting themselves into. 

If you or someone you know is experiencing a substance use emergency, call the SAMHSA National Helpline at 800-662-4357. It is free, confidential, and available 24 hours a day. For overdose emergencies, call 911. Naloxone reverses 7-OH overdose and is available without a prescription at most New York State pharmacies.