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Missouri DHSS issues Health Advisory on 7-OH

Potent opioid-like substance poses public health risk

7-OH productJEFFERSON CITY, MO — 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.

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