Missouri DHSS issues Health Advisory on 7-OH Potent opioid-like substance poses public health risk7-OH product

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.