AMA Calls for Complete Ban on Sales of 7-OH
/By Pat Anson
The American Medical Association (AMA) is calling for a complete ban on the sale, distribution and marketing of products containing 7-hydroxymitragynine (7-OH), a kratom alkaloid that is of growing concern for its potential to cause dependence and addiction.
7-OH occurs naturally in kratom in trace amounts, but when concentrated acts as a potent pain reliever and stimulant with “opioid-like” effects.
The policy adopted by the AMA at its annual meeting urges the FDA to classify “7-OH kratom products” as adulterated or misbranded. It is particularly concerned about sales to minors and the packaging of 7-OH in colorful, child-friendly forms that could be mistaken for candy.
“We cannot ignore the growing availability of unregulated products marketed in ways that appeal to children and adolescents. Concentrated 7-OH products are being sold in forms that can resemble candy and other treats, creating unnecessary risks for young people,” Dr. Melissa Garretson, a member of the AMA Board of Trustees, said in a statement.
Several states and dozens of cities and counties have already banned 7-OH or put age restrictions on sales. The AMA’s new policy position will likely add weight to more efforts to ban 7-OH.
As dietary supplements, kratom and 7-OH are largely unregulated under federal law, as long as unverified claims are not made about their medical uses.
The American Kratom Association (AKA), an association of natural leaf kratom vendors, supports efforts to ban 7-OH products. but is concerned the AMA was not specific enough about its concerns.
“The AMA correctly identifies the danger posed by concentrated 7-OH products, but it stops short of making the most important distinction,” Mac Haddow, an AKA lobbyist, said in a statement. “These chemically manipulated 7-OH opioids are not traditional kratom products. They are highly concentrated opioids manufactured through chemical conversion processes that fundamentally alter the natural composition of kratom.”
The AKA’s position is at odds with the 7-HOPE Alliance and the Holistic Alternative Recovery Trust (HART), which represent 7-OH consumers and manufacturers. Those groups support age restrictions and regulation of 7-OH, but not outright bans.
“As discussions surrounding kratom continue, HART urges policymakers, medical organizations, and regulators to engage with the available scientific evidence and work toward regulatory solutions that protect children and consumers while preserving access for responsible adults,” Jeff Smith, HART’s National Policy Director, said in a statement to PNN.
“The fixation and misinformation on 7-OH is a deliberate distraction from far more concerning products that remain widely available to consumers. Instead of pursuing misguided bans on naturally occurring compounds, policymakers and regulators should focus on protecting consumers through consistent, science-based standards that apply equally across all kratom products.”
(Editor’s note: An earlier version of this story incorrectly reported that the AMA only wanted a ban on sales of 7-OH products to minors. PNN regrets the error.)
Kratom and 7-OH Often Confused
The lines between kratom and 7-OH often get blurred. A case in point is a recent news release from the Laguna Treatment Center, an addiction recovery clinic in Southern California, which warned of the “growing threat of kratom and its byproducts.”
In the first 5 months of 2026, the center said it was treating 25 patients “who sought help for kratom dependence.” That represents a 525% increase from the 4 kratom consumers who sought treatment at the center in all of 2025. The center makes no distinction between the different forms of kratom.
“An alarming number of patients are coming in dependent on and addicted to kratom and its byproducts, such as 7-OH, who were previously unaware of the risks. This is relatively new territory for many providers, and we encourage insurance providers to expand and prioritize coverage for those seeking treatment for kratom misuse,” said Trace Swartzfager, Executive Director of the Laguna Treatment Center.
Federal policies about kratom and 7-OH are also confusing, if not incoherent. Last month, President Trump said his administration would support the approval of “natural 7-OH,” without clarifying whether he was talking about natural leaf kratom or concentrated 7-OH versions.
Nearly a year ago, FDA commissioner Marty Makary, MD, called on the DEA to classify 7-OH as an illegal Schedule I controlled substance, but not “natural kratom leaf products.” The DEA has yet to act on the FDA’s request and Makary has since been fired. The Trump administration has yet to replace him.
Claims are often made that 7-OH and kratom are opioids that cause addiction and overdoses. Technically, they are alkaloids and are not derived from poppy plants. Kratom and 7-OH stimulate endorphin nerve receptors in the brain – often called “opioid receptors” – but the same could be said about chocolate and coffee, which stimulate the production of endorphins and other natural “feel good” hormones.
Most of the overdose deaths attributed to kratom and 7-OH involve other substances, so it is not clear if they were the actual causes – much as opioid pain medications were mistakenly blamed for many overdose deaths. The FDA admits there is “ambiguity about the contributory role of 7-OH” in many overdoses.
Further muddying the waters about kratom, the National Institutes of Health (NIH) recently said it would study one of its purported health benefits. The NIH is launching a preliminary study to see if the kratom alkaloid mitragynine could be used as a treatment for opioid addiction. Many kratom consumers already use the herbal supplement to help reduce their cravings for opioids and alcohol.
A previous NIH study concluded that kratom is an effective treatment for pain, helps users reduce their use of opioids, and is “relatively safe” to use.
