Latest news with #7OH
Yahoo
4 days ago
- General
- Yahoo
Colorado can still lead on harm reduction. First we need to fix this new law.
A laptop displays the website of an online kratom retailer. (Alexander Castro/Rhode Island Current) Imagine you're a veteran in Wheat Ridge, or a single mom in Lamar living with chronic pain. You've finally found something that works: a legal, plant-based supplement that helps you stay off opioids. But then, just as things start to stabilize, the state passes a law that could complicate how you access it. That's what just happened to thousands of Coloradans. On Thursday, Gov. Jared Polis signed Senate Bill 25-72 into law. We appreciate his commitment to public safety and consumer protection. But this law makes things more confusing, not safer. For the people who rely on kratom-derived products to manage pain or recover from addiction, it's a major step backward. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX I've worked in public policy for over 20 years, and I represent the Holistic Alternative Recovery Trust (HART), a nonprofit advocating for science-based kratom regulation (to be clear, we don't sell or profit from these products). We've been trying to get rules in place that protect consumers and reflect real-world use for years. This bill doesn't get us closer to that goal. Kratom is a plant-based supplement long used in Southeast Asia and now increasingly used here in Colorado. One of its natural compounds, 7-hydroxymitragynine, or 7-OH, is found in products that patients say have helped them avoid returning to painkillers or heroin. Especially in rural and low-income areas, where access to traditional treatment can be limited, these products can mean the difference between stability and relapse. In 2022, Colorado's own state feasibility study laid out a clear, science-backed path for regulating these products. It advocated setting dosage limits, requiring testing and labeling, and establishing strong oversight. But SB-72 doesn't follow that roadmap. It was rushed through in the final days of the legislative session and now leaves Colorado with a fragmented and unclear system. Safe products could be sidelined while dangerous ones remain on shelves. Consider the facts: Claim: The bill bans unsafe high-potency products. Reality: It doesn't. The most dangerous products — high-mitragynine shots and kratom/kava blends — are still on shelves. Meanwhile, safer products made by responsible companies are pushed out. Claim: It regulates 7-OH. Reality: The law sets a 2% cap on 7-OH but excludes anything above that threshold from regulation altogether. That leaves patients, businesses, and law enforcement in regulatory limbo. Claim: It adds safety and labeling rules. Reality: The bill makes only minor changes for kratom and none for 7-OH, even though that's often the compound patients rely on most. There's also been public discussion tying this bill to the tragic death of Daniel Bregger. We deeply respect his family and their advocacy. But the facts matter: At the time, 7-OH products were not commercially available. Using that tragedy to justify this law distracts from the real dangers SB-72 fails to address. The law now excludes many 7-OH products from the definition of a 'kratom product,' but offers no clarity on how they should be regulated. 7-OH remains legal in Colorado, but SB-72 creates confusion instead of guidance. That helps bad actors more than consumers. Retailers don't know what they can sell, patients don't know what they can trust, and law enforcement doesn't know what to enforce. We want regulation. In fact, the brands we work with already follow many of the rules this bill should have required, such as limiting dosage based on science, testing products, and labeling ingredients. These are basic protections. But SB-72 doesn't ensure they're followed by everyone. It's a major missed opportunity. Colorado has built a national reputation for bold, evidence-based leadership on cannabis, psychedelics, and public health. SB-72 doesn't live up to that legacy. But it's not too late. Let's come back to the table, this time with patients in the room. We can still build a framework that's clear, fair and focused on safety. Colorado can still lead. We just have to choose to. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Medscape
16-05-2025
- Health
- Medscape
‘Legal Morphine' — The Rise of Kratom and 7-OH in the US
Interest in kratom in the United States has soared in the past decade, with estimates ranging as high as 16 million users and more than $2 billion in retail sales. The recent surge in use and increasing availability of products containing the potent kratom metabolite 7-hydroxymitragynine (7-OH) has some experts sounding the alarm over the addictive qualities of the drug, which acts on opioid receptors in the brain. 'People feel that it may be a good treatment for opioid use disorder [OUD] when they are going through withdrawal, which is only partially true and not all that evidence-based,' Petros Levounis, MD, professor and chair, Department of Psychiatry, and associate dean at Rutgers New Jersey Medical School, Newark, New Jersey, told Medscape Medical News . Evidence also suggests that rather than treating addiction and symptoms of withdrawal, the use of kratom may lead to addiction and withdrawal symptoms on its own. 'Perhaps even more concerning is that people start using kratom in a general sense — like it's going to help them with all kinds of nonspecific discomfort. Whether that's anxiety or dysphoria or annoyance or any of the above, they just take a little bit of kratom and feel better, which is probably true,' Levounis said. 'But at what cost?' What are Kratom and 7-OH? 'Kratom' refers to both Mitragyna speciosa, a tree native to Southeast Asia, and to products derived from its leaves that are marketed as herbal supplements. Kratom products are commonly found at gas-station counters, vape and head shops, cannabidiol dispensaries, online vendors, and occasionally in 'wellness' aisles in mainstream pharmacies. Traditional kratom products made from the dried leaves of M speciosa naturally contain dozens of bioactive alkaloids. The most well-studied compounds in kratom are mitragynine and 7-OH. Mitragynine is the predominant alkaloid, making up about 60%-65% of dried leaves, while 7-OH is present only in trace amounts (often < 0.05% of the leaf). Both molecules are psychoactive and are partial agonists at the µ-opioid receptor, with a binding strength the US Food and Drug Administration (FDA) has said is similar to scheduled opioid drugs. At low doses, mitragynine's mixed receptor profile (adrenergic, serotonergic, dopaminergic) yields mild stimulant and mood-boosting effects. By contrast, concentrated 7-OH preparations are 30-40 times more potent at opioid receptors and produce rapid-onset analgesia, euphoria, respiratory depression, and classic opioid-type withdrawal. As previously reported by Medscape Medical News , research has shown that 7-OH (formerly known as (7-HMG) has high abuse potential and may also increase the intake of other opiates. Why the Alarm? Current estimates of kratom use vary widely, with federal data reporting just under 2 million users in 2022 and a national kratom advocacy group putting the number significantly higher, at 11-16 million. The US retail sales were estimated at roughly $2.2 billion in 2024. Since late 2023, there has been a surge in 'kratom' products marketed as '7-OH,' '7-Hydro,' or 'legal morphine.' And 7-OH is 'much more potent and there are some animal studies that have shown that 7-OH is much more addictive than the good old parent molecule and can very well get you in trouble,' Levounis said. Even the American Kratom Association recently issued a consumer alert on synthetically concentrated 7-OH products that are 'deceptively' labeled and marketed as 'kratom.' The association has warned that products with 7-OH levels that exceed 2% of the overall alkaloid content are no longer kratom. Recently, independent lab tests commissioned by regulators in Texas and Colorado have found some 7-OH pills exceeding 40% purity and mislabeled as 'kratom extract.' The FDA issued an alert last year, warning consumers not to ingest optimized plant mediated solutions black liquid kratom, noting that the product, which contains 7-OH, has been linked to one death and numerous adverse health effects including seizures and liver toxicity. The FDA reported cases of kratom-related substance use disorder (SUD), in which patients use kratom for longer and in larger amounts than intended, experience kratom cravings and withdrawal symptoms, and continue use despite adverse consequences (either physically or in their personal life). Cases of neonatal abstinence syndrome, in which newborns experience such as jitteriness, irritability, muscle stiffness, and other withdrawal signs following prolonged prenatal exposure to kratom, have also been reported. Are Kratom and 7-OH Regulated? Although widely available, kratom and its ingredients have not been approved by the FDA. 'There are no FDA approved kratom drug products or over the counter drugs containing kratom, or its ingredients — mitragynine, or 7-OH-mitragynine — that are legally on the market in the US. FDA continues to warn consumers not to use kratom because of the risk of serious adverse events, including liver toxicity, seizures, and substance use disorder.' In 2016, the US Drug Enforcement Agency (DEA) declared its intent to classify kratom as Schedule I, which would have criminalized possession and distribution of the substance. However, the agency withdrew the notice after push back from the public and members of Congress. As a result, on the federal level, kratom products are not specifically regulated, nor are kratom or 7-OH listed as controlled substances, reported the Legislative Analysis and Public Policy Association. However, kratom remains on the DEA's 'Drugs of Concern' list. At the state level, there is a patchwork of regulations on kratom. Six states – Alabama, Arkansas, Indiana, Rhode Island, Vermont, Wisconsin – currently ban the substance outright and nine states have imposed specific regulations or restrictions on sale and distribution of kratom products. Kratom is legal without specific statewide regulations in 35 states, although certain local jurisdictions within these states may have their own restrictions or bans. Earlier this year, Colorado lawmakers advanced a bill to require companies that process the plant M speciosa to register with the state and follow labeling and product rules designed to limit potency. And the governor of Georgia recently signed a law adding regulations for production and sale of kratom. Is My Patient Using Kratom? Kratom use is 'something that all clinicians should ask patients about as they can buy it at convenience stores or online and its use is going up so we need to ask about it,' Roger S. McIntyre, MD, professor of psychiatry and pharmacology, University of Toronto, Toronto, Ontario, Canada, told Medscape Medical News . The key is knowing which kratom product a patient is using, said researcher Kirsten Smith, PhD, MSW, assistant professor of psychiatry and behavioral sciences, Johns Hopkins Medicine, Baltimore. 'R ule number one — ask patients exactly what they are using and record the brand name because there are so many different products out there,' she told Medscape Medical News . 'Right now you can fairly easily test for mitragynine and usually when people say that they tested for kratom, what they're really saying is that they tested for mitragynine because if someone is using it regularly, it can stay in their blood for like 12 days after their last use,' Smith said. Testing for 7-OH right now is much harder. 'You would have to send it off to a specialty lab, and it's going to be more qualitative than quantitative because 7-OH is just not stable in the blood for that long,' Smith said. Even in the absence of testing, many patients will readily admit to using kratom — much more so than cocaine, methamphetamine, or heroin — because the culture has moved to the point where it is considered to be just a supplement, Levounis said. 'The bad news is that they will also feel that there is nothing wrong with using kratom,' he said. 'It appears from a clinical perspective that the number one reason why people use kratom is to self-medicate kratom withdrawal. It's something that we have seen with benzodiazepines and cannabis where people use these substances to self-medicate the benzodiazepine or cannabis withdrawal,' he added. 'All of these substances that make you feel better are misinterpreted by the patients as doing something good for them. Meanwhile all that it is doing is bringing them back momentarily to baseline in order to satisfy the withdrawal symptoms,' Levounis said. How Do I Treat Kratom Misuse? Currently, there are no specific medications available to treat kratom misuse. While the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision does not specifically list kratom use disorder, experts noted that the 'substance use disorder — not elsewhere classified (SUD-NEC)' is a catch-all category for SUDs that don't fit neatly into the specific categories for specific substances like alcohol and cannabis. 'It's important to note that lower doses of kratom work as a stimulant and higher doses as an opioid. If you are pretty convinced that what you see is a stimulant aspect of kratom use, it's perfectly okay to give a patient a diagnosis of stimulant use disorder and then explain in your note that this is primarily kratom,' Levounis said. 'If you are convinced that the way that this particular patient uses kratom is as an opioid, because of a higher dose, then it's okay to give the patient the opioid use disorder diagnosis and in your note address the fact that this opioid is kratom,' he noted. The most frequent approach for treating kratom-related physical dependence is medication for OUD, specifically buprenorphine or buprenorphine-naloxone, Smith said, adding that treatment should be individualized. Treatment may also include psychotherapy and counseling, Levounis noted, adding 'it's important to treat any co-occurring psychiatric or other medical conditions, such as a legitimate pain disorder or opioid use disorder or anxiety or depression.' One reason for the lack of kratom-specific treatments is the lack of published case reports on kratom and 7-OH, Smith said.
Associated Press
13-03-2025
- Health
- Associated Press
Global Kratom Coalition Supports Nebraska's Kratom Consumer Protection Act (LB 230)
GKC celebrates the closing of loopholes to protect consumers from dangerous 7-hydroxymitragynine products mislabeled as kratom LOS ANGELES, CA, March 12, 2025 (EZ Newswire) -- The Global Kratom Coalition (GKC) has been working with the Nebraska legislature since early 2024 in support of Nebraska's Legislative Bill 230, the Kratom Consumer Protection Act, introduced by State Senator Bob Hallstrom (District 1, Lincoln-NE). This proposed legislation aims to establish common-sense regulations that will enhance consumer safety and promote responsible manufacturing, marketing, and sale of kratom products in Nebraska. Among the bill's key provisions are measures designed to protect consumers, including prohibiting the marketing of kratom products designed to appeal to children, prohibiting the sale of kratom products to individuals under 21 years of age, and requiring product labeling that discourages use by women who are pregnant or breastfeeding. One of the most important regulations in LB 230 ensures that any level of 7-hydroxymitragynine (7OH) does not exceed 2% of the overall alkaloid composition of the product. This safeguard effectively eliminates the risk associated with synthesized high-potency isolate 7OH products (known as '7') that are proliferating across the state. Unlike natural-leaf kratom products, synthesized products like '7' contain eight unknown compounds and 100 times more 7OH than true kratom products. These new, untested products have no scientific data to support their use. They are being marketed as a cure for the opioid crisis when in fact they are fueling their own addiction and health crises through their unfettered access across the nation. Organizations such as the Holistic Alternative Recovery Trust (HART) are attempting to either kill kratom regulations bills or strike out core consumer safety provisions that protect consumers from these dangerous synthetic products. They have no data to support their position and contradict opinions expressed by the leading kratom scientists in the US who say '7" products should not be considered kratom. Proponents of '7" are not making factual or credible claims about the safety and efficacy of these products. HART's aim to promote '7" products comes at the risk of consumers. During a press event held by HART in October 2024, panel members advocated for the regulation of 7OH products as if they were natural kratom, making unapproved new drug claims. 'When organizations like HART make unapproved claims that 7OH products are intended for pain relief or opioid use disorder, they are promoting these products as drugs as defined by the FDA,' said Matthew Lowe, Executive Director of the Global Kratom Coalition. 'Without prior FDA approval, such products are unlawful to sell.' The Global Kratom Coalition has been actively involved in encouraging the development of LB 230 since its introduction on January 14, 2025, working alongside stakeholders to ensure that consumers have access to safe, natural kratom products and are protected from dangerous synthesized alternatives. 'Our goal is to support legislation that empowers consumers to make informed decisions while maintaining continued access to responsibly manufactured kratom products,' Lowe added. 'Nebraska's Kratom Consumer Protection Act is a significant step forward in achieving those goals.' The Global Kratom Coalition urges lawmakers and stakeholders to support LB 230 and reject any attempts to weaken the bill's vital protections for consumers. About the Global Kratom Coalition The Global Kratom Coalition is an alliance of kratom consumers, experts, and industry leaders dedicated to protecting access to kratom while advancing scientific research, driving consumer education, and developing robust regulations to protect consumers. For more information, visit Patrick George
