Unveiling the Impact of Kratom, Often Referred to as 'Street Heroin,' on the Human Body
The U.S. Food and Drug Administration (FDA) has recommended classifying certain products containing 7-Hydroxymitragynine (7-OH), a potent derivative of the kratom plant (Mitragyna speciosa), under the Controlled Substances Act (CSA) due to concerns about public health risks and opioid-like effects.
7-OH, a minor but potent opioid alkaloid, is synthetically produced and sold in dangerously high quantities. Unlike natural kratom leaves, which contain less than 2% 7-OH by alkaloid content, concentrated or synthetic forms of 7-OH are the subject of regulatory scrutiny.
The FDA has not approved any medical products containing 7-hydroxymitragynine or kratom alkaloids. Kratom and its components, including 7-OH, are not legally marketed as dietary supplements or added to foods in the U.S. without FDA evaluation of safety and efficacy through formal new drug applications (NDAs).
The FDA continues to warn consumers about the risks of using kratom or 7-OH for medical treatment without approval or scientific validation. The safety of kratom intake is a concern due to factors like environmental exposure, processing, and accelerated rates of absorption in Western products.
While kratom leaves have a long history of traditional use in Southeast Asia and remain available as herbal products in the U.S., 7-hydroxymitragynine is viewed differently due to its concentrated, opioid-like pharmacology. It is considered an emerging opioid threat rather than a legitimate herbal medicine on par with kratom leaf products.
The main alkaloid in kratom is mitragynine, which functions like an opioid and offers various effects such as anti-inflammatory, sedative, stimulant, anti-depressant, and anti-anxiety effects. Kratom is particularly effective in alleviating pain and boosting quality of life, especially for those with certain chronic conditions. Some people use kratom as a replacement for coffee or for mood-boosting purposes, while others use it to combat depression or anxiety.
However, 7-OH, another notable alkaloid, is a derivative of mitragynine and acts on mu-opioid receptors, which are involved in pain relief, sedation, drug addiction, and other physiological functions. Given their differences in potency, effects, and risks, 7-OH should be seen as a completely separate drug from kratom, as stated by Steven Ey, MD, an addiction medicine specialist at Hoag.
In summary, 7-hydroxymitragynine is not considered a legitimate plant medicine comparable to other kratom forms but rather a potent opioid derivative under regulatory control due to safety and abuse concerns. The FDA's regulatory actions are aimed at controlling the distribution and use of concentrated or synthetic forms of 7-OH, not the natural kratom leaf itself.
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