As kratom use grows, particularly among younger populations, federal authorities are stepping up enforcement—especially targeting products containing the potent opioid derivative 7-hydroxymitragynine (7‑OH).

Rising Popularity, Mounting Concerns

Kratom is derived from the leaves of Mitragyna speciosa, a coffee-family tree native to Southeast Asia. Used for its stimulant, mood-lifting, or sedative effects, it is sold in many forms—teas, capsules, vapes, and powders—and remains largely unregulated in the U.S.

Although national prevalence varies, studies estimate that up to one-third of kratom users experience adverse effects, including cardiac arrest, liver damage, seizures, brain hemorrhage, and, in some cases, fatal overdoses. WikipediaFrontiersPMC

Kratom and Heart Risks

Evidence indicates that kratom may directly affect heart function. In cell-based models, compounds such as mitragynine can prolong the QTc interval—a marker for dangerous arrhythmias like torsades de pointes. Frontiers

Real-world cases reinforce these findings. For instance, a healthy young individual suffered cardiac arrest following kratom use—possibly due to respiratory depression or its opioid-like effects. PMC

Liver Damage and Other Systemic Effects

The herb has also been linked to acute liver injury, with symptoms such as jaundice, abdominal discomfort, and dark urine usually emerging within weeks of regular use. Liver biopsies often reveal cholestatic or mixed injury patterns. Trung tâm Thông tin Sinh học Quốc giaPMC

Further complications linked to kratom include:

• Neurological issues: seizures, coma, memory impairment

• Respiratory problems: pulmonary edema, respiratory arrest

• Renal failure

• Muscle injuries: rhabdomyolysis, compartment syndrome

• Infant withdrawal in babies exposed in utero Frontiers

Despite these risks, kratom remains readily available in many states, though several—including Alabama, Indiana, Rhode Island, Vermont, Wisconsin, Arkansas, and Tennessee—have banned or restricted its use. PMC+1

The FDA’s Crackdown on “7‑OH” (Legal Morphine)

The FDA is actively targeting 7-hydroxymitragynine (7‑OH)—a potent, semi-synthetic derivative of kratom that acts strongly on opioid receptors. Not widely present in natural kratom, 7‑OH is increasingly found in products like gummies, drink shots, and tablets. GQThe Washington Post

On July 29, 2025, the FDA recommended that 7‑OH be classified as a Schedule I controlled substance, citing its high potential for abuse and lack of approved medical use. U.S. Food and Drug AdministrationThe Washington Postmedscape.com

Prior to this, the agency issued warning letters to seven companies for illegally marketing 7‑OH products as dietary supplements or unapproved drugs. content.govdelivery.comNutraceuticals World

What to Know—Essential Takeaways

• Kratom use is often accompanied by serious health risks—ranging from heart complications and liver injury to neurological symptoms, respiratory failure, and death. FrontiersTrung tâm Thông tin Sinh học Quốc giaPMC

• Kratom may act like an opioid at high doses, and withdrawal can be severe, with symptoms like irritability, anxiety, and hallucinations. Physicians are advised to routinely ask about kratom use. PMC

• The FDA is moving to strictly regulate 7‑OH, a powerful derivative often added to consumer products, while leaving leaf-based kratom mostly untouched—for now. U.S. Food and Drug AdministrationThe Washington PostGQ

• Despite its “natural” marketing, kratom is not safe. Consumers exposed to kratom or 7‑OH are at risk—especially since potency and dosing are unregulated. The SunWikipediaAxios