- Kaiser Permanente names SVP, Fresno service area manager
- Nebraska hospital CEO resigns amid allegations of $38K in improper spending
- Northwell’s direct contracting business wants to ‘link up’ with other health systems
- PDS Health among 1st to deploy Epic-integrated AI platform
- CommonSpirit’s 5 targets for judging payer prior auth reform — and its Humana milestone
- LifeBridge names division president
- Private equity struggles in healthcare amid mounting pressures: 5 notes for dentistry
- Who’s actually winning the fight for ASC ownership?
- Why some ASCs are buying their own anesthesia groups
- Hospital Sisters Health System names chief technology officer
- Top Medicare Advantage plans for member satisfaction in 2026: JD Power
- How a 12-hospital system saved millions with an inventory overhaul
- Corporate medicine is burning out 90% of employed physicians: 10 survey findings
- HCA Florida hospital names assistant CFO
- GE HealthCare taps new CFO
- 6-property outpatient portfolio acquired
- Patients deserve every evidence-based option for mental healthcare
- 10 anesthesia controversies in 2026
- The $314K cost of employing a physician
- Who’s driving physician M&A in 2026? 5 deals to know
- 5 ways insurers are undercutting anesthesia payments: ASA
- Prior GLP-1 use doesn’t affect bariatric surgery results: 6 things to know
- Statement on Regulation Crypto Assets: Fit-for-purpose Exemptions for Crypto Market Innovation
- Filling the Regulatory Tank: Regulation Crypto Assets Proposing Release
- Statement on Regulation Crypto Assets
- Dental therapy program enrollment up 533% in 5 years
- Dental assisting program enrollment down 5.2% in 5 years
- Dental hygiene program enrollment up 15% in 5 years
- Surgery Partners ditches its $200M M&A target in favor of de novo growth: 5 things to know
- The dental specialties DSOs will prioritize next
- Statement on Commencement of Appointment Process for Public Company Accounting Oversight Board Seat
- Dental school enrollment in the 10 states with the most dental shortage areas
- How To Protect Yourself During Wildfire Season
- Ballmer Institute lands $125M to expand child behavioral health training nationwide
- Judge weighs whether man charged with killing dentist can act as own attorney
- FDA Seeks Public Feedback to Inform Regulatory Approach for Generative AI-Enabled Medical Devices
- Included Health to offer Carrum specialty care for alternative plan members
- 52 behavioral health executive moves to know
- Hospital performance improves in June, but lags 2025
- University of Toledo gets nearly $2M to support behavioral health workforce
- CTA reporting requirements eliminated for most dental practices: 5 things to know
- National Alliance on Mental Illness names chief medical officer
- Pennsylvania opens 24/7 behavioral health crisis center
- Cyber criminals target DSOs, dental groups: 3 updates
- OpenAI boosts mental health safeguards for teens
- UnitedHealthcare expands behavioral coaching to 13 million members
- Kindergarten Vaccine Exemptions Hit Record High, New CDC Data Shows
- Loneliness Is A Health Crisis, But Doctors Alone Can't Cure It, Analysis Argues
- Ousted OHSU Healthcare CEO files lawsuit alleging wrongful termination, discrimination
- JD Power: Member satisfaction with Medicare Advantage plans continues to slide
- AMA applauds updated CMS prior authorization reporting guidance
- Constipation In Space: A New Study Provides Answers
- Social Media Beauty Trends May Up Teens' Exposure To Hormone-Disrupting Chemicals
- HIPAA-compliant marketing platform Ours Privacy lands $15M amid growing pixel concerns
- Pharma commercialization partner Valeris brings in new strategy chief
- Biokin bispecific ADC iza-bren hits goal in lung cancer trial, boosting case for BMS’ global test
- CSL shares up 17% as immunoglobulin boost points to signs of recovery
- R1 acquiring Humata Health to bolster AI-powered prior authorizations
- Revance hires Janelle Wichmann as chief marketing officer of skincare unit
- CMI adopts orphan drug field with dedicated center of excellence
- Waist Size Is Accurate Way To Gauge Unhealthy Excess Weight, Study Says
- Panel Offers First Guidelines For Using E-Cigarettes To Help Smokers Quit
- Celcuity keeps cool amid questions about Revtorpyk launch timing
- Newsom Promotes Affordable Insulin, But California's Generic Label Off To A Slow Start
- What Geriatric Emergency Departments Do Differently
- Drive for Nuclear Power Boosts Uranium Industry — And Tribal Health Concerns in Southwest
- Rural primary care company Hopscotch clinches $53M to expand beyond NC
- Eurofins expands operations to meet growing high-potency API demand
- 24 new behavioral health projects to know
- Four health systems, including Ochsner and Denver Health, go live with Epic's real-time prior authorization checks
- 8 new psychiatric residency programs to know
- DocGo agrees to acquire virtual care provider Hicuity Health, assumes $52M debt
- Papa, eternalHealth expand partnership around Plus platform
- Happy Health secures $75M to expand AI-powered care in the home starting with sleep apnea
- As healthcare costs weigh on patients, states could play a bigger role, report finds
- Jalapeño Recalls Keep Growing As Salmonella Outbreak Investigation Continues
- Music Streaming Linked To Rise In Traffic Deaths
- EyePoint shares plummet after phase 3 stumble for AMD drug-device combo Duravyu
- Quanovate takes back marketing claims for Mira fertility wand after P&G challenge
- Sanofi to lay off 229 Blueprint Medicines staffers, close Cambridge offices following acquisition
- Whoop expands Advanced Labs to non-members, adds Grail’s multi-cancer detection test to lineup
- Quartz Countertop Workers Are Falling Prey To Lung Disease
- Kaiser Permanente notches 4.6% Q2 operating margin, $5.3B net income
- Epic faces Federal Trade Commission antitrust investigation, Reuters reports
- Innovaccer, Mastek ink strategic partnership to scale agentic AI in healthcare globally
- Sandoz strikes $322M biosimilars deal with Shanghai Henlius
- Argenx heads to FDA with Vyvgart after ph. 3 win in potential blockbuster autoimmune indication
- Many Smokers Unaware Of Heart, Brain Risks Of Smoking
- Tylenol, Other Medications Fuel Spike In Liver Damage Cases, Poison Center Data Says
- AstraZeneca touts Enhertu, Orpathys dual lung cancer wins amid bispecific failure
- My Husband Was Kicked Out Of Hospice For Dying Too Slowly
- Tadalafil (Cialis), Used for BPH and ED, Might Increase Glaucoma Risk, Study Says
- Kennedy’s Quiet Hunt for Autism Culprits Stalls as Trump Orders Baseless Changes to Childhood Shots
- Newsom Promotes Affordable Insulin, but California’s Generic Label Off to a Slow Start
- Inside agency view: Real Chemistry’s Frank Mazzola on audience nuance and rewarding creativity
- Abridge expands AI decision support to more clinicians in bid to become healthcare's copilot
- Danish politicians call out Eli Lilly obesity campaign
- Universal Health Services closes $835M Talkspace acquisition
- Gounder Brings Clarity to Egg Freezing, AI Virus Creation, and New Trump Vaccine Order
- States Enact Emergency Orders On Kratom While Awaiting Federal Rules
- Study examines how ICHRA adoption could help stabilize ACA risk pools
- Winter Is Coming: How Vaccines Help Protect Against Respiratory Illness
- Screen Time Is Not All Bad For Kids' Brains
- Processed Foods Linked To Prostate Cancer Risk
- Updated Statement Regarding the Division of Corporation Finance’s Role in the Exchange Act Rule 14a-8 Process
- It's BMS vs. Celgene investors once more after US appeals court revives lawsuit
- Industry Voices—AI should help cancer patients survive the healthcare system
- Tavneos trial flagged for 'serious breaches' of protocol as EU regulators dissect market withdrawal decision
- Sleep Disturbances Linked To Genetic Alzheimer's Risk
- Pre-K Sets Kids Up For School Success, Study Says
- Expect Other Seniors To Act Their Age? Then Expect Problems With Your Own Memory, Study Says
- A genomics library for the AI era
- BMS bags first FDA approval for CELMoD franchise with Zenbexus multiple myeloma nod
- People With Disabilities Say Medicaid Income Limits Stifle Career Advancement
- Trump Team’s Use of Arcane Budget Rule Threatens Medicaid Coverage
- My Husband Was Kicked Out of Hospice for Dying Too Slowly
- Fierce Pharma Asia—Legend’s first profit; Taiho, Cullinan’s EGFR win; WuXi AppTec’s reprieve
- Rare Bacteria In Coastal Waters Has Killed 7 This Summer
- It's crunch time for Karyopharm as company faces potential default next month
- Socializing: A Prescription For Healthier Brain Aging
- Taking The Stairs May Lower Your Risk Of Dying From Heart Disease
- AZ's blood pressure newcomer Baxfendy fails to meet cost-effectiveness bar, ICER says
- How consumerization is reshaping pharma marketing
- Sweet Tooth? It Could Be Shaping Your Decisions, Study Says
- Stressed Parents Turn To Screens For Help, Study Finds
- Gambling Linked To Mental Health Problems Among College Students
- Hospitals Say They Found A Tool To Help Reduce Childbirth Risks: Wristbands
- Listen to the Latest ‘KFF Health News Minute’
- Readers Speak Out on Work Requirements, Federal Data Grab, Opioid Payback Cash
- People With Disabilities Say Medicaid’s Limits on Income Stifle Career Advancement
- FDA Wants More Information From Food Makers On New Food Chemicals
- Aspirin/Omega-3 Combo Matches Antibiotics In Treating Gum Disease, Trial Finds
- Endometriosis Linked To Higher Type 2 Diabetes Risk
- Beyond Compliance: Rethinking No Surprises Act strategy
- Tamiflu Helps Keep Severely Ill Kids Out Of The ICU, Study Finds
- 'Normal' Can Backfire During Doctor/Patient Discussions
- Experimental Pulse Oximeter Accurate Regardless Of Skin Tone, Researchers Say
- Patients Wary Of Governments, Companies Pushing AI As A Rural Healthcare Solution
- Executive Order Calls For Fewer Routine Childhood Vaccines, Doctors Push Back
- Real-World Performance Of Alzheimer's Drug, Leqembi, Matches Trial Data, Study Finds
- Study Finds Undisclosed Chemicals In Most Personal Care Products
- Chairman Paul S. Atkins Letter to Robert Walley, Chair, CAT NMS Plan Operating Committee
- What 524B and QMSR Change About Medical Device Risk
- Taking Lean Manufacturing to the Next Level
- Why Few MedTech Sales Teams Are Using AI Where It Matters Most
- Why Organizations Miss Emerging Product Risk: Understanding the engineering mechanisms that remain hidden long before complaint trends become visible
- Update on the SEC’s Work Toward Treasury Clearing Implementation [August 2026]
- The Interface is the Risk: A MedTech Blueprint for AI and System Integration
- Restoring Regulatory Clarity: Statement on Technical Amendments to Rule 0‑1(a)(7)
- Beyond the Status Report: Using LLMs to Reveal the True State of SaMD Development
Michigan healthcare freedom community forum
This is the first Kratom hearing posted in the MHF Forum. Worldwide its legal status varies so much, the World Population Review has mapped it.
You probably haven't heard of it if you're not a chronic pain patient or working in ER or law enforcement, so I'll add more background below.
I've emphasized the Kratom bill in bold. Italicized bills have more information in a previous thread.
Thursday, October 30, 2025 9:00 AM
AGENDA
HB 4745 (Rep. Woolford)
Businesses: charitable organizations; exemptions from registration and reporting requirements; modify.HB 4692 (Rep. Rigas)
Occupations: cosmetologists; branch facilities for a school of cosmetology; provide for.HB 4693 (Rep. Liberati)
Occupations: cosmetologists; cosmetology licensing fees; modify.HB 4254 (Rep. Aragona)
Animals: care and treatment; conducting of research or training activities on dogs in a manner that causes pain or distress; prohibit.HB 4969 (Rep. Cavitt)
Food: other; regulation of distribution, sale, and manufacturing of kratom products; provide for.HB 4963 (Rep. Aragona)
Marihuana: other; marihuana licensees; require to pay for marihuana at the time of sale.Presentation from Lume.
OR ANY BUSINESS PROPERLY BEFORE THIS COMMITTEE
Within the chronic pain community, the constant refrain since government's war on opioid prescribers is difficulty finding adequate pain control by legal means. Kratom is one of the very few options available. I've never needed Kratom myself, or heard of widespread abuse of it, so I weigh in on the side of freedom and personal responsibility.
https://www.health.harvard.edu/blog/kratom-fear-worthy-foliage-or-beneficial-botanical-2019080717466
Kratom: Fear-worthy foliage or beneficial botanical?
September 9, 2024Depending on what you read, the botanical herb kratom is a dangerous, addictive drug with no medical utility and severe side effects — including overdose and potentially death — or it is an accessible pathway out of chronic pain and opiate withdrawal. How can the US Drug Enforcement Agency (DEA), medical professionals, and millions of regular kratom users have such divergent views of the same plant? How can we get on the same page?
What is kratom?
Kratom (Mitragyna speciosa) is a tropical tree from the coffee family native to Southeast Asia, with properties that range from stimulant-like, energizing and uplifting, to opioid-like, causing drowsiness and euphoria. Kratom has dozens of active components, which makes it difficult to characterize as one particular type of drug, such as stimulant or opioid. The two main chemicals, mitragynine and 7-hydroxymitragynine, have activity at the main opioid receptor, the "mu" receptor, which is the same one stimulated by heroin and oxycodone.Kratom is thought to be used by as many as two million to 15 million Americans, many of them using it successfully to help alleviate undertreated chronic pain, or to help as a harm reduction method with symptoms of opioid withdrawal. Kratom is commonly consumed orally (with added sweetener to overcome its harsh bitterness), made into tea, or swallowed as a pill.
There are much more concentrated and potent kratom products on the market than there used to be, which increases the potential harms. Side effects can include agitation, tachycardia, drowsiness, vomiting, and confusion. There can also be grave side effects such as seizures, as well as respiratory suppression and cardiac arrhythmia.
Kratom can be found in gas stations and paraphernalia shops in most parts of the US, except in the handful of states and cities that have banned it. Many people purchase kratom over the Internet, where it is sold "for soap-making and aromatherapy" to avoid the fact that in 2014 the FDA made it illegal to import or manufacture kratom as a dietary supplement. None of these avenues of procurement — or these products — are regulated at all.
What are some of the problems with kratom?
There is little to no control or reliable information on the growth, processing, packaging, or labeling of the kratom sold in the US, which adds to the already considerable uncertainty of its health risks. In 2018 the FDA instituted a mandatory recall over concerns about Salmonella contamination of kratom-containing products. The DEA has recently placed kratom on its Drugs and Chemicals of Concern list, but has not yet labeled it as a controlled substance, and currently does not seem as if they are planning to restrict it on a federal level.Kratom can be addictive due to its opioid-like qualities. According to one study, 12.3% of kratom users qualified as addicted. A small minority of people addicted to kratom require treatments for opioid use disorder, such as with suboxone (buprenorphine). Others have characterized kratom addiction as comparable to caffeine addiction (and, yes, there are bad outcomes to caffeine addiction as well, such as insomnia, gastritis, and arrhythmia.)
The CDC claims that between 2016 and 2017, there were 91 deaths due to kratom, but this claim should be greeted with skepticism, as all but seven of these casualties had other drugs in their system at the time of death, making it impossible to uniquely implicate kratom.
Why do people use kratom?
The DEA maintains that kratom has no medical uses or benefits, but in Asia kratom has been used for hundreds of years to treat cough, diarrhea, opioid withdrawal, and chronic pain, and to boost energy and sexual desire. More recently, in the US there has been an uptick in the use of kratom by people who are self-treating chronic pain and acute withdrawal from opiates. They are seeking a safer and more accessible alternative to prescription medications.One could argue that this is quite important given how inadequate our current medical system is for treating both of these conditions. Despite a vocal community of supporters, and numerous anecdotal testimonials of effectiveness, these treatment practices using kratom have not been rigorously studied as either safe or effective.
A patient wishing to use kratom for pain or to mitigate withdrawal symptoms would encounter several problems, not all of which have to do with the intrinsic properties of kratom itself.
While kratom is not currently scheduled under the Controlled Substance Act, the DEA periodically threatens to make it a Schedule 1 controlled substance, in the same category as heroin or methamphetamine. This would make it difficult to access, and would likely make the supply as a whole even more dangerous. Given how many kratom users there are, and given the potential benefit it offers, it seems unlikely that the federal government will aggressively move against kratom, but several jurisdictions have banned it.
The complete lack of oversight or quality control — the wholesale lack of regulation — in the production and sale of kratom makes its use more dangerous, especially as increasingly concentrated products appear on the market.
Kratom has not been well studied for any of the uses its proponents claim, though as the saying goes, "absence of evidence of benefit isn't evidence of absence of benefit."
A final problem is that kratom doesn't show up on drug screens, and one can argue that the wider adaptation of another potentially addictive opioid-like substance, in the midst of an opioid epidemic with tens of thousands dying each year, is the last thing we need.Is there a sensible path forward with kratom?
I'm not sure that anyone has the answer to this question, as there are so many different perspectives, concerns, and interests surrounding kratom. At bare minimum, safety could be improved with:Regulation: It would be safer if people knew the exact dosages they were consuming and that it was free of contamination. Ideally, the super-concentrated products could be reined in.
Education: Educated consumers, who know the dangers and potential benefits, are far less vulnerable to misleading claims.
Research: If kratom does have benefits for either addiction or chronic pain, we should be able to demonstrate this. It is critical that we better define the risks of using kratom, so that people can make informed choices.
If all of the above could somehow be accomplished by scientists and public health specialists, without overdue distortion from corporate interests, antidrug ideology, and romanticism by kratom enthusiasts, we could then have enough clarity to answer the questions: is kratom helpful, and how can we best use it to improve health?Dr. Peter Grinspoon is a primary care physician, educator, and cannabis specialist at Massachusetts General Hospital; an instructor at Harvard Medical School; and a certified health and wellness coach. He is the author of Seeing Through the Smoke: A Cannabis Specialist Untangles the Truth About Marijuana, as well as the groundbreaking memoir Free Refills: A Doctor Confronts His Addiction. He is a board member of the advocacy group Doctors for Cannabis Regulation. He is also a TedX speaker and commonly lectures on the topics of cannabis, psychedelics, addiction, opioids, and physician health.
Today's original agenda was revised to add mobile barber licensing, first heard last week.
Thursday, November 13, 2025 9:00 AM
AGENDA
HB 4969 (Rep. Cavitt)
Food: other; regulation of distribution, sale, and manufacturing of kratom products; provide for.HB 4501 (Rep. Mueller)
Marihuana: other; cannabis regulatory agency; allow to operate a marihuana reference laboratory and to collect, transport, possess, test, and perform research with marihuana.HB 4678 (Rep. Aragona)
Agriculture: weights and measures; certain definitions; provide for.HB 4679 (Rep. Liberati)
Agriculture: weights and measures; certain definitions; provide for.HB 5060 (Rep. Pavlov)
Occupations: individual licensing and registration; licensing of bouncers; provide for.HB 5061 (Rep. Pavlov)
Liquor: licenses; positional asphyxiation prevention training for bouncers; require.HB 4388 (Rep. Tisdel)
Trade: business practices; regulation of social media use by minors; provide for.HB 4911 (Rep. Schmaltz)
Occupations: barbers; mobile barber shops; allow.OR ANY BUSINESS PROPERLY BEFORE THIS COMMITTEE
House Regulatory Reform has received HB 5537, a new bill to ban kratom:
https://www.wlns.com/capital-rundown/new-bill-would-ban-growing-selling-kratom-in-michigan/
https://www.dea.gov/sites/default/files/2020-06/Kratom-2020_0.pdf
https://www.legislature.mi.gov/Bills/Bill?ObjectName=2026-HB-5537
New bill would ban growing, selling kratom in Michigan
By Sean Graney - March 17, 2026LANSING, Mich. (WLNS) — Health care workers and lawmakers raised red flags at the State Capitol Tuesday about a drug they say is too easy to get and too dangerous to ignore.
A new bill would make kratom, a plant-based drug, illegal to sell and grow in the state of Michigan.
The U.S., Department of Justice classifies kratom as a tropical tree that could cause psychotic symptoms and result in psychological dependence. House Bill 5537 would ban a potent derivative of kratom, 7-OH, a chemical that stimulates the brain’s opioid receptors.
The drug can be used to manage pain, but doctors say it can cause opioid-like symptoms and death.
Roger Maufort owns the Seed Cellar dispensary in Jackson and says while he understands the health concerns, he believes this bill challenges the freedoms of Michiganders.
“So, I don’t feel that kratom should be taken out of the realm of food grade and manufacturing process and let people use it as they wish,” Maufort said.
State Rep. Cameron Cavitt (R-Cheboygan), who introduced the bill last September, says without a ban, Michigan could become a pipeline for kratom into neighboring states.
“We’re the only Great Lakes state right now that doesn’t have a ban. And especially in the state of Wisconsin, we’re seeing a lot of folks come in and buy bulk kratom and bring it back into Wisconsin,” Cavitt said. “So, we don’t want to be a supplier for the rest of the Great Lakes.”
The consequences are severe. If signed into law, penalties include jail time and fines.
Cavitt says kratom is showing up largely among younger Michiganders and the criminal justice system.
“You’re seeing children get into the criminal justice system because they’re shoplifting this product. And they’re entering our rehabs and it’s just, we got 12 year olds who are hooked on heroin. It’s gas station heroin,” Cavitt said.
Maufort argues this moment isn’t just about safety — it’s about control and revenue.
“It’s not about patient safety, people safety. It is about revenue for the state, and that’s a concern of mine,” Maufort said.
As of now, a date for the House Committee on Regulatory Reform to hear the bill has not been set.
This month's MDHHS Public Health Bulletin for Health Care Providers is all about kratom:
7-Hydroxymitragynine (7-OH)-Enhanced kratom products: What providers need to know
Public Health Bulletin for Health Care Providers - March 2026
Dear colleagues,
We want to bring to your attention the rise of "synthetic kratom" and concentrated 7-hydroxymitragynine (7-OH) products (or 7-OH-enhanced kratom products) in Michigan’s unregulated market, and the ongoing public health impacts.
While kratom (mitragyna speciosa) is a Southeast Asian tree known for mild stimulant effects from mitragynine and trace amounts of 7-OH, modern products carrying the "kratom" label are often unregulated, significantly more potent – containing added concentrations of 7-OH – and dangerous. These high-potency products, or 7-OH-enhanced products, are rapidly displacing traditional kratom leaf-products on retail shelves, creating a false sense of safety for consumers and increasing public health risks.
We continue to see calls to the Michigan Poison and Drug Information Center (MiPDC) related to exposures from kratom-labeled products, including cases involving adverse interactions, polysubstance use and concerns about severe symptoms. These calls often involve concentrated products containing 7-OH or situations where labeled kratom products were used alongside other substances. According to the MiPDC, in 2025, 7-OH-enhanced kratom product exposures demonstrated higher risk of overdose, higher withdrawal burden, more frequent buprenorphine recommendation/administration and higher ICU utilization. This suggests that rapid market penetration of the highly potent 7-OH-enhanced kratom products is associated with greater health care utilization and withdrawal severity.
While the annual number of reported exposures has fluctuated over time, cases increased in 2025. Adults ages 20-39 accounted for the highest number of reported kratom-related exposures to the MiPDC, however, exposures were reported across all age groups, including 69 cases involving children.
Kratom’s primary psychoactive alkaloids, mitragynine and 7-OH, bind to opioid receptors. At lower doses, these products may produce stimulant-like effects. At higher doses, concentrated 7-OH products have more potent opioid-like effects. While kratom products are not approved by the Food and Drug Administration for medical use, people report using kratom to self-manage pain, anxiety, fatigue or symptoms related to opioid withdrawal. However, regular use of 7-OH-enhanced kratom products can lead to dependence and withdrawal, overdoses resulting in seizure, other serious health events and even death. Severe events are often in relation to polysubstance use, used in combination with opioids, benzodiazepines, alcohol or other depressants.
Kratom and 7-OH products are widely available in gas stations, smoke shops, convenience stores and online marketplaces, often marketed as natural, herbal and/or legal. A commercial product’s potency and composition can vary significantly. Some products, particularly extracts or “enhanced” formulations, may contain higher concentrations of 7-OH, which binds more strongly to opioid receptors and is substantially more potent than traditional leaf kratom products that people may be more familiar with.
The continued reports underscore the importance of provider awareness and clinical recognition. We hope this bulletin serves as a reference for understanding health risks, drug interactions and clinical considerations to support screening, counseling and care for patients who may be using 7-OH-enhanced kratom products. Thank you for your continued commitment to protecting the health and safety of Michigan residents.
Sincerely,
Natasha Bagdasarian, MD, MPH, FIDSA, FACP
Chief Medical Executive, State of MichiganSarah Lyon Callo, MS, PhD
Senior Deputy Director and State Epidemiologist, MDHHS Public Health Administration
Recognizing 7-OH-enhanced kratom products
7-OH-enhanced kratom products are often not immediately recognized by patients or clinicians as substances of concern, particularly because they are marketed as supplements, wellness products or energy boosters.
They are sold in a wide range of product types that may resemble common supplements or beverages, including powders and capsules.
- Teas and energy or "wellness" drinks.
- Gummies and candies.
- Concentrated liquid shots or extracts.
Some of these products are packaged similarly to energy shots, herbal supplements or flavored beverages, which can make them easy to overlook during screening or medication reconciliation. Patients may use the term “kratom” or may refer to these 7-OH-enhanced kratom products by strain names: Maeng Da, Bali, Borneo, Indo, Red, White or Green Kratom. Increasing provider familiarity with how these products appear and are labeled may support earlier identification and more accurate clinical assessment
Health risks and clinical considerations
Regular use of 7-OH-enhanced kratom products has been shown to lead to physical dependence and reported withdrawal symptoms, such as:
- Anxiety, irritability and restlessness.
- Insomnia and fatigue.
- Gastrointestinal distress.
- Muscle aches, chills and runny nose.
Patients may increase dose or frequency to avoid withdrawal symptoms.
7-OH-enhanced kratom products can interfere with how the body processes many prescription medications. Because of this, people who use these products may experience stronger-than-expected side effects from their medications. This is particularly important for:
- Certain antidepressants and antipsychotics.
- Medications for anxiety or sleep, especially benzodiazepines.
- Some heart medications.
- Medications for pain.
- Any drug where small changes in dose can have a big effect.
Sedation and overdose risk may increase if 7-OH-enhanced kratom products are used with opioids, especially when combined with alcohol or benzodiazepines. Serious adverse events can occur, including:
- Seizures.
- Agitation, hallucinations and mood changes.
- Increased heart rate, hypertension or other cardiac symptoms.
What this means for clinicians
Because 7-OH-enhanced kratom products are unregulated in Michigan, product labels may not accurately reflect contents or potency. Some products have been found to contain varied or unexpectedly high alkaloid concentrations, heavy metals and stimulants or opioid-like substances. Effects can be unpredictable, particularly with concentrated products or when combined with alcohol, opioids, benzodiazepines or other sedating medications.
MDHHS encourages health care providers to incorporate 7-OH-enhanced kratom products into routine substance use assessment and clinical care:
- Screen routinely: Ask patients about use of 7-OH-enhanced kratom products, including teas, powders, capsules, liquid shots or gummies.
- Assess risk: Document frequency, product type, dose (if known) and co-use with other substances.
- Monitor for adverse effects: Be alert for sedations, agitation, seizures, gastrointestinal symptoms or withdrawal.
- Prevent overdose: Counsel patients on the heightened risk of combining 7-OH-enhanced kratom products with opioids, alcohol and sedatives. Ensure naloxone access when possible. Naloxone can be effective with 7-OH-enhanced kratom products, but because of the unregulated nature of these products and the exact 7-OH concentrations are unknown, there is no guarantee the naloxone will be effective.
- Educate patients: Explain that 7-OH-enhanced kratom products are unregulated in Michigan, meaning potency and contents may not match labeling.
- Support reduction or discontinuation: Use nonjudgmental, patient-centered approaches. Provide symptomatic support and referrals to behavioral health or addiction medicine services when appropriate.
Providers should remain alert to clusters of adverse events potentially linked to 7-OH-enhanved kratom products or specific products. Unusual patterns may be reported through appropriate clinical and public health channels, including MiPDC and local health departments.
Additional Resources
Kratom Education
Data and Surveillance
- DOSE Dashboard: Nonfatal Overdose Emergency Department and Inpatient Hospitalization Discharge Data.
Provider and Partner Tools
Get MHF Insights
News and tips for your healthcare freedom.
We never spam you. One-step unsubscribe.























