The kratom industry is railing against 7-OH products as problematic, but are extra-strength kratom extracts problematic too?
The controversy surrounding the rise of new 7-hydroxymitragynine (7-OH) products has sparked a debate among various players in the kratom industry, as well as scientists and consumers.
A debate called “The 7-OH Fault Line” took place at the CHAMPS Trade Show in Las Vegas this past Friday, between Jeff Smith of Holistic Alternative Recovery Trust (HART), an advocacy organization sponsored in part by 7-OH vendors, and Mac Haddow of the American Kratom Association (AKA), an advocacy organization sponsored in part by vendors of highly concentrated kratom alkaloid extracts.
The AKA as well as the Global Kratom Coaltion (GKC) have come out against 7-OH products as potentially dangerous and highly addictive. They believe having these products on the market, especially the ones that label these products as “kratom”, will taint the industry as a whole. HART counters that while 7-OH dominant products have never been consumed before, 7-OH is a safe alkaloid because it’s naturally produced within the body as a metabolite of mitragynine. They blame “Big Kratom” for negatively focusing on 7-OH and confusing lawmakers who knee-jerk react by banning all kratom products. Each accuses the other of attempting to eliminate competing products off the market.
With the kratom industry attacking 7-OH, the question has arisen of whether highly concentrated extracts, though more representative of the spectrum of alkaloids present in natural leaf kratom, are themselves safe given the strong doses at which they are sold. The marketing of these products have come into question, as extremely strong extracts are often packaged in bottles similar to, and often stocked on gas station shelves alongside, caffeine products like 5-Hour Energy. It’s reasonable to assume that even if the bottles are labelled properly with appropriate warnings, the print is so small that many customers would not read it. Because of tactics like this, the kratom industry has been accused and even sued for marketing to naive consumers who have no idea of the risks of dependency or toxicity herb-drug interactions.
The two main kratom industry lobbying and advocacy organizations, AKA and GKC, both list as donors vendors of widely-distributed, highly-concentrated (very strong) extract products.
Scientists have been trying to sound the alarm that neither 7-OH nor strong extracts are very much like the traditional leaf kratom that has been used for at least centuries.
In a 2023 letter to the editor of the journal Addiction entitled “Not all kratom is equal: The important distinction between native leaf and extract products”, kratom experts, including Dr. Chris McCurdy, a medicinal chemist who has been studying kratom for two decades, state in very plain language their concerns with the dangers of the type of strong extracts that were on the market long before 7-OH products:
Recently, there is a growing and concerning commercial trend in Western countries towards the production and marketing of kratom extract products created via extraction of kratom leaves using organic solvents. This enrichment process can increase the mitragynine concentration to 40% or higher in such products. Of great concern from a public health perspective, commercial kratom extract products lack data regarding their safety, efficacy and abuse potential. In addition, the formulation of concentrated kratom extracts as capsules, tablets, liquid shots or gummies circumvents kratom’s natural self-limiting qualities (e.g. unpleasant taste) and reduces the volume of product needed to achieve an effect, thereby raising the risk of users ingesting larger amounts of alkaloids with potentially toxic effects.
Dr. McCurdy recently shared his views on the popular science podcast Huberman Lab on how strong extract products are causing problems:
It becomes a very, very slippery slope, in my opinion, with these different products that are out there in the marketplace. And so if someone is not paying attention to what the actual serving is supposed to be, then this is where problems come. I stopped at a Murphy USA gas station, Walmart’s gas station, and they had [kratom extract] shots right next to the 5-hour Energy shots. And so if you were in a hurry and you weren’t even paying attention, you might accidentally grab something that you thought was a 5-hour Energy shot, right?…I normally take two of those and…throw them right back. What we worry about is kids getting [extract shots] and then taking a whole bottle, which may be multiple servings, and they don’t feel anything right away, and somebody told them you’re going to get high from this. You can’t believe it, but you’ll get high from this thing you can buy in the gas station. And then they don’t feel anything and then suddenly they have another one, right? And then all of it gets absorbed and hits them harder, almost all at once.
You can think of it like if you sat down and you drank a light beer and you drank that 12-ounce beer in a short period of time. You could really drink it fast. You’re not going to get very much alcohol exposure because there’s only 3.5% [alcohol by volume] in that 12 ounces. But if you sit down and you do three shots of tequila in a row in that same time frame, your body is getting exposed to significantly more alcohol… And that’s what our concerns are around some of these products.
Multiple wrongful death and other lawsuits have been filed against makers of strong extract brands.
Scientists, including Dr. McCurdy, are also sounding the alarm about 7-OH products. In another letter to the editor of Addiction entitled “The rise of novel, semi-synthetic 7-hydroxymitragynine products“, Dr. Kirsten Smith, along with Dr. McCurdy and others write:
To date, 7-hydroxymitragynine product marketing fails to distinguish itself from kratom. Kratom-naïve consumers purchasing 7-hydroxymitragynine products may erroneously believe that they are relatively safe ‘natural’ products similar or identical to kratom products that have been used in the United States for at least two decades. Consumers of these novel products are unwittingly exposing themselves to high-dose, MOR-binding formulations that have never undergone human or animal testing. Apart from toxicity risks from acute exposure, chronic 7-hydroxymitragynine product use could result in opioid-like physical dependence and possibly addiction. Scale and severity may be distinct from kratom leaf-based and extract products, which have not produced widespread severe addiction, but rather mild–moderate physical dependence
The authors also point out a possible reason for HART’s claim that there have been no confirmed deaths due to 7-OH:
As forensic laboratories use mitragynine as a surrogate marker for kratom use, 7-hydroxymitragynine-related fatalities would incorrectly implicate kratom, as the presence of mitragynine in these products arises from incomplete conversion of mitragynine into 7-hydroxymitragynine.
At the debate, Dr. McCurdy refuted a correlation made by HART’s Jeff Smith showing a decrease in opioid overdose deaths in recent years, at the same time an increase in the consumption of 7-OH products occurred. Dr. McCurdy suggested the abundance of medical literature finds the rise in free distribution of Narcan, or naloxone, to be a key factor in the opioid death decrease.
In 2022, Dr. McCurdy told Kratom Science in an interview:
We should be finding leaf material that has no detectable levels of 7-hydroxymitragynine to start with, because, yeah, we believe that when it’s ingested into the body that the amount of 7-hydroxymitragynine that’s produced from mitragynine is sort of canceled out by the other alkaloids that are present, and that the pharmacological effect is not achievable that you see when you isolate 7-hydroxy by itself.
In the question/answer session following the “The 7-OH Fault Line” debate, Dr. McCurdy fielded a question from an audience member who asked a pointed question:
AUDIENCE MEMBER: With your opinion as a medical professional, would you say that a number of the different brands that are funders of the AKA that sell these extract kratom products that have unidentified mechanisms of action for these various alkaloids are essentially trying to do the exact same thing that 7OH is doing right now with unprecedented human trials, in your opinion, and they should go file an IND [Investigational New Drug application, filed with the FDA] for possible approval as a pharmaceutical]?
DR. MCCURDY: I mean I’ve said it here. I’ll say it again. I think the only product that should be in the marketplace is the
natural leaf. That’s my opinion.
IMPORTANT UPDATE
Tuesday, July 29: In a press conference, the Department of Health and Human Services and the Food and Drug Administration have announced plans to recommend 7-OH for scheduling as a controlled substance by the Drug Enforcement Administration. Please continue to follow Kratom Science for updates