02/14/2026
Fruit flavoring. Colorful packaging.
Available in convenience stores, gas stations, and smoke shops across most states.
No restrictions on who can buy or sell them.
Marketed as "natural" stimulants and energy boosters, related to kratom, a plant from south Asia.
But these products contain lab-made 7-OH, a powerful opioid, in much higher concentrations than is found in kratom leaves. So they can rapidly lead to increased use, , and even overdoses.
Legal loopholes mean they're not regulated in most places, though policymakers have started to make efforts.
But our addiction treatment specialists are treating more and more people for 7-OH addiction, in what they are calling the "third wave" of the opioid epidemic.
Fortunately, the same medications used to treat other opioid use disorders, and to immediately reverse overdoses, also work on 7-OH.
Read one patient's story, and to learn more from U-M experts: https://michmed.org/MDB2g
Our experts also offer free online training for health care providers who want to get up to speed on understanding this issue, and prescribing medication to treat opioid use disorder including in patients who use 7-OH products. See the links in the story.
