Kratom, derived from the leaves of Mitragyna speciosa, a tropical evergreen tree native to Southeast Asia, has traditionally been used in countries like Thailand and Malaysia. Its leaves were typically chewed or brewed into drinks. However, its increasing availability and the proliferation of highly concentrated derivatives in the United States have become a significant concern for health and law enforcement officials.
The Rise of 'Gas Station Heroin'
While kratom has been marketed in the US for various purposes, including pain relief, relaxation, and managing opioid withdrawal symptoms, the US Food and Drug Administration (FDA) has not approved it for any medical use. The controversy has intensified around a potent compound found in kratom, 7-hydroxymitragynine (7-OH).
Officials and local authorities have increasingly used the colloquial phrase “gas station heroin” to describe highly concentrated 7-OH products. These are distinct from ordinary dried kratom leaves, where 7-OH occurs in relatively small, natural amounts. Concerns stem from commercial products where 7-OH is concentrated or added at elevated levels, often sold as tablets, capsules, gummies, powders, liquid shots, and dissolvable strips in convenience stores, gas stations, smoke shops, and online.
Federal Action and Health Risks
The FDA has warned consumers to avoid concentrated 7-OH products, describing them as potent opioid-like substances. The issue escalated to federal action in July 2026, when the Drug Enforcement Administration (DEA) initiated a process to temporarily place 7-OH above a specified threshold, along with three related synthetic compounds, into Schedule I of the Controlled Substances Act. This action specifically targets concentrated or synthetic products, distinguishing them from botanical kratom with naturally occurring 7-OH below the threshold.
The risks associated with kratom use extend beyond 7-OH. The FDA has linked kratom to serious adverse events, including liver toxicity, seizures, and substance-use disorder. Reports of withdrawal symptoms and physical dependence are also common. Furthermore, some kratom products have been found to contain contaminants such as Salmonella or concerning levels of heavy metals.
CDC Data Highlights Growing Safety Problem
A March 2026 CDC analysis revealed 14,449 kratom exposure reports to US poison centers between 2015 and 2025, a dramatic increase from 258 in 2015 to 3,434 in 2025. The CDC recorded 233 deaths associated with kratom exposures during this period. However, 79% (184 deaths) involved multiple substances, with opioids present in 62% of those fatalities, alongside benzodiazepines, stimulants, and alcohol. This data underscores a growing safety problem but does not definitively establish kratom as the sole cause of every reported death.
Why 7-OH is a Particular Concern
Scientists and regulators are increasingly differentiating ordinary kratom from highly concentrated 7-OH products. The FDA notes that 7-OH binds to opioid receptors with greater potency than mitragynine, exposing consumers to levels far exceeding those found naturally. Currently, no 7-OH products are FDA-approved, and their safety and effectiveness for claimed uses like pain or anxiety relief remain unproven. Addiction, withdrawal symptoms, seizures, gastrointestinal problems, anxiety, and depression are among the concerns highlighted by the FDA regarding 7-OH products.
Fragmented Regulation and Evolving Market
The widespread availability of kratom is partly due to a regulatory gap. Kratom products often resemble ordinary consumer goods, sold as herbal supplements, teas, powders, gummies, or “shots.” Regulation varies significantly across the US; some states have banned kratom or specific compounds, while others have introduced age restrictions, manufacturing standards, labeling requirements, or limits on 7-OH concentrations. This fragmented landscape makes monitoring a rapidly evolving market challenging.
For officials, the primary concern is shifting from traditional plant preparations to high-potency, concentrated, and chemically modified products entering the consumer market. Federal regulators are working to keep pace with an industry that appears to evolve faster than conventional drug-safety oversight.