Cracking Down On This Opioid Alternative Is The Wrong Move

The Food and Drug Administration (FDA) wants to classify “gas station heroin” as a Schedule I substance. 7-OH, the synthetic derivative of kratom, a leaf from Indonesia that’s a safer substitute for opioids, would be put on a par with hard drugs like heroin, fentanyl and bath salts. It would make possession of 7-OH products strictly illegal, with potential years-long prison sentences and hefty, several-thousand-dollar fines.

In reality, kratom is a safe, plant-based option for pain relief. It is a prominent alternative to traditional opioids and can help prevent addiction relapse. While the substance still requires additional studies and FDA-defined standards for dosage and prescription protocols, it represents a major improvement over the side effects of prescription painkillers and can help those with chronic pain ease off of those stronger substances.

When used appropriately, kratom poses minimal risk, with no confirmed fatal outcomes and far fewer adverse effects than many legal, regulated substances. Media reports of kratom-related deaths often involve unregulated, tampered-with synthetic derivatives. That’s precisely the problem with state bans and Schedule I classification. Making 7-OH illegal will only drive its sale and consumption underground, with the green-powdered pill hidden among “supergreens” and seaweed supplements in small-town stores and black markets.

By contrast, if approved for medical use, kratom could be regulated with clear guidelines for access and pharmaceutical formulations. While traditional opioids account for more than 100,000 deaths annually, kratom has zero recorded deaths — despite an estimated 500 million doses consumed.

The FDA shouldn’t get in the way of people trying to seek alternatives to traditional treatment. Research shows more than a quarter of the million of Americans who use the substance do so to replace dangerous opioids, with another 10% using them to block withdrawal symptoms.

Meet Zak Greene, a web designer in New York City. Greene was born with club foot, a medical condition under which one foot is painfully inverted. After early childhood interventions and surgery in his 20s, he continued to endure chronic foot pain while doctors refused to prescribe him hydrocodone — one of America’s most popular opioids. As a result, Greene turned to kratom for relief after learning about it from the podcast Street Fight Radio in 2017.

“Opioids are the only thing that’s ever worked for my foot,” Greene said, acknowledging both their effectiveness for pain relief and the potential risk of addiction or even death, especially when obtained illegally. Still, he needed relief. “I was waking up at five in the morning because of the pain,” he said. “I needed a pill.”

A millennial who’s witnessed the fallout of widespread prescription painkiller abuse, Greene is hyper aware of the potential for addiction. His prior use of opioids only came in times of extreme pain, exercising an abundance of restraint and responsibility around them.

For him, kratom offers a level of self control over dosage, and at a cheap price: $20 for a 100g bag from Indonesia. He finds kratom powder, mixed into a cup of coffee, to be overall a much milder pain reliever. Starting around 2018, Greene began taking two grams of the supplement twice a day. In the past few months he has tapered his use to once every few days. He’s experienced no negative health effects from kratom ever, aside from addictiveness that made him decide to reduce his dosage, a process he says was difficult but not impossible. He says he experienced some withdrawal symptoms, like irritability and “anxiety that didn’t feel like it came from anywhere.”

While Greene says he’s never used the 7-OH compound in isolation (far more potent than ground kratom), and he doesn’t plan to, because he’s seen how it can be abused, the compound is still present in his powdered kratom and could still be subject to regulation.

Criminalizing 7-OH might seriously hurt people like Greene. It would also undermine recent gains in combating opioid overdoses. Potent and widely-abused opioids such as OxyContin and fentanyl remain not only legal, but widely prescribed by US doctors. This continues despite the oftentimes fatal respiratory depression they cause, a side effect not found with kratom.

Opioid overdose rate peaked in 2022, with two-thirds of cases involving synthetic opioids like fentanyl — often 50 times stronger than heroin. But the tide is beginning to turn as natural options like kratom and other non-opioid alternatives gain popularity and the Trump administration takes decisive action against the cartels.

The federal move to ban 7-OH has some state precedent, with states like Florida restricting the compound, and others banning it outright. These actions largely as a result of the statements made against 7-OH by current leadership of the Food and Drug Administration. The knives are out for kratom.

Yet every person who switches from fentanyl to regulated 7-OH options represents a life potentially saved. And states banning kratom have seen higher opioid overdose mortality as people turned to far more dangerous substances. Ending the opioid crisis is a hallmark of the Trump administration’s agenda. Going after kratom products runs in direct contradiction to that goal.

Rather than engaging in a reasonable scientific exploration of how this natural substance can be safely used for pain relief, politicians rush to judgement. It is true 7-OH is a potent derivative of kratom and comes from in many forms, including synthetic products potentially laced with other more dangerous substances. Users of natural kratom, which often contains less than a hundredth of a percent 7-OH, stand out from those “lined up outside smokeshops,” as Greene shared.

Legislation to establish a regulatory framework could set clear standards for appropriate age of use, product testing and labeling, manufacturing quality control and more. Other efforts by the FDA to target products misleading consumers about their contaminants or falsely advertising them as natural kratom supplements are fair.

But efforts to designate 7-OH as a Schedule I product would put American lives and livelihoods at risk. Letting Americans’ explore options including safe, natural remedies like kratom is essential to sustaining recent progress in reducing opioid harm. Legitimate safety concerns, namely with synthetic forms and potency, can and should be addressed through public policy without criminalizing an entire industry or denying patients the right to explore new treatments.

Putting a natural ingredient like this one on Schedule 1 is wrong on the science and won’t help people. Doing so is a grave mistake and ultimately will make America poorer and sicker. Instead, we need a pathway to better pain management in America through clearly-written laws and consumer-centred policy.

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