With exposures precipitously higher than in preceding years, the Texas Department of State Health Services (DSHS) is urging people not to use products containing an opioid-like chemical found in the kratom plant and providing clinical guidance, including administration of naloxone for reversal of respiratory depression.
Unsynthesized kratom products typically contain a low concentration of 7-hydroxymitragynine (7-OH), or less than 2% total content. But higher 7-OH concentrations of up to 98% in semi-synthetic or synthetic kratom products can cause significant health problems and may have the potential for dependence or abuse.
Kratom and 7-OH products are marketed as natural remedies for pain, anxiety, and to ease opioid withdrawal. In testimony in support of Senate Bill 1868, filed during the 2025 regular legislative session to prohibit kratom and other hallucinogenic substances, the Texas Medical Association delineated kratom’s known risks, including liver toxicity, seizures, and substance use disorders.
“Despite kratom not being FDA-approved, an estimated 1.7 million Americans aged 12 and older used kratom in 2021,” TMA wrote. “Though the health effects of kratom still need to be further researched, studies so far have also shown risks of addiction and potential long-lasting cognitive and behavioral deficits among adolescents.”
Despite TMA’s advocacy in support of SB 1868, the bill didn’t make it out of the House public health committee.
As of Aug. 27, the Texas Poison Center Network had received 192 reports of exposures involving kratom or another product containing 7-OH this year, versus 107 exposures in all of 2024 and 122 in all of 2023.
Of the calls related to kratom or 7-OH, about 10% have involved exposure to concentrated 7-OH products, which are sold at gas stations, smoke shops, and online as pills, gummies, candies, and imitation ice cream cones. Of the 19 patients reporting exposure to concentrated 7-OH products, 11 required treatment at a health care facility, DSHS reports in its health alert. The alert also details symptoms characteristic of 7-OH exposure.
DSHS recommendations for physicians are to:
- Provide general emergency and critical care medical support as warranted;
- Administer naloxone for reversal of respiratory depression;
- Observe and manage symptoms of opioid use disorder following use of kratom or 7-OH products; and
- Contact the Texas Poison Center Network at 1-800-222-1222 for any questions about medical management.
Jessica Ridge
Reporter, Division of Communications and Marketing
(512) 370-1395