Many Illinois residents have likely never heard of 7-OH, even though a federal official has warned that the substance — often sold in tablet, liquid and gummy form in vape shops and convenience stores — could drive the next wave of the opioid epidemic.
Now, a federal proposal that would ban 7-OH has sent Illinois business owners scrambling to clear it from their shelves, and led some addiction recovery providers to brace themselves for an influx of new patients if 7-OH products are no longer available.“We’ve seen a threefold increase in new patients due to 7-OH,” in recent weeks, said Dr. David Kushner, medical director at Brightside Recovery, a substance use disorder treatment provider headquartered in Northbrook. “It’s been dramatic.”
The compound 7-OH, short for 7-hydroxymitragynine, is found in very small amounts in the kratom plant. But in recent years, companies have started selling tablets, gummies and liquids containing artificially high concentrations of 7-OH, which acts like an opioid on the body.
Over the summer, the U.S. Drug Enforcement Administration proposed temporarily adding products containing elevated levels of 7-OH to its list of Schedule I substances — a designation reserved for drugs with no acceptable medical use and a high potential for abuse, such as LSD and heroin. The move would make 7-OH products illegal.
A comment period related to the proposed change ended Sept. 10, and it’s unclear if or when the change might be finalized. A DEA spokesperson said in a recent email that it’s “still in process, and we do not have anything to report in respect to a timeline.”
If the change goes into effect, an order could be issued placing 7-OH on Schedule I for up to two years, according to the U.S. Food and Drug Administration.
But Illinois businesses selling the product haven’t waited for a final decision to take action.
One Chicago-area vape shop owner, who asked not to be named for business reasons, said that after hearing about the impending ban, he put the products on clearance and had no more left within a few days.
Phil Atteberry, co-founder and executive vice president of Brightside, said he visited about 50 Chicago-area vape shops earlier this summer to make sure they knew about the potential change and to hand out Brightside’s cards in case patrons needed treatment.
“Almost all of them had stopped buying (7-OH) and had very little left,” Atteberry said.
He said the shop owners and workers were also receptive to handing out Brightside’s cards to customers who might need help.
Brightside and others have worried that the change will lead to many people going through withdrawal, including some who may not have realized 7-OH was addictive until they could no longer get it. They hope that when those people can no longer find 7-OH, they seek treatment rather than turn to other substances such as fentanyl.
Withdrawal symptoms after stopping 7-OH can include nausea, weakness, diarrhea, pain and depression, among other problems, Kushner said. He said it’s “kind of like the worst flu you’ve ever had.”
Withdrawal symptoms can last days or weeks.
“When people start getting sick, they will do anything to not get sick,” said Laura Fry, executive director and CEO of Live4Lali, an Arlington Heights-based group that works to reduce stigma, prevent harmful substance use and minimize harms associated with substance use. She said a hotline that Live4Lali helped establish with the village of Arlington Heights and Brightside saw the number of calls from people struggling with 7-OH rise over the summer.
Users of 7-OH come from all walks of life, including people who didn’t realize it was an opioid when they started taking it, said Dr. Puneet Lakhmani, medical director for Rosecrance Therapies, which has locations throughout the Midwest.
“It’s drastically expanded the availability of opioids to people who were not planning on using opioids, and had they had better education would not have gone down that pathway,” Lakhmani said.
He said he’s seen an uptick in patients interested in being treated for 7-OH addiction as it becomes less available, and he expects to see even more if it becomes illegal and disappears entirely.
Many 7-OH users originally turned to the substance as an alternative to other types of opioids, said Jim Scarpace, community division president at Alpharus Health, a substance use and mental health treatment provider formerly called Gateway Foundation. Scarpace suspects that when people can no longer get 7-OH, they might return to using other kinds of opioids they previously used.
Alpharus has already seen patients who said they tried 7-OH but ultimately switched to a different substance because they experienced problems such as seizures and memory loss with 7-OH, Scarpace said.
“You’re seeing people with opioid use disorder say, ‘Hey, maybe I can turn to this instead of heroin or instead of prescription opiates or fentanyl and I’ll get the same desired effects,’ because they’re struggling with a disorder and they’re really trying to feed an addiction,” Scarpace said. “The accessibility of this substance in the tobacco shops has made it easier to get, but unfortunately, the problem is the damage it causes is substantial.”
Ryan, in the Chicago suburbs, knows all too well the toll 7-OH can take. Ryan asked that his full name not be used to protect his and his family’s privacy.
He said he was prescribed Vicodin after he injured his back at work two decades ago and ultimately became addicted to the painkiller. After several years, he went to an inpatient treatment program and was able to stop taking Vicodin. A few years later, Ryan, still in pain but unwilling to go back on a prescription opioid, began taking kratom.
Ryan had been taking kratom on and off for about a decade when the local shop where he bought it introduced him to 7-OH. He said he was given free samples and was told it was a more cost-effective variant of kratom.
“Next thing you know, I tried to stop it and I couldn’t, and I found myself needing more and more of the product in order to get the same base effect,” Ryan said.
He said he tried to quit as many as 10 times, but struggled with withdrawal symptoms. “You will spend literally 14 days wide awake,” he said. “You cannot eat. You cannot sleep. You cannot function. … It is the absolute worst hell you can imagine going through.”
Ultimately, he said he drained his savings paying for 7-OH. He continued taking 7-OH until his wife gave him an ultimatum — he needed to quit or he wouldn’t be allowed to come home. He checked himself into a 10-day inpatient rehab program, and then started going to Brightside, where he began receiving medication to help him stay off 7-OH. He’s now been sober for about three months.
“I definitely don’t think it should be sold at our local retail establishments between the 5-Hour Energy and a pack of bubble gum,” Ryan said. “That is absolutely not the place for this type of product. It’s a very dangerous product to have out there.”
It may be difficult in coming months to reach people who may be affected by a 7-OH ban, said Maryann Mason, a professor of emergency medicine at Northwestern Medicine Feinberg School of Medicine and principal investigator for Illinois’ Statewide Unintentional Drug Overdose Reporting System.
“It’s just so much harder with these over-the-counter substances because there is no record of who’s using them and how to outreach to them,” Mason said. “It can be kind of complicated and messy for people. And people may not even be aware they’ve become dependent on it or will experience withdrawal.”
Though the state’s unintentional drug overdose reporting system doesn’t track overdoses due to 7-OH specifically, between 2019 and 2024, Illinois had 380 unintentional overdose deaths that involved the active ingredient in kratom — a category that would also include any deaths involving 7-OH.
Some are speaking out against the proposed federal change, saying they’d like to see the substanc