Health Dept. warns of increase in withdrawal patients from planned 7-OH rescheduling
The Pennsylvania Department of Health is alerting healthcare providers to a likely increase in patients suffering from opioid withdrawal symptoms after a currently legal substance is rescheduled, which could happen as soon as Nov. 13.
The Drug Enforcement Agency intends to reschedule 7-hydroxymitragynine (7-OH), its related substances MGM-15 and MGM-16, and tianeptine as Schedule I controlled substances.
The health department said 7-OH and its related substances have a similar effect to opioids and are found in leaves of the kratom tree. Kratom and 7-OH are commonly sold at vape shops and convenience stores. Their availability may have misled customers to believe the products were safe, according to the department.
The department said 7-OH naturally occurs in kratom in very small amounts. However, the danger lies in concentrated and synthetic 7-OH derivatives sold as tablets, gummies and drink mixes.
Beyond the dangers of using the concentrated products readily-available in gas stations and other retail stores, rescheduling could create an increased risk of overdose as people seeking the substance turn to street supplies or other illicit substances.
Groups who commonly use the substances for pain management and those who do not identify as having a substance use disorder may be at heightened risk for negative health outcomes and difficulty assessing care, the health department said. Buprenorphine and methadone, which are used to treat opioid use disorder, are also commonly used to treat 7-OH withdrawal.
“Our clinicians have experience successfully treating withdrawal from these substances using approaches similar to those used for opioid withdrawal,” said Michael Lynch, a UPMC emergency medicine physician.
“Our focus is on education, awareness and preparation, as well as adapting existing treatment protocols,” Lynch said.
Current overdose death data does not distinguish between natural kratom and synthetic 7-OH, but some labs have started testing specifically for 7-OH and related substances.
Through July, 7-OH contributed to 17 overdose deaths in the state in 2026, according to health department data. It contributed to 33 deaths in 2025, 38 in 2024 and 65 in 2023.
Pennsylvania poison control centers have recorded 284 cases of kratom exposure and 66 cases of 7-OH exposure between 2022 and June 30, 2026. Of those cases, 156 reported significant illness, 38 required Narcan and 26 needed to be put on a ventilator.
A representative from the West Virginia University Health System declined to comment.
