Officials warn the next opioid epidemic could come from substance sold at vape shops for less $10

Public health experts and officials have trained their sights on a new vape shop staple they fear could spur the next wave of the opioid epidemic.

Department of Health and Human Services made a formal proposal to the DEA to classify 7-OH, a component of the pain reliever kratom, as a Schedule 1 substance, alongside heroin, LSD, and other drugs with no accepted medical use.

While natural kratom contains only trace amounts of 7-OH, manufacturers have begun chemically isolating and concentrating it into a synthetic opioid-like drug estimated to be 10 to 13 times more potent than morphine.

These ultra-potent extracts, often sold as gummies, shots and pills, now flood gas stations and vape shops with spotty age restrictions.

FDA Commissioner Dr Marty Makary said: ‘Vape stores are popping up in every neighborhood in America, and many are selling addictive products like concentrated 7-OH. After the last wave of the opioid epidemic, we cannot get caught flat-footed again.'

The FDA’s move was quickly followed by the Florida state attorney general James Uthmeier’s decision to ban selling, having, or sharing 7-OH altogether, citing an ‘immediate danger to the public health, safety and welfare.’

The announcement makes Florida the first state to ban products containing 7-OH, which could set off a nationwide domino effect with more and more states following suit.

7-OH is a relative newcomer, and data on deaths are not well documented, but poison control center reports suggest it is growing rapidly more popular. The Pennsylvania Department of Health issued a warning earlier this month about it, noting ‘increased call volume around both kratom and 7-OH consumption.’

Pressed about 7-OH overdose risks, Makary cited scarce data and doctors' inability to identify it, while still calling the compound a 'killer,' far deadlier than plain kratom.

The federal government has not tracked any deaths due to 7-OH specifically, though at least one has occurred.

Matthew Torres, a 39-year-old Oregon carpenter, died from violent seizures in May 2021 after using kratom to manage chronic pain. His girlfriend found him foaming at the mouth at their Beavercreek home. The coroner ruled his death was caused by 'toxic effects of mitragynine (7-OH).'

His mother Mary Torres is now pursuing a $10M wrongful death lawsuit against the smoke shop that sold it, alleging they failed to warn about risks.

Jordan McKibban, 37, died in 2022 after consuming kratom powder purchased from an organic store, believing it to be a natural pain remedy.

His death certificate listed 'toxic effects of mitragynine (kratom)' as the cause.

Kratom has been used traditionally in Southeast Asia for centuries, and commercially sold in the US for decades as dried leaves or powders.

Many states have different laws about the sale of kratom, limiting it to people either 18 and up or 21 and up.

No federal age restrictions exist for 7-OH sales. Enforcement relies entirely on individual businesses. Most vendors voluntarily require ID for customers to confirm they are 18 and up or 21 and up, but this isn't mandated by law.

‘We’re not targeting the kratom leaf or ground-up kratom,’ Makary said. ‘We are targeting a concentrated synthetic byproduct that is an opioid.’

While 7-OH is naturally present in small amounts from 0.6 percent to 0.7 percent on average in kratom leaves, modern extraction techniques have made it possible to create highly concentrated products, including shots, pills, and gummies.

7-OH tablets, for example, are pre-measured dosage forms containing concentrated amounts of the compound, typically ranging from 5mg to 22mg per tablet.

An FDA-led report on 7-OH cited mounting research showing the extract acts like an opioid, hijacking the same brain receptors as morphine or prescription painkillers.

In multiple experiments, 7-OH triggered strong 'mu-opioid' effects, the same pathway targeted by drugs like oxycodone, often with 13 times the potency of morphine and nearly double the strength of kratom’s primary compound, mitragynine.

When tested on cells and animal tissue, 7-OH behaved like a full opioid agonist, meaning it does not just mildly activate these receptors; it switches them on entirely, setting the stage for repeat, problem use in the future.

The FDA’s report added that 7-OH’s effects were reversed with the anti-overdose nasal spray naloxone.

Florida AG Uthmeier cited the FDA’s findings in his decision to schedule the substance.

He said: ‘We are taking emergency action now because we see immediate danger. Last week the FDA commissioner issued a warning about 7-OH, putting people on notice to the dangers, calling on states to observe and take action where necessary.

‘So here in Florida, we are not going to rest on our laurels. We move fast. We want to help lead the way when it comes to public safety.’

By designating the potent kratom extracts as Schedule I drugs, the state now ranks them alongside heroin, LSD, and illegal fentanyl, deeming them equally dangerous with zero medical value.

The emergency rule grants law enforcement and regulators immediate authority to raid gas stations and smoke shops statewide, seizing the products.

Agriculture Commissioner Wilton Simpson, appearing alongside Uthmeier, told business owners to ‘get it off your shelves.’

‘We are going to be very aggressive,’ he added.

Makary, in turn, celebrated Uthmeier’s decision in ‘fighting back and educating Floridian parents, law enforcement professionals, teachers and community leaders about this threat to public health.’

He added: ‘I encourage other states to act now and use common sense regulation to safeguard the well-being of our youth and Make America Healthy Again.’

Florida’s decision to explicitly ban 7-OH is unprecedented, though several other states, including Colorado, Mississippi, Arizona, Oklahoma, Texas, and Utah have different restrictions on the concentration of 7-OH in the products.

‘I am very supportive of people seeking alternatives outside of traditional Western medicine for wellness,’ Florida Surgeon General Joseph Ladapo said.

‘Our problem here is not with kratom. The problem today is with 7-OH. We don't need any more substances that disconnect people from reality.’