The Los Angeles County Department of Public Health is advising retailers to immediately stop selling and remove products that contain kratom and the synthetic kratom compound known as 7-Hydroxymitragynine from shelves.

Per the U.S. Food and Drug Administration, kratom and 7-OH products are not lawfully marketed in the U.S. or California as a drug product, dietary supplement or food additive. Products containing 7-OH, particularly concentrated or synthetic forms, are not approved and illegal for sale in any form.

Public Health inspectors will begin inspections at tobacco shops and other retailers to ensure that kratom and 7-OH products are not being sold. If found, these illegal products will be red-tagged and must be removed from sale. Failure to comply could result in product seizure, destruction, fines and other penalties.

Recently, six overdose deaths in Los Angeles county among people aged 18 to 40 years old have been tied to 7-OH ingestion.

“Kratom and 7-OH products are sold as natural remedies, but they are illegal and unsafe,” said Dr. Muntu Davis, Los Angeles County Health Officer. “They are sold in gas stations, smoke shops, online and other retailers. People should avoid using these products and store owners/operators must remove them immediately to prevent harm. At lower doses, 7-OH acts like a stimulant and at higher doses, it acts like an opioid. Mixing or using it with alcohol, prescription drugs or illicit substances can significantly slow breathing and lead to death. Because these are unregulated products, their strength is unpredictable, making accidental overdose more likely. The safest choice is to avoid all 7-OH products.”

7-OH, the psychoactive component of kratom leaves, is being synthetically concentrated into various products that are sold in gas stations, smoke shops and other retail and online venues in L.A. county. At lower doses, 7-OH can have stimulant-like effects and at higher doses it has opioid-like effects. They are unregulated and often labeled with terms such as “plant alkaloids” or “alkaloid” and marketed as dietary supplements to address a broad range of issues such as pain, anxiety and mood disorders, opioid withdrawal, or energy/general well-being. These products come in various forms such as tablets, gummies, drink mixes and concentrated liquid extracts or shots for drinking, which significantly increase its adverse and life-threatening effects.

Particularly when used with alcohol, medications, and/or illicit drugs, 7-OH can cause severe respiratory depression and death. Importantly, these products are unregulated and may contain unknown concentrations of 7-OH, increasing the risk of unintentional overdose.

In July 2025, the Federal Drug Administration issued warning letters to firms for illegal marketing of concentrated 7-OH products and posted product images, saying, “7-OH is not lawful in dietary supplements and cannot be lawfully added to conventional foods. Additionally, there are no FDA-approved drugs containing 7-OH, and it is illegal to market any drugs containing 7-OH. Consumers who use 7-OH products are exposing themselves to products that have not been proven safe or effective for any use.”

The safest course of action is to avoid using any 7-OH or kratom-related products.

To reduce the risk of overdose and death, Public Health urges anyone using these substances to:

Never use alone: Using with another person is protective and increases the chances of lifesaving interventions such as the administration of naloxone in instances of an overdose. Naloxone can reverse 7-OH toxicity.

Stagger drug use with others: Making sure at least one person in the group can administer naloxone to reverse an overdose can save a life.

Avoid mixing 7-OH with other drugs: The effects of combining substances may be stronger and more unpredictable than using one drug alone and mixing and using multiple drugs increases the risk of an overdose.

Carry naloxone: Naloxone can reverse an opioid overdose and successfully restore breathing to reverse the effects of opioids, including 7-OH. Additional naloxone doses may be needed if no improvement or symptoms return until help arrives. Naloxone can be administered through the nose or as an intramuscular injection to save their life. Both methods are equally effective.

Additional Resources:

Los Angeles County Department of Public Health Overdose Prevention Webpage: This Substance Abuse Prevention and Control website features information sheets and toolkits for the community relevant to overdose prevention. lacounty.gov/sapc/public/overdose-prevention.htm

Poison Control: (800)222-1222

Finding Substance Use Disorder Treatment In Los Angeles county, the general public, health care providers, and patients can find publicly funded substance use treatment services and bed availability using an online, filterable service locator known as the Services and Bed Availability Tool, in the resource section of RecoverLA.org, or by calling the Substance Abuse Service Helpline. Services include outpatient and intensive outpatient treatment, residential treatment, withdrawal management and Opioid Treatment Programs.

Service and Bed Availability Tool: SUDHelpLA.org

Substance Abuse Service Helpline: (800) 854-7771