The California Department of Public Health is collaborating with the California Department of Alcoholic Beverage Control and the California Department of Tax and Fee Administration to remind consumers and retailers that products containing kratom or 7-hydroxymitragynine, commonly known as 7-OH, are associated with addiction, serious harm, overdose and death.

These products, often sold in smoke shops and gas stations, are labeled with terms such as “plant alkaloids” or “alkaloid,” and may be marketed as dietary supplements to address issues such as chronic pain, anxiety and depression, and opioid withdrawal. However, these products have not been tested for safety, consistency, effectiveness or accurate labeling, and have not been approved for sale by the FDA. Especially when combined with prescription medications, alcohol and/or street drugs, kratom and 7-OH can cause severe respiratory depression and death.

Both 7-OH and kratom may carry high risk of addiction, especially for those already struggling with substance use disorders. Kratom and 7-OH side effects include withdrawal symptoms, insomnia and anxiety, seizures and fatal respiratory depression.6

Under the Sherman Food, Drug and Cosmetic Act (aka Sherman Law), CDPH has authority specific to adulterated or misbranded food, drug, medical device and cosmetics. Food and dietary supplements containing kratom and/or 7-OH are adulterated pursuant to federal and state law. To date, CDPH has seized more than $5 million worth of kratom and 7-OH products. CDPH continues to take action to remove products or raw materials containing kratom or 7-OH from retail facilities selling to consumers for consumption and from locations where these products are manufactured.

CDPH is collaborating with the California Department of Alcoholic Beverage Control and California Department of Tax and Fee Administration to educate and inform California retailers about kratom and 7-OH products, which are not legally approved to sell or manufacture for consumption. The following resources have been developed to raise awareness of the health risks and the fact that it is illegal to sell these products for consumption.

Compliance education effort and enforcement: This advisory to ABC licensees informs and reminds them that kratom and 7-OH products are illegal to sell for consumption and to inform retailers that ABC will begin taking enforcement actions.

About Kratom Fact Sheet for Local Environmental Health Agencies: This fact sheet was created to provide information to Local Environmental Health Agencies who may want to take voluntary action or educational efforts on kratom and 7-OH in their jurisdictions.

Prohibition on the Sale of Kratom and 7-OH Products to Tobacco Retailers: This letter addresses tobacco retailers to educate and inform retailers that kratom and 7-OH products are illegal to sell for consumption and that retailers may be subject to legal actions and enforcement measures.

For healthcare providers: This CDPH Health Advisory provides healthcare providers with information about kratom and 7-OH, clinical recommendations and additional resources and references.
Consumers are advised to avoid using kratom-derived or 7-OH products.

CDPH Recommends:

Consumers should be aware that products claiming to contain kratom or 7-OH have not been tested for safety, consistency, or accurate labeling, nor have they been approved for sale by the FDA. Kratom and 7-OH products are typically sold as beverages, shots, powders, tablets, capsules and gummies, and often marketed using bright, colorful packaging designed to mimic regulated products.

To reduce risk of overdose, anyone who may use 7-OH is advised to never mix with alcohol or other drugs, know the signs of overdose, and carry naloxone. Naloxone is a life-saving medication used to reverse an opioid overdose, including overdose related to heroin, fentanyl, prescription opioid medications or 7-OH.

If you or someone else are experiencing any ill effects after consuming kratom or 7-OH products, contact Poison Control (1-800-222-1222) or visit www.poisonhelp.org or consult a health care provider.
Understand that kratom derivatives should not be assumed to be safer alternatives to opioids and other drugs; they carry their own risks, including high risk of addiction—particularly for highly potent synthetic products such as 7-OH.

Anyone seeking alternatives to opioids and other drugs can be linked to free or low-cost treatment, including medications for opioid use disorders, by contacting Choose Change California or calling 988.

Know the signs of an overdose and how to respond. If someone is unresponsive, administer naloxone and call 911 immediately, keep the person awake and breathing, lay them on their side to prevent choking and stay with the person until 911 responders arrive.

To report the unlawful sale of these products, consumers may call the CDPH Complaint Hotline at (800) 495-3232 or submit an electronic report.

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