Virginia Doctors Say Kratom Cases Went From Rare to Weekly as 7-OH Circles Past State Ban

A ban on the books has not emptied the shelves. Four months after Virginia outlawed 7-hydroxymitragynine — the concentrated kratom compound known as 7-OH — doctors across the state say the patients keep coming, and they are arriving far more often than they used to.

Dr. John Downs of the Virginia Poison Center told CBS 6 Richmond that the center logged a little over 60 reported encounters involving kratom-related products in 2025. An addiction specialist interviewed alongside him, Dr. Breslin, put the trajectory in starker terms: roughly one case every two months two years ago, and now one to two every week.

"It's becoming a more predominant drug of choice in the community," Breslin said.

A Legal Ban, a Lingering Supply

Virginia's prohibition on 7-OH took effect in May, and Hanover County law enforcement issued its own public warning about the products this week. Yet both physicians cautioned that items like it remain on store shelves. The compound occurs naturally in the leaves of the Southeast Asian kratom tree, but manufacturers now sell versions refined down to the concentrated chemical itself, typically as pills in convenience stores. Breslin described the newer formulations as reaching potency "to the level that it has an equivalency to heroin and fentanyl at this point."

The clinical picture mirrors opioids. "People are overdosing on kratom itself, more particularly 7-OH," Breslin said. Downs explained the mechanism plainly: in opioid toxicity, the body loses the reflex that tells it to breathe. He added that the speed of the market's growth is part of the danger — unregulated products that appeared almost overnight, with credible reports of users developing physical dependence within a short span of first use.

The warnings are not confined to Virginia. In Mississippi, two University of Mississippi students were found dead Monday in what officials described as possible overdoses; sister-station reporting indicated packaged kratom was discovered at both scenes, though authorities have not confirmed a cause of death or whether the cases are connected. On Thursday, South Carolina Attorney General Alan Wilson publicly urged drug awareness in response, warning that unregulated kratom supplies can be contaminated or laced with fentanyl and pressing parents to talk openly with their children. "Experimenting just once can prove fatal," his office emphasized.

"Natural" Is Not a Safety Label

Downs' closing advice was aimed squarely at the marketing. "Because something is labeled as natural, that doesn't necessarily mean that it's safe," he said. Breslin's concern is generational: a wave of dependence forming among younger users who have no idea what the long-term effects look like.

Because 7-OH acts on the same receptors as opioids, dependence on it tends to behave like opioid use disorder — including withdrawal severe enough that some patients need medication-assisted treatment to stop. Families navigating that situation can find free, confidential help around the clock through the national helpline at 1-800-662-4357, and professional assessment is the safest first step rather than abrupt, unsupervised quitting.