S6 E7: Hot Topics in Addiction Medicine: Kratom & 7-OHS6 E7: Hot Topics in Addiction Medicine: Kratom & 7-OH
Addiction Medicine Podcast
A specialist in addiction medicine shares what he is seeing among patients using kratom and 7‑OH, focusing on dependence, safety, regulation and treatment options. The conversation blends harm reduction, practical clinical tips and a call for open-hearted, open-minded care.
23:27•8 Oct 2026
Kratom, 7‑OH and Clinical Reality: What Doctors Are Seeing Now
Episode Overview
- Patients using kratom and 7‑OH often show classic substance use disorder features, including compulsive use and prolonged withdrawal.
- Products sold as kratom or kratom-adjacent are poorly regulated, with labels that may not reflect actual contents or potency.
- Kratom and 7‑OH appear less risky than fentanyl in current clinical experience, but still carry significant dependence and polysubstance overdose risks.
- Harm reduction advice includes not using alone, widespread access to naloxone, and clear conversations about all substances being used.
- Methadone and buprenorphine are proving effective for patients wanting to stop or reduce kratom and 7‑OH use, easing withdrawal and craving.
“You got to have both, I think, to be a good doctor for this particular topic, addiction. Open heart means that whatever the person's situation, expect that they're just trying to do their best. And open mind means, like, you might think you have the right answers, and it's going to change tomorrow.”
How do different strategies aid in addiction recovery? This episode of the Addiction Medicine Podcast zooms in on kratom and 7‑hydroxymitragynine (7‑OH), two products that many patients are picking up at petrol stations and vape shops, then bringing into the clinic with some tough questions. Hosted by Pollen Williamson and Mel Ramage, the conversation centres on addiction specialist Dr Suchin Shukla, who shares what he's seeing on the ground.
He describes patients with "classic symptoms of substance use disorder"—compulsive use, difficulty going even a few hours without dosing, night-time use, and withdrawal that can last for weeks. At the same time, he notes that people are often switching from fentanyl to kratom or 7‑OH and "they're often feeling and looking healthier", while overdose from sole use appears uncommon in his practice.
You'll get a clear breakdown of why product labelling is so misleading, how supplements sold over the counter are rarely truly regulated, and why something bought legally at a petrol station can behave more like a street drug than a standard medicine. Shukla walks through the messy overlap of "legal vs illegal" and "regulated vs unregulated" and stresses how quickly these products have shifted from plant-based teas to synthetic, kratom-like compounds.
For clinicians wondering what to actually offer patients, there's practical reassurance: methadone and buprenorphine are helping people reduce or stop kratom and 7‑OH use, without the same initiation headaches seen with fentanyl. Harm reduction stays front and centre, with emphasis on not using alone, normalising naloxone, and talking explicitly about polysubstance use.
Perhaps the most memorable moment comes at the end, when Shukla urges colleagues to keep "an open heart and an open mind"—recognising that patients are trying to do their best and that the drug supply will keep changing. If you're curious how to respond thoughtfully when someone says, "I get my opioid-like product at the gas station", this conversation is well worth your time.
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