Dr. Kacey Clyburn says Oklahoma’s 7oh problem is changing fast: products sold as kratom are showing up in overdose cases, and the shift is now centered on concentrated compounds rather than the plant itself. From January 2025 through June 2026, the Oklahoma medical examiner’s office detected a kratom-related alkaloid in roughly 57 cases.
She said the product has been sold legally on shelves in gas stations and smoke shops, often next to energy drinks, making it easy for buyers to miss how much is inside. Clyburn added that a standard 4-tablet package can contain 16 doses when each tablet is scored into 4 sections.
7-OH in Oklahoma cases
In January 2025, most kratom-related cases handled by the Oklahoma medical examiner’s office involved mitragynine alone. By October and November 2025, cases involving 7-OH and related synthetic derivatives began climbing sharply. That shift is the clearest sign that the current overdose problem is not being driven by the natural plant form alone.
Dr. Kacey Clyburn, a toxicologist with the Oklahoma medical examiner’s office, described it as a moving target. “What we have now is this kind of changing landscape,” she said.
Dr. Kacey Clyburn on potency
Kratom is a tropical tree native to Southeast Asia, and its leaves have been chewed for centuries there as a stimulant in small doses and more like a sedative in larger ones. Clyburn said manufacturers have found ways in recent years to extract and concentrate 7-OH into semi-synthetic products that do not resemble the natural leaf.
“It does not have the mitragynine, and it has some of these other semi-synthetic products, and they’re concentrating it down,” she said. “They are significantly more potent than the [natural alkaloid] alone,” she said of concentrated compounds including 7-OH and MGM-15.
16 doses in one package
Clyburn said that concentration changes the risk in a way many buyers would not notice from the packaging. “They can have respiratory depression that ultimately leads to death, because these are more potent than something like morphine,” she said.
She also pointed to how the tablets are sold. “Most people don’t recognize this is 16 doses of a substance,” she said. “They’re just going to pop one tablet. Well, that’s four doses of a highly potent opioid.”
The practical issue for Oklahoma is simple: products labeled kratom can contain concentrated 7-OH and related derivatives, while the plant name on the package can make the contents seem familiar and low-risk. For buyers, that means the label alone does not tell the full story. For officials, the count has already reached roughly 57 cases in just over a year, with the sharpest rise in late 2025.
What remains in the story is the same question that now hangs over the shelf display: how synthetic 7-OH and related products are still being sold legally while officials tie them to fatal overdoses.
