Kratom & 7-OH in Mississippi: What You Need to Know About the Law, Dependence, Withdrawal, and Treatment

Kratom has become increasingly visible in Mississippi, with products sold in convenience stores, smoke shops, specialty stores, and online. More recently, highly concentrated products containing 7-hydroxymitragynine (7-OH or 7-HMG) have created additional concern because of their potent opioid-like effects.

Recent deaths involving two University of Mississippi students have brought even greater attention to kratom and related products across Mississippi. However, an important question remains unanswered:

Did kratom actually cause these deaths, or was something else involved?

At this time, we do not know.

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Two Ole Miss Students Found Dead

In September 2026, two University of Mississippi students were found deceased in separate locations.

The University subsequently identified them as Aidan Hamilton, an 18-year-old freshman from Englewood, Colorado, and Robert Strang, a 20-year-old junior from Atlanta.

According to Mississippi Today/AP — “Deaths of students at the University of Mississippi cast spotlight on kratom”, packaged kratom purchased from a retail source was discovered during both investigations.

This led Lafayette County Metro Narcotics to issue a precautionary warning regarding kratom.

However, law enforcement emphasized something extremely important:

There was no confirmed information showing that kratom contributed to either death.

The original Mississippi Today — “Oxford police investigate 2 university student deaths, warn against using kratom” report stated that authorities had no confirmed evidence that the deaths were connected and no information establishing that kratom or another substance contributed to either death.

Therefore, the discovery of kratom should not be interpreted as proof that kratom caused these deaths.

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Fox News: Investigators Address Possible Foul Play

Additional information was subsequently reported by Fox News — “Ole Miss names students found dead as official addresses potential for foul play”.

Mississippi Department of Public Safety Commissioner Sean Tindell told Fox News that investigators had not uncovered indications of foul play at that point.

However, authorities were not prepared to completely rule out foul play until autopsies were completed and investigators had finished collecting evidence and statements.

That distinction is important.

Not ruling something out does not mean investigators have evidence that it occurred.

Toxicology results were still unavailable at the time of the report, meaning investigators could not yet determine whether kratom, another drug, or another factor contributed to either death.

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Why Is the Timing of the Two Deaths Important?

The Fox News investigation revealed another potentially important detail.

Commissioner Tindell said the two deaths appeared to have occurred around the same time, or at least within several hours of one another.

He characterized the timing as suspicious.

One possibility investigators are considering is whether the students could have ingested a substance obtained from the same source.

If evidence eventually demonstrates that the students consumed the same substance or product, investigators could attempt to trace that substance back to its source.

At present, however:

• Authorities have not established that the deaths were connected.
• Authorities have not established that kratom caused either death.
• Authorities have not established that both students consumed the same product.
• Authorities have not reported finding fentanyl in the kratom.
• Authorities have not established that the kratom was contaminated or adulterated.

These are questions that toxicology and further investigation may help answer.

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Could the Kratom Have Contained Something Else?

That possibility cannot currently be confirmed or excluded.

When an unexpected drug-related death occurs, comprehensive toxicology testing can help identify substances that may have been present.

Depending upon the testing performed, investigators may look for substances such as:

• Fentanyl
• Other opioids
• Novel synthetic opioids
• Prescription medications
• Alcohol
• Stimulants
• Synthetic or designer drugs
• Mitragynine
• 7-hydroxymitragynine
• Other toxic substances

The Fox News report also noted that Greek-life leaders had circulated a warning concerning a synthetic opioid called cychlorphine.

That does not mean cychlorphine has been identified in either student's toxicology.

Likewise, there is currently no confirmed evidence that fentanyl, cychlorphine, or another foreign substance was present in the kratom recovered during these investigations.

Contamination is therefore one possible hypothesis—not an established fact.

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Can Someone Die From Kratom Alone?

This question deserves a nuanced answer.

Fatalities attributed solely to traditional kratom appear to be uncommon, and reported kratom-associated deaths have frequently involved other substances.

However, that does not mean kratom is incapable of causing serious toxicity or that a kratom-only death is impossible.

Kratom contains pharmacologically active alkaloids, particularly mitragynine, and concentrated extracts can expose someone to substantially different quantities than traditional kratom leaf.

The situation becomes even more concerning when products contain concentrated 7-hydroxymitragynine (7-OH).

Therefore, while the presence of kratom in the Ole Miss investigations is noteworthy, it is scientifically inappropriate to conclude that kratom caused the deaths before toxicology and autopsy findings are available.

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What Is Kratom?

Kratom (Mitragyna speciosa) is a tree native to Southeast Asia.

Its leaves contain numerous biologically active alkaloids, but two have received particular attention:

• Mitragynine
• 7-hydroxymitragynine (7-OH)

Kratom's pharmacology is complicated. Its alkaloids interact with opioid receptors as well as other neurochemical systems.

People report using kratom for:

• Pain
• Energy
• Mood
• Relaxation
• Anxiety
• Self-management of opioid withdrawal
• Recreational effects

Regular exposure can also result in tolerance, physical dependence, withdrawal, and problematic use.

A 2024 study published in the Journal of Addiction Medicine examined 2,061 current kratom consumers. Approximately 25.5% met the study's adapted DSM-5 criteria for kratom use disorder. Among those meeting the criteria, tolerance and withdrawal were particularly common.

You can read the study here: Hill et al. (2024) — “Prevalence of Kratom Use Disorder Among Kratom Consumers”.

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What Is 7-OH?

7-hydroxymitragynine, commonly called 7-OH, 7-Hydroxy, or 7-HMG, deserves particular attention.

Small amounts of 7-OH can occur naturally in kratom.

That is very different from products specifically manufactured or marketed with enhanced or concentrated levels of 7-OH.

These products may be sold as:

• Tablets
• Gummies
• Shots
• Drink mixes
• Extracts
• Other concentrated preparations

The U.S. Food and Drug Administration — “Products Containing 7-OH Can Cause Serious Harm” describes concentrated 7-OH products as novel potent opioid products that have not been demonstrated to be safe or effective for medical use.

The FDA reports receiving adverse-event reports involving problems such as:

• Addiction
• Withdrawal
• Anxiety
• Depression
• Gastrointestinal distress
• Insomnia
• Seizures

The FDA's warning specifically distinguishes products containing enhanced or added 7-OH from the trace quantities naturally occurring in kratom.

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Why Is 7-OH Different?

7-OH has substantial activity at the mu-opioid receptor.

That receptor is involved in the effects of traditional opioids.

This does not mean that 7-OH and fentanyl are the same substance.

It does mean concentrated 7-OH products may produce clinically significant opioid-like effects and can potentially result in:

• Euphoria
• Sedation
• Tolerance
• Physical dependence
• Withdrawal
• Substance-use disorder

This is one reason clinicians should ask patients exactly which product they are using, rather than simply asking whether they use “kratom.”

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Is Kratom Legal in Mississippi?

Mississippi significantly tightened its regulation of kratom beginning July 1, 2025.

According to the Mississippi Legislature — HB 1077 legislative summary, Mississippi prohibits the sale or distribution of kratom products to individuals younger than 21 years old.

The law also requires kratom products offered for retail sale to be kept behind the retailer's counter.

Importantly, Mississippi also restricts the amount of 7-OH permitted in a kratom product.

HB 1077 prohibits products containing:

• More than 1% 7-hydroxymitragynine within the alkaloid fraction, or
• More than 0.5 milligrams of 7-OH per container.

The law also contains restrictions involving controlled substances and certain synthesized kratom constituents.

Therefore, something being marketed or sold as “kratom” does not automatically establish that every product complies with Mississippi's requirements.

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Can You Become Dependent on Kratom or 7-OH?

Yes.

Not everyone who uses kratom develops dependence or a substance-use disorder.

However, frequent exposure—particularly repeated use of concentrated extracts or enhanced 7-OH products—can result in physical dependence.

Potential warning signs include:

• Needing progressively larger amounts
• Taking the substance increasingly often
• Craving it
• Feeling unable to function normally without it
• Spending increasing amounts of money obtaining it
• Trying unsuccessfully to stop
• Using it primarily to avoid withdrawal
• Continuing despite physical-health problems
• Continuing despite psychiatric problems
• Problems at work or school
• Relationship difficulties
• Experiencing withdrawal when stopping

The 2024 Journal of Addiction Medicine study on kratom use disorder found that among participants meeting criteria for kratom use disorder, 81.3% reported tolerance and 68% reported withdrawal.

Physical dependence and addiction are related, but they are not identical. Someone can develop physiological dependence and withdrawal without necessarily meeting full diagnostic criteria for a substance-use disorder.

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What Does Kratom or 7-OH Withdrawal Feel Like?

Withdrawal may resemble opioid withdrawal, particularly following frequent or high-dose exposure.

Possible symptoms include:

• Anxiety
• Irritability
• Restlessness
• Insomnia
• Muscle aches
• Joint or body pain
• Sweating
• Chills
• Runny nose
• Watery eyes
• Abdominal cramps
• Nausea
• Vomiting
• Diarrhea
• Tremor
• Rapid heartbeat
• Depression or dysphoria
• Strong cravings

The FDA's 7-OH consumer warning specifically identifies withdrawal symptoms including restlessness, body aches, fatigue, irritability, and cold sweats among reported adverse effects associated with 7-OH products.

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Kratom & 7-OH Dependence Quick Screen

The quick screen below is an educational tool, not a diagnosis. Your answers are scored only in your browser; nothing is saved or sent.

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Can Kratom or 7-OH Dependence Be Treated?

Yes.

There is currently no FDA-approved medication specifically labeled for kratom use disorder.

Treatment therefore needs to be individualized based on factors including:

• The exact product being used
• 7-OH concentration
• Daily quantity
• Frequency of use
• Duration of use
• Current withdrawal symptoms
• Other opioid exposure
• Other substance use
• Medical conditions
• Psychiatric conditions
• Previous substance-use history

Published medical literature has described the use of buprenorphine-containing medications for selected patients with significant kratom dependence.

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What About Suboxone?

Suboxone (buprenorphine/naloxone) is an FDA-approved medication for opioid use disorder.

Clinical literature includes reports of buprenorphine/naloxone being used to treat patients experiencing significant kratom dependence.

For example, Kiyokawa et al. — “Kratom use disorder: case reports on successful treatment with home induction of buprenorphine-naloxone” described treatment of patients with kratom use disorder using buprenorphine/naloxone.

This does not mean every person using kratom should receive Suboxone.

The decision requires an individualized clinical assessment.

Patients also should not attempt to determine their own buprenorphine dose or induction timing from information found online. Starting buprenorphine at an inappropriate time in someone with opioid-type physical dependence can potentially precipitate withdrawal.

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What About Brixadi?

Brixadi is an extended-release injectable formulation of buprenorphine approved for opioid use disorder.

Long-acting buprenorphine can provide sustained medication exposure without requiring a patient to remember a medication every day.

Evidence specifically studying Brixadi for kratom dependence remains limited.

However, published literature has described extended-release injectable buprenorphine as part of treatment for severe kratom use disorder.

For example, Swart et al. — “Isolated Kratom Use Disorder Treated With Extended-Release Buprenorphine Taper” reported the use of extended-release buprenorphine following stabilization with sublingual buprenorphine.

Whether long-acting buprenorphine is appropriate requires individualized evaluation.

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What About Vivitrol?

Vivitrol (extended-release naltrexone) works differently from buprenorphine.

Naltrexone blocks opioid receptors rather than partially activating them.

For appropriately selected patients, naltrexone may be considered after withdrawal has resolved and an adequate opioid-free interval has occurred.

It should not simply be administered to someone who remains physiologically dependent on opioid-type substances because opioid antagonism can precipitate abrupt withdrawal.

Clinical assessment is therefore essential.

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How Can Turned Leaf Psychiatry Help?

If kratom or 7-OH has changed from something you occasionally use into something you feel like you have to use, Turned Leaf Psychiatry can provide a comprehensive evaluation.

Depending on the individual patient's needs, evaluation and treatment may include:

• Comprehensive substance-use assessment
• Identification of the exact kratom or 7-OH product
• Quantity and frequency assessment
• Withdrawal assessment
• Psychiatric evaluation
• Evaluation of co-occurring anxiety or depression
• ADHD evaluation when appropriate
• Trauma assessment
• Treatment of co-occurring psychiatric disorders
• Buprenorphine/naloxone treatment when clinically appropriate
• Evaluation for long-acting buprenorphine
• Evaluation for Vivitrol when appropriate
• Withdrawal-supportive medications
• Medication management
• Relapse-prevention planning
• Therapy or substance-use treatment referrals
• Referral to a higher level of care when outpatient treatment is insufficient

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When Should You Seek Emergency Help?

Call 911 or go to the nearest emergency department if someone experiences:

• Difficulty breathing
• Blue or gray lips
• Loss of consciousness
• Inability to awaken
• Severe confusion
• Seizure
• Severe chest pain
• Severe agitation or psychosis
• Suspected overdose
• Suicidal thoughts or behavior

If an opioid-type overdose is suspected and naloxone (Narcan) is available, administer it according to its instructions and call 911.

Even if the person responds to naloxone, emergency medical evaluation is still necessary.

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What Do We Know About the Ole Miss Cases Right Now?

The most important conclusion is also the simplest:

We do not yet know what caused these two students' deaths.

Mississippi Today/AP reports that toxicology results were not yet available and that Mississippi officials were working to expedite them.

Fox News reports that authorities had not identified evidence of foul play but had not completely ruled it out while awaiting autopsy results and completion of the investigation.

Packaged kratom was recovered during both investigations.

That fact deserves attention.

But presence does not establish causation.

Likewise, the unusual timing of the deaths does not establish that the students consumed a contaminated batch, that fentanyl was involved, or even that the deaths were connected.

Those questions should be answered by toxicology, autopsy findings, and the continuing investigation—not speculation.

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More Details to Come

This remains an active investigation.

Turned Leaf Psychiatry will continue following the official toxicology findings, autopsy findings, medical-examiner reports, and law-enforcement announcements concerning these cases.

As new verified information becomes available, this article will be updated.

Please check back periodically for updates.

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Turned Leaf Psychiatry

Innovative • Personalized • Evidence-Based

The increasing availability of kratom extracts and concentrated 7-OH products creates a new challenge: someone may begin using a product marketed as “natural” without realizing that repeated exposure can result in tolerance, opioid-like physical dependence, and withdrawal.

You do not have to wait until it becomes a crisis.

If you are experiencing escalating kratom or 7-OH use, cravings, withdrawal symptoms, or difficulty stopping, contact Turned Leaf Psychiatry for a comprehensive evaluation.

Early intervention may help prevent an emerging substance-use problem from developing into a more serious medical or psychiatric condition.

Request an appointment or call (601) 494-5503. If you are in crisis, call or text 988, or call 911 in an emergency.