Products Sold as Kratom Are Linked to Deaths Across the South — What Officials Want Families to Know

Law enforcement and health officials in the South are issuing a new round of warnings about products sold as kratom — specifically the concentrated, semi-synthetic versions marketed as 7-OH — after a string of overdose deaths in Florida and Mississippi that are still under investigation.

This alert is not a claim that kratom leaf killed these people. The picture is more specific, and more useful to families, than that. Officials are pointing at a category of store-bought products whose potency is unpredictable, whose labels do not tell you what is inside, and which bind to the same brain receptors as opioids. The difference between a leafy botanical product and a concentrated 7-OH gummy, oil, or extract is the most important thing a family can take from this week's news.

What officials are reporting

In Northwest Florida, the District 1 Medical Examiner's Office has recorded at least nine kratom-related overdose deaths since May, spanning Escambia, Santa Rosa, Okaloosa, and Walton counties. Okaloosa County Sheriff Eric Aden told local news that all nine came from products bought over the counter.

"We've had nine deaths in our circuit just since May that are from these over-the-counter products," Aden said. Santa Rosa County Sheriff Randy Tifft said his deputies believe roughly half of those deaths occurred in Santa Rosa County.

Escambia County Sheriff Chip Simmons drew the distinction public health officials also make: a green leafy version that is lower-concentration, and a concentrated version — gummies and oils — "which has a high level of what they call 7-OH."

Aden described 7-OH as "13 times stronger than morphine" and said the deaths in his circuit have been tied to it. The Florida Department of Law Enforcement is working on a field test that would let officers identify high-concentration 7-OH products on sight; officials say criminal charges are already pending against some sellers.

In Mississippi, the deaths that drew national attention were two University of Mississippi students found dead on September 21 in what police are treating as separate incidents. Aidan Hamilton, an 18-year-old freshman from Colorado, and Robert Strang, a 20-year-old junior from Atlanta, both had packets of a synthetic kratom-like substance in their rooms, according to reporting at the time. Their causes of death have not been determined; toxicology results are pending, and officials have cautioned against drawing conclusions before the lab work is complete.

On October 1, Oxford police responded to another suspected overdose: a 22-year-old, not a student, found unresponsive around 5 a.m. and revived by emergency medical personnel. Police said the person had "synthetic kratom products" in their possession and that the incident was not connected to the student death investigations.

The same week, the West Tennessee Violent Crime and Drug Task Force announced a raid on a Memphis shop and the seizure of roughly 30,000 packages of what the Shelby County district attorney described as illegal kratom products. District Attorney Steve Mulroy warned residents about the sale and purchase of "synthetic kratom" — a term officials are using for concentrated and semi-synthetic products, not for the traditional leaf.

What the health department is telling residents

The Mississippi State Department of Health issued its own warning on September 23 titled "Beware of Counterfeit and Unregulated Drugs." Its guidance is deliberately not limited to one substance, and it is worth repeating verbatim in spirit:

Do not assume a pill or product is legitimate because of its color, shape, markings, or packaging.
Use caution with psychoactive products from unregulated or unverifiable sources.
Do not assume that commercial packaging — or availability in a store or online — means a product has been evaluated or approved by the FDA for safety, effectiveness, quality, or consistency.
Keep naloxone available. Naloxone can rapidly reverse an opioid overdose.
Fentanyl test strips can detect fentanyl in many products but do not identify every dangerous substance. A negative result is not proof that a product is safe.
Call 911 immediately if an overdose or serious adverse reaction is suspected.

"If you cannot verify the source and contents of a product, do not assume that its appearance, label, packaging or previous use tells you what is inside," said Sherry Hubanks of MSDH. The department's position is that public health precautions should not wait for lab results.

Mississippi's attorney general has since recommended a statewide ban on kratom products, and the mayors of Southaven and Olive Branch have urged the same. The American Kratom Association has pushed back, arguing that the products found in the student investigations were not traditional leaf kratom and that the botanical itself is being mischaracterized.

What 7-OH actually is

Kratom refers to Mitragyna speciosa, a Southeast Asian tree, and to products made from its leaves. Its best-studied compounds are mitragynine and 7-hydroxymitragynine, or 7-OH. Both activate mu-opioid receptors — the same molecular targets as prescription opioids and heroin — although their effects only partially resemble those of classic opioids, according to the National Institute on Drug Abuse.

That partial resemblance is the important part. NIDA notes that kratom leaf and mitragynine by themselves do not appear to cause the dangerous slowing of breathing that defines a life-threatening opioid overdose. But in laboratory models, 7-OH can cause respiratory depression, and that depression is reversed by naloxone. As mitragynine breaks down into 7-OH in the body, the amount of 7-OH a product delivers — not the amount of leaf — is what drives the risk.

Three practical consequences follow:

Concentration changes everything. A product labeling itself "kratom" may contain trace 7-OH or a 7-OH content many times higher. Gummies, oils, extracts, and "pseudoindoxyl" products fall in the high-potency range.
The label is not a guarantee. NIDA reports that kratom products have been found to contain contaminants — including heavy metals and harmful bacteria — that produce effects not associated with kratom compounds alone.
Mixing raises the stakes. Multiple studies suggest many people who use kratom also use other substances. NIDA describes polysubstance use involving kratom as associated with severe outcomes, including death and liver injury.

NIDA's own summary is worth holding onto: compared with deaths from other drugs, a very small number of deaths have been linked to kratom products, and nearly all of those cases involved other drugs or contaminants. The agency also flags rare but serious effects in case reports — confusion, tremors and seizures, high blood pressure, slowed breathing, and liver problems — and notes that long-term, high-dose use has been tied to serious liver injury in a small minority of people.

At the federal level, no kratom product is approved by the FDA for any use. In July 2026, the DEA issued a notice of intent to temporarily place 7-hydroxymitragynine above a specified threshold in Schedule I of the Controlled Substances Act; the comment period was extended in late August. That action targets concentrated 7-OH, not traditional leaf.

What to do

If you or someone you know uses these products, the guidance is familiar from the fentanyl era, and it applies here:

Treat any unregulated product as unknown. Buy nothing from a gas station, vape shop, or website that you cannot verify. Do not judge a product by its packaging.
Concentrated is not the same as mild. If the product is a gummy, oil, extract, or liquid shot, assume a high 7-OH content.
Keep naloxone on hand and tell the household where it is. Naloxone reverses opioid-type overdose and will not harm someone if no opioid is involved.
Do not rely on test strips for this. Fentanyl test strips do not detect 7-OH or most other adulterants.
Do not use alone, and do not mix. Alcohol, benzodiazepines, and other opioids compound respiratory risk.
Call 911 at the first sign of slow or stopped breathing, unresponsiveness, snoring or gurgling sounds, or bluish lips. Most states, including Mississippi and Florida, have Good Samaritan laws that protect the person calling for help.

For families, the MSDH message is also a communication strategy: avoid framing this as a single "bad drug" or a moral failure. The honest version — we do not know what is in these products, and the concentrated ones can stop your breathing — is both accurate and more likely to be heard than a scare tactic.

Where to get help

988 Suicide and Crisis Lifeline — call or text 988, 24/7.
SAMHSA National Helpline — 1-800-662-4357, free and confidential, 24/7.
Find treatment — findtreatment.gov.
Mississippi residents — free naloxone kits by mail through the Mississippi State Department of Health (msdh.ms.gov/opioids) and through ODfree.org.
Poison Control — 1-800-222-1222.
If someone is unresponsive or not breathing — call 911, give naloxone if you have it, and stay with them.

If you are using kratom products to manage pain, opioid withdrawal, or cravings, that is a conversation worth having with a clinician rather than a store shelf. Medications for opioid use disorder — buprenorphine and methadone — are FDA-approved, evidence-based, and available, and they are safer and more effective than any unregulated product sold as a supplement.