Recent reporting from the Pittsburgh Post-Gazette highlighted growing concern about kratom-related harms in southwestern Pennsylvania. The article reported that mitragynine was involved in 24 deaths in Westmoreland County since 2019 and appeared in 15 Allegheny County cases from 2024 to the present, including two known Allegheny County deaths attributed to mitragynine alone. The reporting comes as Pennsylvania lawmakers consider proposals to regulate kratom products.
A new zine from Pgh MOUD, What’s the Deal with Kratom and 7-OH?, offers an accessible, nonjudgmental guide to kratom and more concentrated products such as 7-hydroxymitragynine, commonly called 7-OH, and mitragynine pseudoindoxyl, or MP.
The zine explains that traditional kratom comes from the leaves of the Mitragyna speciosa plant, which grows in Southeast Asia. However, products now sold under the kratom label can vary significantly. Some may contain plant material, while others may include concentrated extracts, caffeine, CBD, kava, or other ingredients.
This distinction is especially important when it comes to 7-OH and MP. The guide explains that these concentrated substances are much stronger than traditional kratom leaves and can affect the body more like opioids. Because product labels do not always clearly communicate what is inside, someone purchasing a product marketed as “kratom” may not realize its potency.
Rather than assuming that everyone uses these products for the same reason, the zine recognizes a range of experiences. Some people use kratom or its extracts for energy, relaxation, pain, or weight loss. Others use them as an alternative to substances such as fentanyl. Some may not fully understand what they are taking.
The guide also makes an important distinction between physical dependence and addiction. Regular use of kratom, 7-OH, or MP can lead to withdrawal symptoms when someone stops. At the same time, addiction involves more than physical dependence. The zine encourages readers to consider their individual relationship with the substance and whether that relationship feels beneficial, neutral, or harmful.
For people who want to reduce or stop their use, the guide discusses medications for opioid use disorder as a possible option. It describes how buprenorphine medications, including Suboxone, may be used to manage withdrawal or support a longer-term change. It also encourages people to discuss their circumstances and treatment options with a trusted healthcare provider.
Personal stories are woven throughout the zine, illustrating how kratom or 7-OH use can become difficult to manage and how treatment, including medications like buprenorphine, can help. These accounts acknowledge the stigma that people may encounter when considering medication while reinforcing that recovery does not have to follow one prescribed path.
The zine also provides practical overdose-prevention information. It cautions against combining kratom or concentrated extracts with substances such as opioids, benzodiazepines, sleeping medications, or alcohol. It recommends keeping naloxone available, avoiding using alone, and starting with a smaller amount when the contents or strength of a product are uncertain.
Pgh MOUD is a Pittsburgh-area group working to fight stigma toward medications for opioid use disorder. Created by people with lived experience of addiction, recovery, and MOUD, the organization has worked since 2022 to create safer spaces, address common myths, promote justice, and encourage people to share their experiences.
That lived-experience perspective shapes the new zine. Its goal is not to shame or frighten people who use kratom or related products. Instead, it gives readers information they can use to better understand these substances, reduce potential harms, and consider their options if their use is no longer working for them.
Pgh MOUD encourages individuals and organizations to print and distribute the zine anywhere this information could be helpful. The zine is also part of the Carnegie Library of Pittsburgh’s zine collection, where anyone can access it.
What’s the Deal with Kratom and 7-OH? was compiled and organized by Jess Williams, with Dan Cohen, MD, serving as medical reviewer. The project was supported by the Staunton Farm Foundation.
Read the Pittsburgh Post-Gazette article, read and download the zine, and learn more about Pgh MOUD.
