For those of us working in addiction treatment, it is rare that we get to talk about a national trend moving in the right direction. But the latest overdose data gives us a reason for cautious optimism.
At the same time, we cannot afford to become complacent. The substance use landscape continues to change quickly, and the growing concern around highly concentrated kratom-derived products is a good example of why treatment providers, families and communities have to stay alert
Regulators Take Aim at Concentrated 7-OH
Kratom, or Mitragyna speciosa, is a plant native to Southeast Asia. While traditional kratom leaf contains several naturally occurring compounds, federal attention has increasingly focused on 7-hydroxymitragynine, or 7-OH, a psychoactive alkaloid with opioid-like effects.
The distinction matters. The FDA’s recent actions are not aimed at traditional botanical kratom leaf itself, but at products containing concentrated or enhanced levels of 7-OH, including tablets, gummies, shots and other products increasingly available online and in convenience stores and smoke shops. The FDA has warned that concentrated 7-OH products have not been demonstrated to be safe or effective and cannot lawfully be marketed as dietary supplements or added to conventional foods.
The federal response intensified in 2026. On July 1, the Drug Enforcement Administration announced its intent to temporarily place 7-OH above a specified concentration threshold, along with several synthetic related compounds, into Schedule I under the Controlled Substances Act. Importantly, the DEA proposal excludes botanical kratom containing naturally occurring 7-OH below the proposed threshold.
Several states have also moved to restrict or regulate 7-OH products through bans, concentration limits, age restrictions and labeling requirements.
From my perspective, this distinction is important. We should be careful not to treat every kratom product as identical. What has changed is the potency, accessibility and commercialization of concentrated products that can carry very different risks.
Meanwhile, Overdose Deaths Are Falling
These regulatory changes are occurring against a surprisingly positive national trend.
CDC data show that U.S. overdose deaths began declining in 2023 after years of increases. The decline then accelerated dramatically. Final CDC data show the age-adjusted overdose death rate fell 26.2% from 2023 to 2024, while provisional estimates indicate approximately 69,973 overdose deaths occurred in 2025, nearly 14% fewer than in 2024.
The improvement appears to be continuing. CDC’s latest provisional data estimated 67,798 overdose deaths during the 12 months ending March 2026, another 12.3% decline from the comparable prior-year period.
Much of the reduction has involved opioids, particularly illicit fentanyl. CDC estimated opioid-involved deaths declined from approximately 55,300 in 2024 to 44,600 in 2025.
That progress should be celebrated but not mistaken for the end of the overdose crisis. The rapid emergence of concentrated 7-OH products demonstrates how quickly the substance landscape can change.
For treatment providers, communities and policymakers, the challenge is increasingly twofold: continue the strategies that are reducing overdose deaths while identifying emerging substances early enough to prevent the next wave of addiction and overdose.