When it comes to reducing the harm caused by illicit drugs, we’ve learned we need to trust people to make safer choices, not legislate them out of existence. People getting their lives back on track need all the options they can get.
The opioid epidemic has ravaged the United States since the 1990s, and over the past 10 years, we’ve dealt with yet another wave of widespread misuse of prescription and illicit opioids resulting in increased addiction, overdose, and death.
Luckily in the past few years, we’ve started to see declines in opioid-related deaths due to a combination of expanded harm reduction, improved access to treatment for opioid-use disorder, evolving drug-supply dynamics, and more targeted public health and safety interventions.
One endangered harm reducer is 7-hydroxymitragynine, or 7-OH, a natural compound that adults actively trying to get off opioids use to steady withdrawal and keep symptoms manageable. For many, it’s a practical step that lets them get through the workday and sleep reliably, keeping life on track without sliding back to stronger opioids.
Unfortunately, several states and the Food and Drug Administration are considering an outright ban on 7-OH, which could lead to an uptick in opioid misuse, addiction, overdose, and death.
Utah has learned this lesson the hard way. In 2019 the state sharply restricted kratom, capping 7-OH at 2% of kratom alkaloids and outlawed synthetic 7-OH. Within a year Utah’s opioid death toll exploded. The state health department reports that from 2019 to 2020, fentanyl-involved overdose deaths jumped 128% in Utah, and by 2022 fatalities involving illicit fentanyl had outnumbered all prescription-opioid deaths.
Plainly put, right after Utah cut off a legal opioid alternative, fentanyl deaths surged.
Utah’s experience contradicts a national pattern, with national data through 2024 showing overdose deaths falling overall, yet in Utah they are rising, driven by illicit fentanyl. Punitive approaches can backfire, pushing users into more dangerous solitary drug use and away from lifesaving interventions. When an at-risk person loses access to a legal mitigation such as 7-OH, they may unwittingly switch to illicit fentanyl or counterfeit pills.
Again, harm reduction means trusting people to make safer choices, not legislating them out of existence. Advocates aren’t claiming 7-OH is risk-free, only that it is safer than what people would otherwise use. For a patient struggling with opioid dependence, switching to a controlled dose of kratom-derived 7-OH can ease withdrawal without the sky-high risk of an unknown fentanyl-laced cocktail.
In Utah last year, nearly 90% of fentanyl deaths involved another drug, often because users chasing relief end up in the illicit market.
Vaping offers the clearest model for what to do. The Trump administration treated adult smokers as adults and used regulation to move them toward something less dangerous while cracking down on youth use. The FDA set product standards, enforced age checks, pushed packaging toward plain and boring, and required basic manufacturing oversight.
The goal was not to pretend cigarettes would disappear but to reduce harm in the real world. That same mindset should guide 7-OH. A ban would erase the only regulated lane and push demand to illicit sellers and street blends with no testing or accountability. A rules-based approach does the opposite, keeping products aboveboard under verified lab standards with adult-only access, and giving regulators the leverage to pull unsafe items off shelves.
That is exactly the kind of practical regulation HHS Secretary Robert F. Kennedy Jr. (RFK) has said he wants from the FDA, and it is the right way to protect people who are trying to avoid opioids without handing the market to bad actors. RFK has said the FDA should be evidence-driven and use regulation, rather than blanket bans, where it reduces harm. He has vowed to end what he calls the FDA’s “war on public health,” criticizing its “aggressive suppression” of treatments, from psychedelics to raw milk, that people use to stay healthy.
A nationwide ban on 7-OH would directly contradict that promise. Rather than pushing a possibly life-saving alternative underground, regulators should study 7-OH carefully and set safety standards.
Utah’s experience suggests that clamping down on kratom compounds doesn’t make opioid use vanish, it makes it far more lethal. For policymakers genuinely concerned about overdose deaths, sensible harm reduction means preserving safer substitutes, not eliminating them.
Frances Floresca is a policy analyst. Her work has been featured by the Republican Study Committee, Townhall, The Daily Wire, The Daily Signal, Fox News Radio, Salem News Channel, Real America’s Voice, and The Washington Examiner.
