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Opioid Use Disorder

Kratom & 7-OH Addiction Treatment in Tennessee

Evidence-based outpatient care for kratom and 7-OH use disorder — combining medication-assisted treatment, counseling, and certified peer support at four clinics across Southeast Tennessee and North Georgia.

What Are Kratom and 7-OH?

Kratom is a tropical tree (Mitragyna speciosa) native to Southeast Asia. Its leaves contain over 50 alkaloids, two of which matter most clinically: mitragynine and 7-hydroxymitragynine (7-OH). Both act on the same mu-opioid receptors as prescription opioids, which is why kratom produces opioid-like effects and why regular use can lead to physical dependence and opioid-style withdrawal. 7-OH is the more potent of the two at the mu-opioid receptor, and modern concentrated 7-OH products deliver doses of this alkaloid far higher than what the plant naturally produces — which is why the FDA has specifically warned that synthetically enhanced 7-OH products carry greater risk of overdose, physical dependence, and withdrawal than whole-leaf kratom.

Kratom has historically been sold as raw leaf powder and capsules, often marketed as a “natural” supplement for energy, mood, or pain. Over the past few years the product landscape has changed dramatically. Concentrated extracts and isolated 7-OH products — sold as tablets, lozenges, gummies, and liquid shots at gas stations, smoke shops, and online — are now the fastest-growing category. Because potency can vary enormously between brands and batches, many patients describe using more and more to get the same effect, and developing withdrawal symptoms hours after a dose they previously tolerated. This pattern matches the Tennessee Department of Health’s 2026 finding that withdrawal is now the leading reason Tennesseans visit the emergency room after using kratom.

The regulatory picture is shifting quickly. The DEA designated kratom and 7-hydroxymitragynine as “Drugs of Concern” in January 2025. In July 2025, the FDA issued warning letters to seven 7-OH product manufacturers and formally recommended that concentrated 7-OH products be scheduled under the Controlled Substances Act. At the state level, Tennessee currently has two bills pending: HB1647 / SB1655 (“Matthew Davenport’s Law”), which would create criminal penalties for kratom possession and sale, and HB2594, which would take a regulatory approach — capping 7-OH to 2% of the alkaloid fraction (or 1 mg per serving), requiring lab testing and labeling, limiting sales to age 21+, and enforcing through the Alcoholic Beverage Commission. Whichever passes, the message from regulators is consistent: kratom and 7-OH products carry real addiction potential, and the unregulated marketplace has allowed that risk to compound.

Restoration Recovery specifically treats kratom and 7-OH dependence. Because the mechanism is opioid-like, the medication options that work for opioid use disorder — Suboxone, Sublocade, and Brixadi — also work for kratom and 7-OH dependence. Our providers have clinical experience treating both whole-leaf kratom and concentrated 7-OH dependence, and tailor treatment to the distinct withdrawal profile of each.

Kratom-involved ER visits in Tennessee

Annual total, 2019 – 2025

153 2019 2022 2025
77 2024
153 2025 ↑ 99% YoY

Kratom-involved ER visits in Tennessee doubled from 2024 to 2025 — from 77 to 153 visits. The 2019 – 2025 total reached 414 visits, with growth accelerating every year since 2022.

Withdrawal became the leading reason in 2025

Kratom-related ER visits by reason, 2025

67 Withdrawal #1 reason
50 Side Effects
20 Overdose

For the first time, withdrawal surpassed side effects as the leading reason for kratom-related ER visits in Tennessee — evidence that kratom dependence is producing opioid-style withdrawal severe enough to send people to the emergency room.

The Tennessee Kratom & 7-OH Picture

Tennessee’s own public health data shows what’s happening on the ground. In February 2026, the Tennessee Department of Health’s Overdose Surveillance Program published a detailed kratom brief using seven years of emergency room and death certificate data. A few findings stand out.

  • Kratom-involved ER visits doubled from 2024 to 2025 — from 77 to 153 visits statewide — with the fastest increases among men and adults aged 18 – 44.
  • Withdrawal became the most common reason for a kratom ER visit in 2025 (67 visits), surpassing side effects (50) and overdose (20). When a Tennessean arrives at the ER with a kratom problem today, they are most likely arriving because of withdrawal they can’t manage at home.
  • Between 2–3% of Tennessee’s fatal drug overdoses each year involve kratom, a rate that has held steady since 2019. Kratom-only fatal overdoses are rare (typically 1–7 per year); the vast majority of kratom-involved deaths also involve fentanyl or other substances.
  • The demographics match our patient base — 77.6% of kratom-involved fatal overdoses are in men, 72% in adults 25 – 44, and 95% in white Tennesseans. Middle and East Tennessee Grand Regions account for roughly three-quarters of kratom ER visits.

The clinical takeaway is clear. For an increasing number of Tennesseans, kratom and 7-OH are producing opioid-style dependence severe enough that people need real medical treatment to stop — not a tapering guide, not a home remedy, not willpower. Outpatient buprenorphine-based MAT is specifically designed for this.

Sources: Tennessee Department of Health, “Emerging Trends: Kratom in Tennessee” (Overdose Surveillance Program Brief, February 2026); FDA 7-OH assessment (July 2025); DEA Drug of Concern designation (January 2025); CDC MMWR kratom poison-center report (March 2026).

Why People Using Kratom & 7-OH End Up in the ER

TDH’s seven-year dataset (2019 – 2025, n = 414) reshapes what “kratom risk” actually looks like clinically. Only about one in ten kratom ER visits are for suspected overdose. The overwhelming majority are for withdrawal, adverse side effects, or a mental health crisis triggered or worsened by kratom use.

For every emergency kratom overdose, there are roughly three kratom-withdrawal visits, four-and-a-half side-effect visits, and nearly two kratom-involved mental health events. The care these patients need is not naloxone — it’s stabilization on buprenorphine so withdrawal stops driving the cycle.

At the same time, when kratom is involved in a fatal overdose, it is almost never acting alone. TDH’s SUDORS toxicology data shows fentanyl was detected in 66% to 87% of kratom-involved fatal overdoses across 2019 – 2024 — the real driver of the death toll. Polysubstance use is what turns a kratom exposure from an ER visit into a fatality.

This is why we treat kratom dependence the way we treat any opioid use disorder: with medication that stops withdrawal from driving use, counseling to address the reasons people reached for kratom in the first place, and an open door for patients already using fentanyl or other substances alongside.

Why Tennesseans visit the ER for kratom

All ER visit reasons, 2019 – 2025 (n = 414)

Side Effects
19045.9%
Withdrawal
12630.4%
Mental Health
7518.1%
Overdose
4310.4%
Injury (fall, MVA)
143.4%
Drug Screen
41.0%

Only about one in ten kratom ER visits is for suspected overdose. Withdrawal, side effects, and mental health events together account for 94% of kratom-related ER use in Tennessee.

Fentanyl in kratom-involved TN deaths

Share of SUDORS toxicology, kratom-detected

66% 2019
87% 2021
69% 2024

Kratom alone rarely causes a fatal overdose in Tennessee. When a kratom-involved death does occur, fentanyl is detected in roughly two-thirds to seven-eighths of cases — the dominant driver of lethality.

Signs of Kratom & 7-OH Use Disorder

Kratom use disorder is a medical condition. Physical dependence develops with regular use, especially with concentrated 7-OH products. Common signs include:

  • Rapid tolerance. Needing more kratom or stronger products (extracts, 7-OH concentrates) to achieve the same effect. Many patients describe moving from occasional use, to multiple daily doses, to concentrated 7-OH products over a matter of weeks or months as tolerance builds.
  • Withdrawal symptoms within hours. Muscle aches, runny nose, sweating, nausea, diarrhea, anxiety, restless legs, and intense cravings — essentially opioid-style withdrawal, often starting 6 to 12 hours after the last dose for users of concentrated 7-OH.
  • Dose stacking. Using kratom multiple times per day to avoid withdrawal, including middle-of-the-night doses.
  • Time and money spent on kratom. Planning the day around doses, buying in bulk, or switching retailers to chase free samples or cheaper concentrates.
  • Transition to stronger products. Moving from leaf powder to extracts to 7-OH concentrates as tolerance builds, often without recognizing the shift.
  • Unsuccessful attempts to stop. Trying to quit and returning because of withdrawal.
  • Continued use despite consequences. Health, financial, or relationship problems that haven’t led to stopping.
  • Secretive use. Hiding kratom or downplaying how much is being used — common because kratom is often perceived (incorrectly) as harmless or as a “wellness” product.
  • Product confusion. Not being sure what you’re actually taking because the product is labeled under different brand names, concentrations, or formulations.

If several of these apply, a professional evaluation can help clarify what is happening and what options exist. And if you’re reading this wondering whether what you’re experiencing is “bad enough” to warrant help — that question itself is often a sign.

Kratom & 7-OH Withdrawal: Timeline and Symptoms

Kratom withdrawal is opioid-style withdrawal — uncomfortable, driven by real changes in brain chemistry, and rarely life-threatening in otherwise healthy adults. Because kratom alkaloids have a shorter half-life than many prescription opioids, the onset of withdrawal can be faster, especially for users of concentrated 7-OH products where peak symptoms can arrive within the first 24 hours. Medication-assisted treatment prevents withdrawal rather than forcing patients to endure it.

A general timeline for kratom withdrawal looks like this:

  • First 6 to 12 hours. Onset of early symptoms: anxiety, restlessness, muscle aches, yawning, watery eyes, and runny nose. With concentrated 7-OH products, this onset can be even faster.
  • Day 1 to day 3. Peak physical symptoms: nausea, vomiting, diarrhea, abdominal cramping, sweating, chills, insomnia, and intense cravings.
  • Day 3 to day 7. Acute symptoms gradually subside.
  • Week 2 and beyond. Post-acute symptoms may continue: low energy, mood changes, and intermittent cravings.

Your provider will assess your specific situation — including which kratom products you’ve been using, at what frequency, and for how long — to determine the right timing for starting buprenorphine and avoid precipitated withdrawal.

How We Treat Kratom & 7-OH Addiction

At Restoration Recovery, kratom and 7-OH use disorder is treated with a combination of medication and psychosocial support. The medication options available are:

  • Suboxone (daily film or tablet). A combination of buprenorphine and naloxone taken sublingually — available as a dissolving film or tablet placed under the tongue. Buprenorphine reduces cravings and prevents withdrawal by partially activating opioid receptors without producing euphoria. Naloxone is included to discourage misuse.
  • Sublocade (monthly injection). A long-acting form of buprenorphine administered once per month at our clinics. Many patients prefer Sublocade because it removes the daily decision-making around taking medication and provides steady blood levels throughout the month.
  • Brixadi (weekly, bi-weekly, or monthly injection). Another extended-release buprenorphine injection, with flexible dosing intervals. Patients who prefer a longer or shorter schedule than Sublocade’s monthly cadence — or who are still finding the right maintenance dose — often start with Brixadi’s weekly or bi-weekly options before transitioning to monthly if that fits their treatment plan.

Medication is paired with:

  • Individual counseling with licensed therapists experienced in substance use disorder.
  • Certified peer support from specialists who have lived experience with recovery themselves.
  • Intensive outpatient programming (IOP) for patients who benefit from a more structured treatment schedule — delivered in a group format by design.
  • Integrated care for co-occurring conditions, including anxiety, depression, trauma, and hepatitis C.

Restoration Recovery is an outpatient clinic. We do not provide medical detox or residential care. For most patients with kratom use disorder, a formal detox is not required — medication-assisted treatment can begin at the appropriate point after last use, under clinical supervision. For patients who need a higher level of care before starting outpatient MAT, we coordinate with regional referral partners.

What to Expect at Your First Appointment

Your first visit typically lasts 60 to 120 minutes and follows a four-step clinical flow:

  1. Intake. You’ll complete paperwork and a clinical intake. For opioid use disorder, this includes a DSM-5 assessment to confirm the diagnosis and its severity, and a COWS (Clinical Opiate Withdrawal Scale) score to measure your current withdrawal state. The COWS score guides whether you’re clinically ready to begin buprenorphine the same day without risking precipitated withdrawal.
  2. Counseling. You’ll meet with a counselor to discuss your substance use history, any previous treatment, and your personal recovery goals.
  3. Doctor evaluation. A medical provider reviews your intake, COWS score, and counselor notes. They walk you through medication options (Suboxone, Sublocade, Brixadi), explain side effects and timing, and answer your questions.
  4. Prescription (and injection ordering, if chosen). If clinically appropriate, you leave the same day with a Suboxone prescription. If you prefer the extended-release route, your provider will order Sublocade or Brixadi during this visit — we don’t stock injections on-site — and you’ll continue on Suboxone as a bridge. Your injection appointment is scheduled for a follow-up once the medication arrives, typically after a short stabilization period on Suboxone (Sublocade’s FDA label requires at least 7 days of transmucosal buprenorphine before the first injection).

Bring a valid photo ID, your insurance card if applicable, and a list of any medications you currently take. If you’d like to see the full process walked through step by step before your visit, our guide on what to expect at your first Suboxone appointment covers it in more detail.

Why Medication-Assisted Treatment Works for Kratom & 7-OH

For many patients, the fear of withdrawal is what keeps them stuck. MAT removes that barrier — the medication prevents withdrawal rather than forcing patients to endure it — which is why it works when willpower alone doesn’t.

Medication-assisted treatment (MAT) is endorsed as the standard of care for opioid use disorder by the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institute on Drug Abuse (NIDA), the American Society of Addiction Medicine (ASAM), and the World Health Organization.

Large-scale evidence shows that patients with opioid use disorder who receive buprenorphine-based MAT:

  • Experience more than a 50 percent reduction in the risk of fatal opioid overdose
  • Stay in treatment significantly longer than those receiving counseling alone
  • Report fewer cravings and lower rates of illicit opioid use
  • Are more likely to maintain employment and stable housing during recovery
  • Have lower rates of infectious disease transmission associated with injection use

Because kratom and 7-OH act on the same receptors as prescription opioids, buprenorphine-based MAT is as effective for kratom dependence as it is for any other opioid use disorder — and our clinic specifically treats this substance rather than dismissing it as a supplement problem. MAT is not a replacement of one drug with another; it is evidence-based medical care for a medical condition. Medication stabilizes brain chemistry enough that patients can engage in counseling, rebuild relationships, and return to work without the daily cycle of cravings and withdrawal.

Why Restoration Recovery

Choosing where to start treatment matters. Restoration Recovery brings together the clinical depth, the practical access, and the kind of care that keeps patients in treatment long enough to get well.

  • Chattanooga’s longest-running outpatient addiction treatment clinic. Our providers have decades of clinical experience treating opioid and substance use disorders in Southeast Tennessee.
  • CARF accredited. The Commission on Accreditation of Rehabilitation Facilities is the gold standard for outpatient addiction care — our accreditation is reviewed on an ongoing basis, not a one-time stamp.
  • Four clinic locations across Southeast Tennessee and North Georgia, with telehealth follow-up available for established patients.
  • Most major insurance accepted — TennCare, Georgia Medicaid, commercial plans, Medicare, and supplemental Medicare. Our patient services team verifies your benefits before your first visit so there are no surprises.
  • Same-day Suboxone appointments in most cases. You don’t have to wait weeks to start.
  • One integrated team. Medical providers, counselors, certified peer support specialists, and psychiatric care under one roof — not parallel referral tracks that leave you coordinating your own care.
  • Licensed in both states. Licensed in Tennessee and Georgia, HIPAA compliant, 42 CFR Part 2 compliant — your treatment is confidential from the first phone call.

Insurance and Access

Restoration Recovery accepts most major insurance plans, including TennCare, Georgia Medicaid, a broad range of commercial plans, and Medicare (plus supplemental Medicare plans). Our patient services team can verify your benefits before your first appointment so you know exactly what to expect in terms of cost.

If you do not have insurance, contact us anyway. We can help you explore options and will walk you through self-pay pricing. For a full list of accepted carriers and details on the verification process, visit our insurance page.

Four Clinic Locations

We operate four outpatient clinics across Southeast Tennessee and North Georgia. All locations offer kratom and 7-OH addiction treatment with same-day appointments in most cases:

  • Chattanooga, TN — 6141 Shallowford Rd, Suite 100, Chattanooga, TN 37421
  • Cleveland, TN — Serving Bradley County and surrounding areas
  • Soddy-Daisy, TN — Serving Hamilton County north and the Sequatchie Valley
  • Ringgold, GA — Serving Catoosa County and Northwest Georgia

Telehealth follow-up visits are available for established patients who have completed their initial in-person evaluation. For directions, hours, and contact information, visit our locations page.

Take the Next Step

Kratom and 7-OH addiction is survivable, and treatment works. You don’t have to figure this out alone — and you don’t need to have all the answers before you call. You don’t need to be clean before your first appointment. Our team will walk you through the process from your first phone call to your first visit and every follow-up after that.

Same-day appointments are available in most cases. Contact us today to schedule your evaluation, or call 423-498-2000 to speak with our team directly.

Get Started

Ready to start kratom & 7-OH addiction treatment?

Same-day appointments in most cases. Most major insurance plans accepted.