Updates: Kratom Drug Test Coverage and 7-OH Risks for Employers

Published September 9, 2025, Updated October 26, 2026

The deaths of two University of Mississippi students on September 21 have renewed concern about kratom and the concentrated products sold under its name. Authorities found packages of suspected kratom derivatives at the locations of both students' passings, with federal prosecutors describing the deaths as appearing consistent with overdoses. The prosecutors announced drug distribution charges against two people as part of the investigation, though the charges remain allegations, and the announcement did not establish which substance caused either death.

For employers, the investigation renews important questions about workplace drug testing programs: Which substances does the current panel detect? Do supervisors know how to respond when someone appears unable to work safely? And do employees understand that a product sold at a convenience store can still carry serious health risks? 

How Do Kratom Leaf, Concentrated 7-OH, and Newer Compounds Differ?

Kratom leaf contains a natural mix of compounds, primarily mitragynine. People have reported both stimulating and sedating effects from kratom; the leaf can carry health risks, including seizures and substance use disorder, even though its composition differs from a concentrated product.

Kratom leaf also contains 7-hydroxymitragynine, or 7-OH, but only in small amounts. This 7-OH compound only makes up less than 2% of the alkaloids in natural kratom leaf... however, products marketed as "7-OH" contain added or enhanced amounts of the substance. These products may be sold as tablets, gummies, shots, or drink mixes. Because 7-OH acts strongly at opioid receptors, concentrated products can cause serious harm.

A third category includes newer manufactured compounds related to kratom and 7-OH, such as mitragynine pseudoindoxyl (MGPI), MGM-15 and MGM-16. These are distinct chemicals, and preclinical evidence indicates that they have potent opioid activity, although their effects in people are less well understood. DEA placed all three (MGPI, MGM-15 and MGM-16) in Schedule I effective August 26, 2026.

What can kratom-related impairment look like?

In order to detect kratom impairment, employers should focus on what a person is doing, rather than trying to identify a drug by appearance alone: In a study of 60 suspected impaired drivers whose blood contained mitragynine (the main compound in kratom), officers reported behaviors such as weaving, collisions, unsteady walking, poor balance and difficulty completing roadside tasks.  

For a supervisor, possible warning signs include unusual drowsiness, slow responses, confusion, poor coordination or difficulty carrying out a familiar safety task.

What Do Kratom Exposure Reports Show?

A CDC report published in March 2026 analyzed kratom-related exposure reports to U.S. poison centers among people aged 12 and older:

• Annual reports increased from 258 in 2015 to 3,434 in 2025, a rise of approximately 1,200%.
• Poison centers received 14,449 reports across the full 2015–2025 study period.
• Reports involving multiple substances were associated with more severe outcomes than reports involving kratom alone.

(Some important drawbacks: These figures describe reported exposures, including suspected contact, rather than confirmed poisonings in every case. They also do not measure how many employees use kratom or work while impaired, nor do they distinguish traditional kratom leaf from concentrated or semisynthetic products.)

Workplace laboratory findings offer a separate, narrower view. In a published Clinical Reference Laboratory analysis, CRL tested 1,000 de-identified, non-regulated samples for mitragynine and 7-OH. It reported 1% positivity using a 10 ng/mL cutoff.

Federal Kratom and 7-OH Actions Through October 2026

In 2025, the FDA issued a recommendation to control certain 7-OH products. Since then, the DEA has taken several subsequent actions:

• July 2025: The FDA recommended federal scheduling action targeting certain 7-OH products, rather than natural kratom leaf products.
• July 2026: DEA published a notice of intent to temporarily schedule 7-OH above specified thresholds.  
• August 26, 2026: A separate temporary Schedule I order took effect for three related compounds: mitragynine pseudoindoxyl, also called MGPI, MGM-15 and MGM-16. The order runs through August 26, 2028, unless extended or made permanent. 

Sources: 1. DEA October notice for 7-OH and MGPI. 2. DEA October notice for MGM-15 and MGM-16. 12. FDA July 2025 scheduling recommendation. 

What does DEA scheduling mean?

When the DEA schedules a substance under the Controlled Substances Act, it places that substance in one of five categories based on factors that include accepted medical use and potential for abuse or dependence. Scheduling brings legal controls to activities such as manufacturing, distributing, possessing and researching the specific substance covered by the rule.  

Schedule I (under which the temporary order would place MGPI, MGM-15 and MGM-16,) is the most restrictive category: it reflects a finding of high abuse potential and no currently accepted medical use in treatment in the United States.

Does Kratom Show Up on a Drug Test?

As far as employers are concerned: Standard workplace panels generally do not include kratom or 7-OH testing, and a panel described as "testing for opioids" should not be assumed to detect every substance that acts on opioid receptors.

Specialized testing is available, but employers should confirm what each assay actually measures. Ask your screener whether their testing targets mitragynine, 7-OH, or both, and whether their screening and confirmation methods cover the substances of concern.  

For example, kratom immunoassay tests target mitragynine rather than directly detecting 7-OH; though the screen may detect exposure because many commercial 7-OH products also contain mitragynine, it should not be viewed as a direct test for that compound.

How Employers Should Review Their Kratom Drug Testing Policies

Use this checklist to review your current program:  

• Confirm your panel's coverage. Obtain the actual list of substances tested at each location, as labels such as “5-panel” or “10-panel” are not indicative of specialized kratom testing.
• Review the written policy. Work with your legal counsel and your provider to assess how the policy addresses emerging substances, testing circumstances, and fitness for duty.  
• Refresh supervisor training. Explain how to document specific observations, address immediate safety concerns, and follow established reasonable suspicion testing procedures. Supervisors should avoid diagnosing substance use based on symptoms alone.
• Give employees clear information. Explain that retail availability and “natural” labeling do not establish safety or FDA approval. Include confidential employee assistance and treatment resources in that communication.
• Review emergency procedures. Your supervisors should know how to get help immediately. For instance, if someone is unresponsive, call 911; they should not wait for a workplace drug test.

Additionally, in terms of kratom testing specifically, ask the laboratory or screening provider to confirm the analytes, specimen type, cutoffs and confirmation process. Request separate confirmation of whether your provider's testing covers newer derivatives such as MGPI, MGM-15 or MGM-16.

Review Your Drug Testing Program with DISA

DISA helps employers build and manage drug and alcohol testing programs through laboratory coordination, medical review, policy support and supervisor education. As new substances emerge, employers can work with DISA to review their current panels and discuss available testing options for their workforce.

If your policy or testing panel has not been reviewed since 7-OH first drew attention, speak with a DISA expert about your program's coverage and next steps.

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