For generations, communities in Southeast Asia have used the leaves of Mitragyna speciosa — kratom — brewed as a drink to relieve pain and steady mood. Its principal alkaloids, mitragynine and the more potent 7-hydroxymitragynine, act on opioid receptors and produce analgesic effects.

Kratom has since gained a significant presence in the United States, where consumers often use it as an alternative to prescription opioids or as a self-directed aid in managing withdrawal. It is sold in teas, capsules, powders, and concentrated extracts, with purified 7-OH products increasingly appearing in vape shops, convenience stores, and online markets.