Flint Officials Warn of Rising Addiction to “Gas Station Opioid”

Health and drug rehabilitation officials in Flint, Michigan, are raising alarms about a growing trend of addiction linked to a substance they refer to as a “gas station opioid.” This term describes a highly concentrated form of 7-Hydroxymitragynine (7-OH), a byproduct of kratom, which is increasingly available at convenience stores and smoke shops across Genesee County. Patients are presenting with addiction symptoms similar to those associated with traditional opioids, prompting urgent calls for regulation.

Dr. Dominic Borgialli, an emergency room physician at Hurley Medical Center, explains that while 7-OH is a naturally occurring compound in kratom, the products sold in stores are often super-concentrated. These formulations can exceed the potency of well-known opioids like morphine. “People think it’s benign, something that gives them a little pick-me-up,” Borgialli noted. “However, they quickly develop a tolerance, leading to dependency and withdrawal symptoms akin to those experienced when quitting heroin.”

The issue gained significant attention when the U.S. Food and Drug Administration recommended classifying 7-OH as a Schedule I controlled substance. In response to similar concerns, officials in Florida enacted an emergency rule listing 7-OH as a substance with high potential for abuse and no accepted medical use.

James Hudgens, Executive Director of New Paths Behavioral and Recovery Center, highlighted the dangers posed by 7-OH. He stated, “It functions like an opioid, is addictive like an opioid, and without any real regulation, it’s the new bestseller at local vape shops.” Hudgens recently urged Michigan Attorney General Dana Nessel to take immediate action to classify 7-OH as a controlled substance under Michigan law, thereby removing it from store shelves.

Despite limited data, Hudgens noted that 7-OH may present a reduced risk of fatal overdose compared to more lethal opioids like fentanyl. However, he emphasized that those dependent on 7-OH experience withdrawal symptoms that can be distressing and debilitating. Borgialli confirmed that emergency room visits are increasing, with patients presenting symptoms such as paranoia, confusion, and hallucinations. “It can be challenging to determine if someone is experiencing a mental health crisis or a drug reaction,” he stated.

During an overdose, naloxone can be administered as a reversal agent, offering some measure of safety for users. However, the lack of regulation surrounding kratom and 7-OH means that consumers are often uninformed about the potency of the products they are purchasing. Borgialli pointed out that estimates suggest 7-OH can be up to 30 times more potent than standard kratom sold in small bottles.

The Drug Enforcement Administration (DEA) has noted that kratom leaves contain two primary psychoactive compounds, mitragynine and 7-hydroxymitragynine. The leaves come from a tree native to Southeast Asia and can be consumed in various forms, including as tea, capsules, or energy drinks. Hudgens provided an example of products on the market, noting that a kratom energy drink contained only 0.01 milligrams of mitragynine, while a pill form of 7-OH purchased in Genesee County was listed as containing 15 milligrams.

“The problem is that there’s no legal dose,” Hudgens remarked. “The situation is akin to the wild, wild West, with no laws to regulate these substances.”

Despite the rising concerns surrounding 7-OH, Michigan has made progress in addressing its opioid crisis, with overdose deaths reportedly declining by nearly 9% from 2021 to 2023. Provisional data suggests a projected 34% decline in overdose deaths from 2023 to 2024. Hudgens cautioned that the emergence of substances like 7-OH could reverse this progress if not effectively managed.

Danny Whimmer, press secretary for Attorney General Nessel, acknowledged the concerns regarding 7-OH and similar synthetic opioids. However, he noted that unlike Florida, Michigan does not currently have provisions allowing the attorney general to issue emergency rules for substance scheduling. Wimmer stated, “I am presently unaware of any provision under Michigan law that empowers the attorney general to issue an emergency rule scheduling a substance.”

The situation in Flint underscores the urgent need for increased awareness and regulation of emerging substances like 7-OH. As officials work to navigate this evolving crisis, the potential for addiction and its accompanying challenges cannot be overlooked.