It would be strange to describe a crisis at length and then not offer to do anything about it. Below is who wrote this, what the clinical experience behind it actually consists of — stated with its limits — what is on offer, and how to get in touch.
This page is not an emergency service and messages are not monitored continuously. If someone is difficult to wake, breathing slowly or abnormally, making choking or gurgling sounds, or turning blue or grey: give naloxone if available and call 911. For poisoning advice, call 1-800-222-1222. For crisis support, call or text 988. To find treatment now, use FindTreatment.gov or read the patient and family guide.
Physician board certified in Addiction Medicine, Anesthesiology, and Sleep Medicine, and founder of EusomniaMD. Clinical work covers assessment and treatment of substance use disorders, opioid dependence, withdrawal and medication treatment, sleep disorders, and the interaction between sleep, sedating drugs, and respiratory risk — a combination that turns out to be unusually relevant to a drug class whose principal acute danger is respiratory depression and whose principal withdrawal complaint is insomnia.
In 2025 he served as faculty for the California Society of Addiction Medicine's Addiction Medicine Board Exam Preparation Course, teaching Basic Science (Neurobiology) and Legal Aspects of Addiction Medicine. CSAM's public faculty listing confirms those teaching roles, the three board certifications, and that no relevant financial relationships were reported for that CME activity.E41
The public course page confirms the teaching roles. It does not itemise every slide, and it does not independently verify that the 2025 presentation contained a segment on 7-OH specifically. That statement is therefore made here as author-reported rather than inferred from the course listing, and would need the final archived 2025 deck to be stated as verified.
Direct treatment of a practice-based case series in the teens involving botanical kratom, concentrated 7-OH, or both — ranging from relatively uncomplicated dependence to severe, high-frequency, high-dose use. Informal clinician consultation on dozens of additional 7-OH withdrawal and treatment cases.E48
The people represented in that experience have not fit one demographic stereotype. They have included younger and older adults, men and women, professionals and people with limited resources, patients with and without prior conventional opioid exposure, and healthcare professionals, including physicians. That range is itself clinically informative: it is why a screening question aimed only at people who look like they use opioids will miss most of this population.
This experience is useful because the formal literature remains small and the commercial market has changed faster than conventional guideline development can follow. It is not a substitute for research, and it is not offered as one.
It is unpublished. It is not an IRB-reviewed research cohort. It is not a prevalence or incidence estimate. It is not proof of a universal withdrawal timeline. It is not evidence that one induction method is best for every patient.
Throughout this resource it is labelled Practice-based synthesis and graded D. Published cases, case series, controlled studies, analytical chemistry, toxicology, and official regulatory documents are cited separately and carry their own grades in the evidence library.
Waiting for a large prospective trial would be scientifically comfortable and clinically useless to patients losing access now. The responsible middle position is to state what is known, identify what is extrapolated, show the limits of every claim, and still give clinicians a structured way to assess risk and apply established opioid use disorder treatment principles.
What follows from that is a practice-based clinical framework, not a national guideline. It is designed to be corrected as direct 7-OH evidence accumulates, and the corrections will be dated and visible rather than silent.
Every claim on this site is graded. Where the honest answer is that nobody knows, the site says nobody knows.
Kratom and 7-OH exposure history, withdrawal assessment, buprenorphine initiation strategy, precipitated-withdrawal risk, differential diagnosis, and level-of-care decisions. Curbside consultation between colleagues, not a formal referral.
Ask a clinical questionWhere legally and clinically appropriate. Subject to licensure, jurisdiction, capacity, and individualised assessment. If you are looking for care and cannot find a prescriber, say so and you will be helped to look.
Patient & family guideDevelopment or review of workflows for detoxification centres, emergency departments, outpatient programmes, and residential treatment facilities — including intake screening, toxicology ordering, and regulatory-transition planning.
Request a reviewGrand rounds, conference lectures, fellow and resident teaching, and public-health presentations. The neurobiology material taught at CSAM in 2025 adapts readily for board preparation or for a general clinical audience. In person in the Bay Area, or by video.
Invite a lectureAvailable to journalists covering the scheduling action for background, on-record comment, or technical review of a draft before publication. The clinical half of this story is being reported thinly, and accurate coverage is genuinely protective.
Press enquiryGuidance for organisations with drug-testing programmes, safety-sensitive roles, or employee assistance responsibilities — including the fact that standard opiate panels do not detect these compounds, and what a defensible policy looks like once they are scheduled.
Discuss a policyClinical services are subject to licensure, jurisdiction, capacity, and individualised assessment. Educational material is not a substitute for emergency care or for a treating clinician.
This project supports decisive regulation of concentrated and semisynthetic 7-OH products. It also holds that removing a widely available opioid product without a treatment bridge creates avoidable harm. Those two positions are not in tension, and anyone who insists they are is arguing about something else.
The purpose of this resource is not to defend the commercial 7-OH market, to create a proprietary detoxification brand, or to make sparse data look abundant. It is to reduce overdose, untreated withdrawal, illicit-opioid substitution, and preventable clinical confusion during a rapidly changing public-health event.
For the 2025 CSAM CME activity, the official course listing states that no relevant financial relationships were disclosed.E41 A course-specific disclosure should not be silently extended to cover all later activity, so a current, resource-specific disclosure is posted separately below.
No financial relationship with any kratom, 7-OH, or dietary-supplement manufacturer, distributor, retailer, trade association, or advocacy organisation. No pharmaceutical industry funding for this resource. No sponsored links. This site is self-published and self-funded. Clinical services described above are offered through EusomniaMD, a private practice.
Suspected errors, missing sources, or potential conflicts may be reported directly. Material corrections are dated and logged rather than silently applied — that policy is part of why a sceptical colleague should be willing to trust the rest of the site. See the evidence library for how each claim is graded.
Please state in your first message which category you are writing about — clinical consultation, patient referral, programme development, teaching, press, or a correction — so that urgent clinical questions can be prioritised.
This is not an emergency service. Messages may not be seen for some time. If you or someone you are with is in danger, call 911.
Do not send protected health information or identifiable patient details through unsecured email. Describe the clinical question without identifiers and a secure channel can be arranged.
Contact does not create a physician–patient relationship. Correspondence about a case is collegial consultation to the treating clinician, who retains responsibility for the patient.
This site is educational and does not constitute medical advice, does not create a physician–patient relationship, and is not a substitute for examination, local protocols, toxicology consultation, or individualised clinical judgement. Anyone experiencing withdrawal from or toxicity due to kratom or 7-OH products should be evaluated by an addiction medicine professional — start with the buprenorphine prescriber finder. In an emergency, call 911.