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. Because kratom and 7-OH act on the same opioid receptors as prescription opioids, the same buprenorphine-based medications that work for opioid dependence work here.
CARF AccreditedLicensed in Tennessee & GeorgiaSame-day appointments availableConfidential from your first call
At a glance
How we treat kratom & 7-OH addiction
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Restoration Recovery treats kratom and 7-OH (7-hydroxymitragynine) dependence with FDA-approved buprenorphine MAT at all four clinics. Daily Suboxone is prescribed everywhere; Sublocade and Brixadi injections are given at our Chattanooga, Cleveland, and Ringgold locations (Soddy-Daisy is oral-only). Kratom’s primary alkaloid mitragynine and its more potent metabolite 7-OH act on opioid receptors; concentrated 7-OH products on the market today produce dependence rapidly and a withdrawal syndrome that closely mirrors short-acting opioid withdrawal. Buprenorphine controls kratom withdrawal effectively because it acts on the same opioid receptors. The 4-step intake (DSM-5 + COWS for opioid-equivalent withdrawal) applies.
Tennessee’s HB1649 (“Matthew Davenport’s Law,” Public Chapter 950) was signed May 7, 2026 and has banned all kratom and 7-OH statewide since July 1, 2026; Georgia has not banned kratom and regulates it under the Georgia Kratom Consumer Protection Act. Our tracker pages follow both laws in detail; our clinics treat the dependence. Same-week appointments; TennCare, BlueCare, BCBS, UHC, and most commercial insurance accepted.
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’s HB1649/SB1656 (“Matthew Davenport’s Law”) passed both the House and Senate on April 16, 2026 and was signed into law by Gov. Bill Lee on May 7, 2026 (Public Chapter 950), with an effective date of July 1, 2026. Tennessee became the eighth state to fully ban kratom on July 1, 2026 — creating Class A misdemeanor penalties for knowing possession (up to 11 months 29 days and a $2,500 fine), Class C felony penalties for manufacture, delivery, or sale (3 to 15 years and up to a $10,000 fine), and Class B felony penalties for sale to a minor (8 to 30 years and up to a $25,000 fine). HB2594, the regulatory alternative that would have capped 7-OH content and required lab testing, did not advance to a floor vote. The message from regulators is consistent: kratom and 7-OH carry real addiction potential, and the unregulated marketplace has allowed that risk to compound. If you’re physically dependent on kratom or 7-OH, please do not stop cold turkey just because the ban took effect. Abrupt cessation is relapse-prone and uncomfortable; the medically safer path is a buprenorphine-based transition — which we provide regardless of your kratom or 7-OH use history.
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. That extends to the newer semi-synthetic 7-OH analogs now appearing in the U.S. market, such as MGM-15 and MGM-16 — laboratory-made compounds in the same opioid class, which respond to the same buprenorphine-based treatment. We treat dependence on these analogs directly — see our MGM-15 & Oxonol treatment page — and for the underlying science, our explainer on 7-OH versus concentrated kratom products.
Most people want to know how long it takes. For unmanaged kratom withdrawal, patients usually describe the worst stretch as the first 7 to 10 days, though it varies, and concentrated 7-OH often hits sooner than leaf. Buprenorphine shortens that stretch and makes it far easier to get through, because it works on the same opioid receptors kratom and 7-OH do. At your first visit the provider will walk you through what to expect for your own situation.
Kratom-involved ER visits in Tennessee
Annual total, 2019 – 2025
772024
1532025↑ 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
67Withdrawal#1 reason
50Side Effects
20Overdose
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.
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).
Tennessee residents
Tennessee’s kratom and 7-OH ban is now in effect. Want a short, action-shaped guide for the next 7 days? Our dedicated landing page covers what changed legally, how to start treatment this week, and FAQs specific to legal-change-driven decisions.
Searching on behalf of someone else? If you found kratom or a 7-OH product (Feel Free, OPMS, 7-OH tablets, gummies, or shots) and you’re worried about a loved one, see how to help a family member using kratom or 7-OH.
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.
Recognizing it
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. If you’re wondering whether it’s “bad enough” to warrant help, that uncertainty is common, and an evaluation will give you a straight answer.
Kratom & 7-OH Withdrawal: Timeline & 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.
First 6 to 12 hours
Early symptoms
Anxiety, restlessness, muscle aches, yawning, watery eyes, and runny nose. With concentrated 7-OH products, this onset can be even faster.
Acute symptoms gradually subside. Sleep remains disrupted, and cravings are still strong.
Week 2 and beyond · Post-acute
Post-acute symptoms
Low energy, mood changes, and intermittent cravings. These can continue for weeks if unmanaged.
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. For a day-by-day walk-through of the typical arc — onset, peak, and post-acute window — see our dedicated article on the kratom withdrawal timeline.
Learn More: Kratom & 7-OH Topics in Depth
Each of the articles below digs deeper into a specific question we’re asked at intake. They’re written by our team for patients who want the clinical reasoning, not marketing copy.
At Restoration Recovery, kratom and 7-OH use disorder is treated with a combination of medication and psychosocial support. Because the mechanism is opioid-like, the same medications that work for opioid use disorder work here. The options available are:
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.
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 or monthly)
Another extended-release buprenorphine injection, with flexible dosing intervals. Patients who prefer weekly injections rather than Sublocade’s monthly cadence — or who are still finding the right maintenance dose — often start with Brixadi’s weekly option and transition to monthly as their treatment plan evolves.
Individual counseling
Licensed therapists experienced in substance use disorder, focused on the patterns behind use and the work of building a stable life in recovery.
Certified peer support
Specialists who have lived experience with recovery themselves and meet with patients one-on-one.
Intensive outpatient (IOP)
Our IOP serves patients who benefit from a more structured treatment schedule — delivered in a group format by design. IOP is the only group-setting service we offer.
Integrated care for co-occurring conditions
Anxiety, depression, trauma, and hepatitis C — addressed alongside MAT rather than handed off to a separate referral track.
Restoration Recovery is an outpatient clinic, and most patients with kratom and 7-OH use disorder start medication-assisted treatment right here — buprenorphine can begin at the appropriate point after last use, under clinical supervision.
Not sure where to start?
You don’t have to be in withdrawal, and you don’t have to have stopped. Call and we’ll walk you through the first visit and time your medication correctly.
Your first visit typically lasts 2 to 3 hours and follows a four-step clinical flow. You leave the same day with a Suboxone prescription.
01
Intake
Paperwork and a clinical intake, including 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.
02
Counseling
You meet with a counselor to discuss your substance use history, any previous treatment, and your personal recovery goals.
03
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.
04
Prescription
You leave the same day with a Suboxone prescription. If you prefer the extended-release route, your provider orders Sublocade or Brixadi during this visit — we don’t stock injections on-site — and you bridge on Suboxone until your injection appointment.
About 2–3 hours.You leave the same day with a Suboxone prescription.Bring a photo ID, insurance card, and a list of any medications.
More on injection ordering and what to bring+
Injection ordering. If you prefer the extended-release route, your provider orders Sublocade or Brixadi during your first visit — we don’t stock injections on-site — and you 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).
What to bring. A valid photo ID, your insurance card if applicable, and a list of any medications you currently take. To book, call 423-498-2000 — the intake call takes 5 to 10 minutes, and same-day appointments are available. 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.
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 — 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. 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.
CARF-accredited outpatient addiction care
TennCare, BlueCare, BCBS, UHC, Medicare & most commercial insurance accepted. We verify your benefits before your first visit — no surprises. Licensed in TN & GA · HIPAA · 42 CFR Part 2.
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.
For Tennessee TennCare members, Restoration Recovery is enrolled in TennCare’s BESMART program, which removes prior-authorization delays for preferred buprenorphine products used to treat kratom and 7-OH dependence — TennCare patient cost is typically $0. Georgia Medicaid coverage runs on a separate framework; our intake team verifies in-network status before scheduling.
If you do not have insurance, contact us anyway. Self-pay is a flat $250 per month, and our team will explain exactly what that covers before your first visit. 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 available.
We also serve Dalton, GA and Whitfield County — the nearest clinic is in Ringgold, about 20 minutes north via I-75 — see kratom & 7-OH treatment for Dalton, GA. 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 need to have all the answers before you call, and 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. Contact us today to schedule your evaluation, or call 423-498-2000 to speak with our team directly. Phones are answered Monday through Friday, 9am to 4:30pm Eastern; after hours, leave a message or use the callback form and we will respond on the next business day. If you need help right now, the 988 Suicide & Crisis Lifeline and the free, confidential SAMHSA National Helpline (1-800-662-4357) are available 24/7.
Cost & coverage
TennCare typically covers MAT at $0 out of pocket through the BESMART preferred-buprenorphine program, and most commercial plans — BCBS, UHC, Aetna, Cigna, Humana — cover outpatient treatment. Self-pay is a flat $250 per month. You can check your plan before you book.
No — as of July 1, 2026 Tennessee’s HB1649 (“Matthew Davenport’s Law,” Public Chapter 950) bans all kratom and 7-OH products statewide — including plain leaf and powder — with knowing possession a Class A misdemeanor. The ban does not restrict treatment: buprenorphine prescribing for kratom and 7-OH dependence continues unaffected at all four of our clinics. Full bill detail is on our Tennessee kratom ban tracker.
Does Suboxone work for 7-OH withdrawal?+
Buprenorphine — the active medication in Suboxone — acts on the same opioid receptors that mitragynine and 7-OH bind, and published case reports and clinical guidance support using it for kratom and 7-OH dependence. It is FDA-approved for opioid use disorder, not for kratom specifically, so our providers prescribe it off-label: the same evidence-based approach used for opioid dependence. Timing matters with concentrated 7-OH; see can you take Suboxone after 7-OH.
Which clinics treat kratom and 7-OH dependence?+
All four: Chattanooga (Monday–Friday), Cleveland (Tuesday and Thursday), Soddy-Daisy (Monday and Wednesday), and Ringgold, GA (Friday). Telehealth follow-up visits are available across Tennessee and Georgia once you have completed the in-person first visit.
What does kratom treatment cost?+
TennCare patient cost is typically $0 through the BESMART preferred-buprenorphine program. Most commercial plans — BCBS, UHC, Aetna, Cigna, Humana — cover outpatient MAT; verify your plan in about two minutes. Self-pay is a flat $250 per month.
References
Primary legal, regulatory, and public-health sources cited in this article.
Tennessee Department of Health, Overdose Surveillance Program. “Kratom Overdose Trends in Tennessee” (Emerging Trends Brief, February 2026). [TDH]
U.S. Food and Drug Administration. “FDA Takes Steps to Restrict 7-OH Opioid Products Threatening American Consumers” (July 29, 2025). [FDA]
U.S. Food and Drug Administration. “FDA Issues Warning Letters to Firms Marketing Products Containing 7-Hydroxymitragynine” (July 15, 2025). [FDA]
U.S. Drug Enforcement Administration, Diversion Control Division. “Kratom (Mitragyna speciosa Korth) — Drugs and Chemicals of Concern” (designation January 2025). [DEA]
Tennessee General Assembly. HB1649 (“Matthew Davenport’s Law”), 114th General Assembly, signed into law May 7, 2026 (Public Chapter 950). [LegiScan]
Tennessee General Assembly. SB1656 (Senate companion to HB1649), 114th General Assembly, passed April 16, 2026. [LegiScan]
Tennessee General Assembly. HB2594 (kratom regulation alternative; did not advance), 114th General Assembly. [LegiScan]
Centers for Disease Control and Prevention. “Increases in Kratom-Related Reports to Poison Centers — National Poison Data System, United States, 2015–2025.” MMWR 2026;75(11). [CDC MMWR]
WSMV4 News, Nashville. “‘Gas station heroin.’ Tennessee kratom ban bill now heads to Gov. Bill Lee’s desk” (April 17, 2026). [News]
A place for hope & healing
Ready to start kratom & 7-OH addiction treatment?
Same-day appointments available, and most major insurance is accepted. Call or use the booking form, and our team takes it from your first visit through every follow-up.
