Mike Mah, MDKratom and 7-OH Dependence
Kratom and concentrated kratom derivatives such as 7-hydroxymitragynine, known as 7-OH, have created a fast-growing dependence problem that very few practices are prepared to treat. People who want to stop often find themselves in a gap: addiction clinics can feel intimidating, residential programs are impractical for working adults, and many general psychiatrists do not treat substance use at all. Dr. Mike Mah treats kratom and 7-OH dependence directly, with discreet, evidence-based outpatient care built for people who are ready to stop.
Understanding kratom and 7-OH
Knowing what a person is actually using matters, because treatment for traditional leaf kratom looks different from treatment for concentrated 7-OH products.
Traditional kratom is the dried, ground leaf of a Southeast Asian tree, usually sold as powder, capsules, or tea. Its main active compound, mitragynine, behaves as a partial opioid: stimulating at low doses, more sedating and pain-relieving at higher ones. Used heavily and daily, leaf kratom produces real physical dependence, though it is generally milder than dependence on prescription opioids.
Over the past few years, a different category of product has appeared in gas stations, smoke shops, and online stores. These contain concentrated 7-hydroxymitragynine and are sold under names such as Dozo Perks, 7Tabz, Hydroxie, Opia, and 7OHMZ. Although 7-OH occurs only in trace amounts in the natural leaf, research indicates it is roughly 13 times more potent than morphine at the brain's opioid receptors. People who use these products regularly can develop true opioid dependence comparable to dependence on prescription painkillers, and withdrawal tends to be more severe. Many patients are surprised to learn what they were taking, because the products are marketed as natural wellness supplements and often do not list their 7-OH content.
If you are using a tablet, shot, or extract and cannot stop without feeling sick, that is a sign of physical dependence. It is a treatable medical condition, and it has nothing to do with willpower.
Common reasons people reach out
Patients come to the practice at very different points in their kratom or 7-OH use. Some of the most common starting points include:
- Repeated attempts to quit on their own have not worked, despite a real desire to stop.
- Doses have climbed over time, or use has shifted from leaf kratom to stronger 7-OH products.
- Stopping brings on withdrawal severe enough to drive a return to use within hours.
- Use has become something they hide from partners, family, or coworkers.
- A spouse, parent, or adult child is searching for help on someone's behalf.
- Use began as a way to manage anxiety, depression, ADHD, chronic pain, or poor sleep that was never fully addressed.
Most people who develop kratom dependence are not who you picture when you hear the word addiction. They are working adults who started using to manage anxiety, pain, or sleep. Treating those underlying conditions is the part most programs miss. Dr. Mike Mah
How treatment works at this practice
Every patient starts with an initial consultation: a 75-minute psychiatric evaluation in which Dr. Mike Mah takes a full history of kratom or 7-OH use alongside a complete medical and psychiatric history. What a person is using, how much, and the goals they bring to that first visit shape the plan. Treatment is individualized, and most plans draw on the following elements.
For moderate to severe dependence, especially with 7-OH products, medication support with buprenorphine (often known by the brand name Suboxone) can ease withdrawal and reduce cravings so patients can stop using without enduring a harsh withdrawal period. Dr. Mike Mah uses a micro-induction approach, increasingly used at academic addiction-medicine centers, which introduces buprenorphine gradually rather than requiring a patient to be in full withdrawal first. For patients using smaller amounts of leaf kratom, a structured taper supported by non-addictive medications is sometimes enough. That decision is always made together with the patient.
Treating the anxiety, depression, ADHD, sleep difficulties, or pain that often drive kratom use is central to lasting recovery, and it is something a psychiatric practice is uniquely positioned to do. Where therapy is part of the plan, Dr. Mike Mah coordinates with experienced Los Angeles therapists who specialize in substance use. Recovery is a process rather than a single appointment, and most patients continue care for several months to a year as their stability builds.
Common questions
The clearest sign is that stopping makes you feel physically unwell, with symptoms like anxiety, aches, sweating, or nausea, and using again relieves it. Needing the substance to feel normal, rather than to feel better, points to physical dependence.
Some people taper successfully on their own, but many cannot, particularly with 7-OH, because withdrawal arrives quickly and intensely. Difficulty stopping reflects physiology, not weakness, and medical support makes the process far more manageable.
Acute symptoms usually begin within hours to a day after the last dose, peak over the first two to three days, and ease over the following week. Milder lingering effects such as low mood, poor sleep, and fatigue can persist for weeks as the brain returns to baseline.
No. Taken as prescribed, buprenorphine treats a medical condition without producing a high at therapeutic doses, much as an antidepressant treats depression. It allows people to function normally rather than organizing their lives around the next dose.
No. For most patients Dr. Mike Mah uses a micro-induction approach, which introduces buprenorphine gradually and lets treatment begin without first going through full withdrawal.
Yes. Treatment records are protected under HIPAA and applicable state and federal privacy laws, and information about your treatment is not shared without your written consent.
Fees and getting started
The initial 75-minute consultation is $750. Follow-up medication visits are 25 minutes at $400. Dr. Mike Mah does not accept insurance directly, but for patients with out-of-network mental health benefits, the office provides a superbill that can be submitted to insurance for potential partial reimbursement.
Patients who prefer to use insurance can be seen at Century City Psychiatry, Dr. Mike Mah's insurance-based group practice, where a hand-selected team of clinicians delivers kratom and 7-OH dependence treatment under his direct clinical supervision.
This page is educational and is not medical advice. Treatment decisions are made together with a clinician based on your individual situation. In a medical emergency, call 911. If you are in crisis, call or text 988 to reach the Suicide and Crisis Lifeline.