Legal at the gas station, impaired at work: what HR needs to know about 7-OH

Most workplace drug policies were written for a world where the dangerous stuff was illegal, impairment looked like impairment, and a five-panel test caught most of it. That world is gone. Today an employee can buy a product labeled “7-OH” at a gas station, take it on a break, and be impaired on the job by something that’s legal in their state, isn’t on your panel, and doesn’t look like anything a manager was trained to spot.

We’re seeing more of these members come to us. The story is usually the same. They started with something sold as a supplement, often for pain or anxiety or to get through a shift, and found they couldn’t stop. Nobody at work caught it. Nothing at work was built to.

What these products are

Kratom comes from the leaves of a tree native to Southeast Asia. Its main alkaloid is mitragynine. It’s been sold for years in products marketed for energy, pain, or mood. The FDA hasn’t approved it for any of that and warns of serious risks.

The newer problem is concentrated 7-hydroxymitragynine, or 7-OH. It occurs in kratom naturally in trace amounts. The tablets, gummies, and drink shots now on shelves contain it at added or boosted levels, and the FDA has warned these products can cause serious harm, including addiction and withdrawal. The DEA has published a notice of intent to temporarily place 7-OH above a specified threshold in Schedule I. That’s a proposal, not an order, and temporary scheduling can move fast. A separate August order already put three synthetic kratom-related compounds (mitragynine pseudoindoxyl, MGM-15, and MGM-16) in Schedule I. States are all over the place. Some ban kratom outright, some regulate it like a consumer product, and many haven’t gotten around to 7-OH at all.

Kratom leaf and concentrated 7-OH aren’t the same thing, and your employee education should say so. For policy purposes, though, they belong in the same bucket. Both are legal in much of the country and both can impair someone on the job.

Why this is harder to spot

Alcohol has a smell. Cannabis has a smell. 7-OH impairment usually doesn’t present as anything a supervisor would flag. It looks like fatigue. A slower pace, a missed step, someone who seems a little off. Every one of those has a dozen innocent explanations, and managers are right to be cautious about making an accusation on that basis.

The product doesn’t help. It comes in bright packaging that looks like an energy shot or a bag of candy. The person using it may not think of it as a drug at all. They bought it at a gas station next to the beef jerky. They may believe, sincerely, that it’s a supplement.

“Most of the people we see didn’t think they were using a drug. They bought it at a smoke shop or a gas station, it helped with pain or anxiety or getting through a shift, and it worked until it didn’t. When they describe the withdrawal, it sounds like what we hear from people coming off prescription opioids. That surprises them. It doesn’t surprise us anymore.” AJ Diaz, Chief Clinical Officer, Accountable

So you end up with impairment that doesn’t look like impairment, from a product that doesn’t look like a drug, that a drug test won’t find. The DOT panel doesn’t include kratom alkaloids. Most commercial panels don’t either unless you ask. A negative result can’t rule out a substance the test was never looking for, which sounds obvious until you watch a supervisor treat a negative as exoneration.

The part most policies get wrong: dependence may be a disability

Before you touch policy or training, you have to hold two ideas at once.

Impairment at work is a fitness-for-duty and safety issue. You can act on it, and you should, based on what was observed.

Dependence is something else. The ADA excludes people currently using illegal drugs from its protections, but kratom and 7-OH aren’t illegal in most states. An employee who has become dependent on a lawful substance, especially with a clinician involved, may well be a person with a disability. If a manager documents an observation, HR treats it as a conduct problem, and the company terminates without ever considering accommodation, that is an expensive way to learn this.

It cuts the other way too. Several states, including New York, Colorado, and California, restrict discipline for lawful off-duty conduct. A policy that says “we don’t allow kratom” may not hold up there. A policy that says “you may not be impaired at work, whatever the cause” generally does. That’s the approach we’d take.

What we recommend

Write the policy around impairment rather than a list of substances. Plenty of policies got this update when cannabis went legal. If yours still hinges on “illegal drugs” or “controlled substances,” it has a gap. The standard should be any substance, legal or otherwise, that impairs an employee’s ability to do the job safely and competently, and it should say in so many words that this includes products marketed as supplements. Carve out lawful medication taken as prescribed. Asking about prescriptions is only permissible when it’s job-related and consistent with business necessity, so don’t let managers freelance that. Have employment counsel review the language for every state you operate in.

Train managers to describe what they see and leave the diagnosis to someone else. This is the single most useful thing you can do, and it looks different depending on where your people work.

If your people are on a floor or in a facility, impairment is observable. The manager follows the safety procedure, pulls the employee off the task if needed, speaks with them privately, and writes down what was seen in plain terms. “Slurred speech, dropped the same tool twice, couldn’t follow the checklist” is useful. “Seemed high” is a liability. Whatever happens next has to rest on the conduct, not on a theory about what caused it. If the manager writes “slurred speech” and HR writes “suspected substance use” underneath it, you’ve recreated the problem the training was meant to prevent. Two trained observers and a checklist beat one manager’s memory every time.

If your people are remote or hybrid, you will almost never observe impairment. What a manager sees is slipping output. Missed standups, slower replies, a camera that’s off more than it used to be. That’s a performance issue until proven otherwise and the manager should treat it as one. The move is a direct conversation that opens a door without demanding a reason. Something like: “I’ve noticed X and Y over the past few weeks. I’m not asking why. I want to make sure you know the EAP and the health plan are there, and I want us to agree on what the next two weeks look like.” Then stop. Managers need explicit permission to stop there. They also need to know that if the employee discloses something, the next call is HR, and the manager’s job is done.

Know what your testing program does and doesn’t do. If you test, ask your provider exactly which substances and metabolites are on the panel. If you have DOT-covered employees, that panel is fixed and a company-authority test is a separate question with its own rules. Don’t change anything reactively. Figure out the limits first, then decide.

Find out whether your benefits can actually handle this. “Check your EAP” is the advice everyone gives and nobody follows up on. Call your EAP account manager and your behavioral health network and ask them directly:

1. Does intake have a protocol for kratom or 7-OH dependence, or does it default to a generic substance use script?

2. Who do you refer to, and does anyone in that network manage withdrawal from these products?

3. What happens after the clinical piece? Who stays with the employee through the next six months?

4. How does an employee find this path, and do they believe it’s confidential?

Most people who end up dependent on these products didn’t set out to get high. They were managing something. A path to care that doesn’t feel like a trap is what gets someone to raise their hand early, and in our experience the fourth question is where the answer falls apart.

Where the clinical piece ends

Someone dependent on kratom or 7-OH needs a clinician to assess them and manage treatment and withdrawal. Your EAP or health plan should be able to get them there. That covers the first two questions.

The third question is the one we built Accountable for. After the clinical episode, the employee goes back to work and back to the routines where recovery either holds or doesn’t. We provide virtual recovery coaching and ongoing support alongside that clinical care. Members work with a certified coach who has lived experience, can attend recovery groups, and can loop in their providers and family when they choose. For an employee stepping back into a normal week, that’s one consistent person to check in with. For the benefits team, it’s the piece that sits between the EAP referral and the return-to-work plan, which is the piece most plans don’t have.

If you’re reviewing how employees and their families get from “I think I have a problem” to sustained recovery, we’d like to talk. Reach us at hello@youareaccountable.com or (646) 450-7641.