During my tenure as CDC Director, I witnessed firsthand how quickly emerging substances can overwhelm our public health infrastructure. Today, I’m compelled to warn about a new threat hiding in plain sight: a potent synthetic opioid masquerading as natural kratom.

As a virologist who has spent decades studying how pathogens adapt and spread, I recognize the same pattern in how dangerous substances evolve to evade detection. What we’re seeing with the compound 7-hydroxymitragynine is a textbook case of how manufacturers exploit regulatory gaps to create products that are, in essence, unregulated pharmaceuticals.

Recent investigative testing by The Tampa Bay Times revealed kratom tablets containing 15 milligrams of 7-hydroxymitragynine each — concentrations that experts have characterized as equivalent to “legal morphine.” These are not trace amounts found naturally in kratom leaf. Laboratory analysis confirms that these levels can only result from chemical manipulation, where manufacturers convert the naturally occurring alkaloid........

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