A growing wave of consumer products labeled as ‘kratom’, ‘7-hydroxy mitragynine’, or ‘7-OH’—which contain potent semi-synthetic opioids—marks the emergence of a new class of kratom-derived NPS. Since 2024, new kratom-related products containing 7-hydroxy mitragynine and mitragynine pseudoindoxyl have entered the market, often disguised as natural supplements. Though structurally distinct from traditional opioids, these compounds can mimic opioid effects and are frequently misrepresented in labeling. This NPS Snapshot summarizes the structures of potent kratom-related NPS, mitragynine conversion pathways, and the historical context of natural kratom alkaloids.