Dangerous
7-OH stacks a strong opioid on methadone that is still active after you stop feeling it.
Do this
Do not combine. Keep naloxone nearby.
Where the risk isTap for why
What to do
- Say what was taken and how much.Responders need it, and in most US states Good Samaritan laws protect both of you from drug possession charges when you call for an overdose.
- Unresponsive: put them on their side, tilt the head back, and stay until help arrives.Never leave someone alone to “sleep it off”.
- Give naloxone (Narcan) if you have it.It is sold over the counter in every US state and does no harm if opioids turn out not to be involved.
- Never Use Alone 1-800-484-3731Stays on the line and sends help if you stop responding.
- Full steps: what to do if it is already happeningOverdose signs, the recovery position, what to say on the call, and whether you can be charged for making it.
- Poison Control 1-800-222-1222Free and 24/7, for “is this bad?” before it becomes an emergency.
What “Dangerous” means
High risk of death or life-changing injury. Do not combine.
How the ratings workThe longer explanation
Methadone is still active long after you stop feeling it, and 7-OH stacks a strong opioid on top of that load.
Sources (4)
- Hill R et al. The respiratory depressant effects of mitragynine are limited by its conversion to 7-OH mitragynine. Br J Pharmacol. 2022pmc.ncbi.nlm.nih.gov
- FDA recommends scheduling of 7-OH (7-hydroxymitragynine). HHS, July 2025hhs.gov
- QT prolongation with methadonepmc.ncbi.nlm.nih.gov
- Methadone Safety: A Clinical Practice Guideline From the American Pain Society and College on Problems of Drug Dependence, in Collaboration With the Heart Rhythm Societysciencedirect.com
Think this is wrong, or know a better source? Send it.
Related combinations
7-OH withWhat not to mix with 7-OH →
Methadone withWhat not to mix with Methadone →
All combinations →Can you mix 7-OH and Methadone?
MixSafe rates mixing 7-OH and Methadone as "Dangerous" — high risk of death or life-changing injury. Do not combine. Source: MixSafe research. Educational information, not medical advice.