What is Kratom and Why Are Some Massachusetts Towns Banning It?
The Kratom Controversy: A Growing Concern
Holly Trouville stood before the Lowell City Council last fall, holding up a green can of seltzer. This, she claimed, was what killed her son. “I knew he drank kratom seltzer,” she said, “but I didn’t know about the dangers.”
Kratom is derived from the leaves of a tree native to Southeast Asia. Over the years, products made from kratom and its concentrated byproduct have gained popularity, despite the lack of federal regulation.
Trouville’s son, Tyrell Njuguna Trouville, died in Florida at the age of 25. His cause of death, as reported by his mother, was toxicity of mitragynine, one of the main psychoactive compounds in kratom. Trouville has been advocating for bans and regulations on kratom, with a bill named after her son aiming to classify it as a Class A controlled substance, placing it alongside opioids. She has shared her story at numerous public hearings.
Kratom products are largely unregulated and available in various forms—powder, pills, and edibles—in places like gas stations, corner stores, and smoke shops. Some products contain 7-OH, a psychoactive compound that is 13 times more potent than morphine, according to the Food and Drug Administration (FDA).
While some users claim significant pain relief from kratom, there is growing concern over its safety. Several cities and towns in Massachusetts, including Northampton, Lowell, and Marlborough, have considered bans or regulations on kratom or its synthetic version. Belchertown became the first municipality in the state to ban it early last year. The Legislature is currently reviewing several bills aimed at regulating or banning the substance. In Connecticut, new regulations are being enacted.
The federal government recently raised an alarm about 7-OH and recommended that the Drug Enforcement Administration classify it as a controlled substance, though not “natural kratom leaf products.” The FDA warns of a “concerning proliferation of concentrated 7-OH products.”
Some fear that synthetic kratom products, widely sold in stores, could contribute to a surge in opioid addiction similar to what happened with prescription painkillers. “This is the fourth wave of the opioid epidemic,” said Dr. C. Michael White, a professor at the University of Connecticut in the Department of Pharmacy Practice. “It could be a little blip or it could be a huge tidal wave.”
However, there are also individuals who find relief from chronic pain through kratom and oppose its ban. For example, a bar in Worcester serves tea brewed from kratom leaves. Its owner, Greg Gately, opposes concentrated 7-OH products but acknowledges the benefits of kratom leaves. “It’s called gas station heroin for a reason,” Gately told state legislators at a hearing in September.
The state Department of Public Health does not track kratom-related overdoses or injuries, according to a department spokesperson. However, the Office of the Chief Medical Examiner has found kratom in the systems of deceased individuals. So far this year, kratom or mitragynine was listed as a cause of death in nine cases, though never as the sole cause. From 2018 through mid-2024, it was included as a cause of death for at least 68 people, either as one of multiple substances or a contributory condition.
In lower doses, kratom acts like an energy booster, while in higher doses, it mimics an opioid. It is not an FDA-approved dietary supplement or ingredient, according to White. “It falls into a gray area where it’s allowed to be sold but doesn’t fall into any of those buckets,” he said.
White is also chair of the Kratom Consumer Advocacy Council, which promotes “responsible use” of kratom and advocates for reforms. Dried kratom leaves began to be sold in the U.S. in the 1970s without many issues, White said. Around 2010, manufacturers began to extract compounds like mitragynine and 7-OH and concentrate them in products.
The pure leaf kratom doesn’t significantly suppress breathing, unlike opioids, but in animal studies, 7-OH does depress breathing, White said. “If you can’t sell morphine in a gas station, you should not be selling this in a gas station because its addiction potential is similar,” he said of the synthetic 7-OH products.
The Kratom Consumer Advocacy Council suggests regulations that include certification that a product has a level of 7-OH similar to that of leaf kratom, along with age restrictions.
Dr. Shelly Berkowitz, a partially retired family doctor in Northampton, didn’t know what kratom was until this spring. Her 33-year-old son purchased kratom in downtown Northampton while visiting. After taking it, he had a seizure. “All of the sudden his eyes were rolling out of his head,” she said.
He started using higher potency kratom products and was later hospitalized for mental health issues and withdrawal symptoms from kratom, Berkowitz said. “He says he will never do it again,” she said. “It’s disrupted our entire family.”
The products don’t include warnings about addiction, and the marketing can make it sound natural and health-conscious, she said. “It’s preying on people’s naivety for profit.”
Her experience with her son motivated her to urge the Northampton Board of Health to ban kratom. The city decided to forbid the sale of synthetic versions of the substance, and the change went into effect Oct. 1.
Holly Trouville’s son, Tyrell, drank kratom seltzers that advertised themselves as having no caffeine, sugar or alcohol, she said. “Tyrell died from a product that is promoted as natural and the truth is just because something is natural does not automatically equate to it being safe,” she told the Lowell City Council.
Dr. Ari Kriegsman, medical director at Springfield Opioid Treatment Program and Carlson Detox Center, said over the last couple of years, about seven people have sought treatment for kratom addictions.
“I haven’t seen a lot of people,” said Kriegsman, who works at Behavioral Health Network, “but we’ve definitely seen people (for whom) it’s really impacted their life, to the point that they check themselves into a residential detox (center) because they felt like they couldn’t stop it.”
Kriegsman said the makeup of kratom is similar to suboxone, the drug used to treat opioid addictions. Drugs like kratom, suboxone and buprenorphine are known as “partial agonists,” which are much less likely to cause an overdose, he said.
“In terms of overdose effects, it’s … nowhere near what we see with heroin or fentanyl,” he said.
But if people aren’t aware of the dependency, it can be dangerous, he said. Withdrawals from kratom could look very similar to that of heroin, causing symptoms like nausea, aches and pains, restlessness, anxiety, depression, pain, stiffness and gastrointestinal issues.
Similar to kratom, Kriegsman pointed to another “gas station drug” called tianeptine, which is a prescription drug for depression, anxiety and chronic pain in other countries. It’s not approved by the FDA for any medical use, but Kriegsman said it can be seen at gas stations and smoke shops in the U.S.
“This particular med also has opioid qualities,” he said. “I’ve seen sort of similar scenarios where people have gotten it, gotten addicted to it, and then needed to get help.”
‘I Have a Life Back’
Amanda Rainer, a New Hampshire resident who spends a lot of time in Massachusetts, has been using kratom on a daily basis for more than eight years. For her, kratom is helpful in managing her chronic disease diagnoses.
Rainer often speaks during the public comment portion of municipal meetings both locally and nationally about kratom and how it has impacted her life. In May, she spoke during the public comment portion of a Northampton Board of Health meeting urging the city not to ban the leaf or 7-OH, though she is supportive of its regulation.
Rainer said she does not buy her kratom from gas stations or smoke shops but from online vendors that she feels are reputable—places that follow responsible manufacturing practices, like maintaining a sterile environment to “ensure products are consistently made to high-quality standards,” she said.
“I have no idea what they’re selling at the gas station or what they’re putting in their packages,” she said.
Rainer’s journey to kratom began when she lost her mom unexpectedly in 2013 from an acute intoxication of morphine and tramadol from a work injury.
“My mom’s toxicology report scared me,” she said. “I wanted to look for holistic ways to treat and manage my pain.” Online groups about kratom alerted Rainer to try the leaf in 2017. She takes kratom powder daily and 7-OH when her pain becomes unbearable.
Rainer has a multitude of chronic illnesses, including Crohn’s disease and Trigeminal neuralgia, which is referred to as “the suicide disease,” she said, explaining she has been on pain medication since she was 9.
Unlike the increasing dosage needed with the pain pills Rainer took, she said her use of kratom has remained at the same level for nearly a decade. She says kratom doesn’t make her feel high; instead, it subdues her pain.
“If the pain medication worked for me, I wouldn’t have sought other, healthier alternatives,” she said. Using kratom allowed her to sit on high school gym bleachers for a few hours during her son’s graduation — something she would’ve struggled with otherwise.
“I’m not addicted to it but I am dependent on it to manage my pain for life,” she said. Most days while taking kratom, Rainer said her pain level — which can range between seven to 10 out of 10 — reduces significantly.
“I have a life back,” she said.
One Northampton resident struggling with scoliosis, endometriosis and chronic pain wrote to the Board of Health to say she found relief with kratom tea, urging the panel not to ban it. Her pain relief came after years of trying conventional medications and alternatives like massage and acupressure, she said.
There are also people who turn to kratom as a way to wean off opioids and help with withdrawal symptoms.
No clinical trials are studying that use, White said, and it’s not an FDA-approved product. But he’s spoken to people and knows there are thousands who were addicted to opioids and kratom helped them recover.
‘A Little Boost of Energy’
Greg Gately serves kratom leaf tea at Root Awaking Kava Bar in Worcester. He’s against 7-OH, the potent synthetic version, but sees kratom leaf as beneficial, he told legislators at a hearing in September. “Customers leave my bar with a little boost of energy and a little focus. That’s it,” he said.
He’s seen it help with pain management. “I’ve had customers come into my bar that after learning about kratom, (and) using it, literally cry in my arms because they’ve said I’ve saved their lives.”
Gately spoke against a proposal to ban the sale of kratom in the state, one of a number of pending bills on the substance.
State Sen. Jacob Oliveira, D-Ludlow, is the co-sponsor of a bill that would put restrictions on kratom sales, but not ban them. That includes requirements for labeling and testing, banning packaging attractive to kids, and allowing only a small amount of the product to be 7-OH.
Oliveira was unavailable for an interview.
State Rep. Rodney Elliott, D-Lowell, filed a proposal for the statewide regulation of kratom earlier this year. His inspiration for the bill came after the city of Lowell passed a ban on the sale and distribution of the leaf and its synthetic version. Elliott’s bill asks the Legislature to consider making kratom a Class A controlled substance, like opioids.
Elliott, the former mayor of Lowell, said kratom doesn’t belong on store shelves.
“I think it’s dangerous,” he said in a recent phone call. “It doesn’t provide any value … (the) substance hasn’t been approved by the FDA by any stretch. So why is it being sold in the United States?”
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