Boston could soon join a growing list of Massachusetts communities that have moved to regulate kratom, a psychoactive substance native to Southeast Asia that has gained popularity in the U.S.
Derived from the kratom tree, the drug has a long history in places like Cambodia, Thailand and Malaysia. But it has recently emerged in the U.S. as an unofficial remedy for anxiety, pain and drug addiction, with companies marketing it in the U.S. as all-natural and safe for consumption.
City Councilor John FitzGerald told GBH News he’s particularly concerned about synthetic kratom containing high concentrations of a psychoactive chemical called 7-hydroxymitragynine, or 7-OH. The chemical is naturally found in low concentrations in kratom, but when manufactured, 7-OH is exponentially more potent, binding to the body’s opioid receptors.
“It’s caused overdose, death, sickness, hospital visits from people thinking that this is marketed as an energy drink or [something to] help you with aches and pains,” said FitzGerald. “Or even in some cases, people say you can use it, too, if you’re trying to fight other opioid addictions.”
Between 2020 and 2025, the Office of the Chief Medical Examiner recorded 91 deaths in which kratom or its primary active compound, mitragynine, was identified as either a cause or contributing factor.
In Massachusetts, kratom is sold widely at gas stations, convenience stores and smoke shops without restrictions.
FitzGerald said he plans to draft a proposal that would ban synthetic versions of the drug, and potentially place age restrictions requiring ID at the point of sale for non-synthetic, or natural, kratom.
Officials with both the Boston Public Health Commission and the Boston Police Department said they don’t collect data on kratom-related incidents. That’s partly because kratom’s relative newness makes it undetectable in standard drug testing.
“Anything like that that’s sold over the counter, unregulated and without the need for proper identification, in my eyes, I see that as a harm to the public good,” said FitzGerald.
FDA urges regulations on kratom
In July 2025, the U.S. Food and Drug Administration recommended that 7-OH be federally regulated as a controlled substance. According to the addiction treatment network Sprout Health Group, six states, including Rhode Island, have outlawed the sale and use of kratom. Several others have passed or are considering limits like age restrictions and bans on the powerful synthetic version.
Despite its relative low lethality, a handful of cities and towns have moved to regulate kratom sales. Kratom opponents, like Holly Trouville of Dracut, are hoping that if Boston implements a ban, that will prompt more cities and towns to act.
“If Boston did ban all kratom, I think that would be huge,” she said. “If you’re a larger city with almost a million people in it saying it’s a problem … I think a lot of other towns and cities would look at [Boston] and say, ‘Why are they banning?’”
Trouville’s son Tyrell died of mitragynine toxicity in 2024 after, she said, he regularly drank kratom products and considered it safe and natural. In Florida, where Trouville’s son died, a local investigation the year before his death revealed that nearly 600 people over the last decade had died of kratom-related overdoses. In most cases, the substance was mixed with at least one other drug.
Trouville, who is now suing the manufacturer of the kratom drinks her son consumed, suspects that’s part of the reason his death certificate reflects mitragynine toxicity as his cause of death.
“So then the wonder is, are there more deaths happening from that than not,” said Trouville. “But people don’t know.”
Dr. Kristin Martin, an addiction physician and chair of the American Osteopathic Associations Conjoint Committee on Addiction Medicine, said kratom is still an emerging area of research. But she says she sees the substance show up regularly in her practice at the River Valley Medical Wellness clinic in Arkansas, where kratom is banned.
“I do see it frequently in daily practice, where patients have often not even realized what it exactly was,” she told GBH News, noting that she has worked in emergency rooms where kratom overexposure has prompted liver complications, seizure disorders and cardiac issues.
“We’ll often see patients that come in who have been trying to get off of one substance — say methamphetamines or opioids — and have reverted to using kratom that they may have gotten from a nearby state,” she said.
She added that if those patients don’t work on their substance use disorder, they can “continue to elevate the amount that they take.”
“It is sometimes astonishing amounts that people are ingesting thinking that they are doing something that is better because they’re not using methamphetamines,” she said.
Does kratom help opioid withdrawal?
On the other side of the kratom debate are those who say it helps with opioid withdrawal without triggering a positive drug test.
Dr. Sarah Wakeman, medical director for substance use disorder at Mass General Brigham, said there’s some truth to that.
“Kratom is really dangerous and harmful and there are case reports of people dying from it,” said Wakeman. “At the same time, for someone who has severe addiction to fentanyl or heroin or oxycontin, kratom is actually a much safer substance, and people are sort of self-managing their withdrawal and their addiction because they can’t access treatment, with this substance that is less risky.”
“It’s a little hard to hold both those truths at the same,” Wakeman said. Personally, she said “I’m a mom and absolutely never want my kids to experiment with kratom and I think it is incredibly problematic.”
But, she added, “For my patients that come to me and have been using illicit opioids and have switched to kratom, they are reducing their risk. Then my job is to try to help make treatment welcoming and available so we can actually treat them with effective therapies that they don’t need self-manage on their own.”
Dr. Kevin Hill, chief of Addiction Psychiatry at Beth Israel Deaconess Medical Center said while there is some data that suggests that it may be helpful to use as a medication to help people get off of opioids, he never recommends kratom to treat patients.
“We have three excellent medications for opioid use disorder,” he said, referring to buprenorphine, methadone, and naltrexone.
“Unfortunately, the reality is with opioids these days and despite the excellent treatments that we have, a lot of patients don’t want those treatments,” said Hill. “There’s a stigma against using medications.”
Lawmakers on Beacon Hill are currently considering several bills that would ban or regulate kratom, including one drafted with the help of the American Kratom Association.
“We fully support regulations on kratom,” said Mac Haddow, senior public policy fellow with the industry group, the American Kratom Association. “There should be product formulation limitations, there should be strict labeling requirements, and there should be age restrictions on the use of any kratom product.”
The group would also support a ban on synthetic kratom, he said, as long as it’s “properly defined” to capture the production of 7-OH and other chemical compounds.
Haddow said while it’s hard to get a “good read” on legislative consensus, the AKA is hoping for passage of regulation rules this year.
Massachusetts State Senate President Karen Spilka and House Speaker Ron Mariano declined to comment for this story.
FitzGerald said he hopes that if Boston adds its name to the kratom regulation list, it will help prompt state action.
“It’d be healthy, not just for the long line of constituents of Boston, but also helping the state look at overall what folks are saying and taking the proper action to do a statewide ban on synthetic kratom.”
If you or someone you know is dealing with addiction, the following resources are available to help:
Substance Abuse and Mental Health Services Administration National Helpline: 1-800-662-HELP (4357)
Greater Boston Addiction Centers: 844-845-6405
