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The Burlington Board of Health on Tuesday voted to ban the sale, manufacture and distribution of kratom, an unregulated substance sold in local convenience stores that coroners have linked to several U.S. deaths.

What is kratom?

Kratom is a plant-derived substance made from the leaves of Mitragyna speciosa, a tree native to Southeast Asia. Its leaves contain mitragynine, the plant's main active compound, which converts in the body into a more potent compound called 7-hydroxymitragynine, or 7-OH. Kratom is typically sold as a powder, pill or extract that people use for its stimulant or sedative effects.

Longtime Board of Health member and former chair Ed Weiner shared a brief explanation of the substance and concerns surrounding it, citing research he'd read in the National Library of Medicine. Weiner said kratom comes in natural and synthetic forms, noting that the products have 14 million to 16 million users in the U.S.

"It's used in the Orient as a stimulant in low doses and as a sedative and analgesic at higher doses, and as a recreational drug it causes euphoria," Weiner said. He added, "There is no regulation, no large-scale clinical studies" to understand the parameters under which the substance can be used safely.

"As early as 2017, the U.S. Food and Drug Administration said they were issuing warnings about kratom, and the CDC in 2019 alone reported 91 deaths linked to kratom," said Weiner. He listed a number of conditions reported to be linked to kratom use, including seizures and liver toxicity. He also added that many kratom products on the market have been found to include compounds not listed on the label and lack compounds that are listed.

Kratom advocates say it has many uses including addiction recovery and pain management and that a ban could cause some users to turn to other illicit substances.

"Some say that kratom may have some usefulness," Weiner said, "however there's no regulation and poor understanding."

Holly Trouville, who lost her son Tyrell in 2024, said mitragynine toxicity was the only cause of death listed on Tyrell's death certificate. He died after drinking a kratom seltzer marketed as free of sugar, alcohol, and caffeine. Trouville called into question claims by kratom advocates about its safety, imploring the board to seek evidence of the substance's efficacy from medical professionals.

Health Department Director Susan Lumenello said department representatives visited gas stations and other establishments in Burlington and found "six or seven" retailers that sell kratom, generally in powder form.

Moving toward a full kratom ban

Massachusetts Governor Maura Healey issued an emergency order in August banning kratom for one year, on the grounds that it creates an "imminent health hazard."

Burlington's Board of Health had already been working the issue. A subcommittee reviewed regulations from other Massachusetts towns and model language from the Massachusetts Association of Health Boards, weighing options that included a full ban and a sales restriction to adults 21 and older. By July, the subcommittee had drafted a full ban, with plans to bring it to the full board in September. In the meantime, the state's emergency order landed.

Burlington's local regulations, developed based on model regulations from the state, would ban only kratom products. The board also established a penalty structure for violating businesses, shaped during the meeting with guidance from Cheryl Sbarra of the Massachusetts Association of Health Boards, for businesses that violate the regulations. This local ban will remain in place even after the emergency order expires.

Citing concerns over safety, as well as a lack of study and regulation up to now, the board unanimously supported a local ban.

"We need to protect the community with unknown substances with very little research and no regulation," said Weiner, "until full research and understanding and full regulation becomes available."

Chair Gayle DaMore echoed Weiner's sentiment, adding, "This is unregulated and often marketed as harmless or a dietary supplement or mood booster, and with no regulation there's no true way to know what's in it."

Steep consequences for non-compliance

The Board of Health discussed consequences for businesses selling kratom products despite the state's emergency order and the town's regulations, once adopted, and decided to institute a $1,000 fine for each violation followed by a suspension or revocation of the business's license for multiple violations within a 36-month time period.

Lumenello said the Health Department will return to the businesses they already identified that sell kratom products to ensure they're no longer on the shelves, but there may be other retailers the department isn't aware of. If other establishments are selling kratom products, "we would depend on the public to bring it to our attention," she said.

Now that the regulations have been accepted by the Board of Health, they'll be advertised in local media once more before taking effect. Any retailers found to be shelving kratom products will be subject to a fine and, in the case of continued non-compliance, more serious consequences.

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