Supervisors Introduce Ordinance to Ban Sales of Kratom and Related Products, Citing Health Concerns

REDWOOD CITY - San Mateo County supervisors on Tuesday introduced an ordinance that would ban the sale of kratom, a substance made from a tropical tree that health officials say has been linked to overdose deaths and other growing health risks.

The proposed ban, introduced by Supervisor Ray Mueller, would also apply to related compounds, including 7-hydroxymitragynine, or 7-OH, a substance found in small amounts in the plant but is increasingly being concentrated or synthesized into more potent products.

The measure, approved by a 5-0 vote of the Board, would prohibit the sale or distribution in unincorporated areas of the county of any kratom product or item containing detectable levels of 7-OH.

"It is destroying lives up and down the state," Mueller said. "People are going in to stores and really finding an opioid that is readily present, available and being marketed and, in many cases, being marketed to youth."

San Mateo County's Health Officer, Dr. Kismet Baldwin-Santana, said she supports the ordinance "in light of the fact there are known health risks due to kratom and its alkaloid derivatives, including overdoses, deaths and other adverse effects."

Kratom and related products are often sold as natural remedies, but a growing body of evidence points to significant risks.

Mueller said kratom and 7-OH products - including tablets, gummies, drink mixes and liquid shots - are widely sold in gas stations, smoke shops and online retailers and marketed as dietary supplements or wellness products.

In a letter to the Board, Dr. Bonnie Halpern-Felsher, a Stanford Medicine professor of pediatrics, warned that distributors use "marketing strategies that mirror those used for nicotine and cannabis products that have driven youth experimentation and harm. As we have seen with e-cigarettes and other substances, once these products become normalized and embedded in youth culture, prevention becomes far more difficult and costly."

Kratom is derived from the leaves of a tropical evergreen tree, Mitragyna speciosa, and is traditionally used in parts of Southeast Asia for pain relief, mood enhancement and to ease opioid withdrawal symptoms. Its compounds act on opioid receptors in the brain, raising concerns about safety and potential misuse as products have shifted from traditional leaf to concentrated extracts.

Supervisors pointed to warnings from the U.S. Food and Drug Administration, which has said concentrated 7-OH products can pose significantly greater risks than traditional kratom leaf products. The Centers for Disease Control and Prevention has reported an increase in calls to poison control centers associated with the substances.

The proposed ordinance describes a range of potential health effects, from nausea and liver damage to more severe risks such as addiction, seizures and respiratory depression, particularly when products are used in combination with other substances.

Under the measure, violations would be treated as a public nuisance and could carry criminal penalties, including fines of up to $1,000 and up to six months in jail. Businesses found in violation could also face permit or license revocation.

The ordinance will return to the Board for a final vote at a later meeting.

The proposal follows similar actions and warnings elsewhere in California, including in Los Angeles County, where officials have moved to restrict kratom and 7-OH sales after reports of overdoses and deaths.

Kratom remains legal at the federal level, though the Drug Enforcement Administration lists it as a "drug and chemical of concern."

Supervisor Ray Mueller
650-421-5759