Holly Trouville stood before the Lowell City Council in autumn 2025 holding a green can of seltzer. This seemingly innocuous beverage, she told the assembled officials, had killed her 25-year-old son, Tyrell Njuguna Trouville.

“I was aware he drank kratom seltzer,” she said, “but I was not aware of the dangers.”

Tyrell’s death in Florida was attributed to toxicity from mitragynine, one of the main psychoactive compounds in kratom. His mother’s testimony has become part of a growing conversation about kratom risks and regulation across the United States, particularly in Massachusetts where multiple municipalities are now taking action.

Understanding Kratom and Its Variants

Kratom leaves originate from a tree native to Southeast Asia. In recent years, products made from kratom have proliferated in corner shops, petrol stations, and smoke shops, largely unregulated by federal authorities. The substance comes in various forms including powder, pills, and edibles.

At lower doses, kratom acts as an energy booster. At higher doses, it mimics opioid effects. However, the kratom safety concerns have intensified with the emergence of 7-OH, a psychoactive compound that occurs naturally in small amounts in dried kratom leaves but is now being concentrated by manufacturers.

According to the Food and Drug Administration, 7-OH is 13 times more potent than morphine. The agency has raised alarms about the “concerning proliferation of concentrated 7-OH products” and recommended that the Drug Enforcement Administration classify the synthetic version as a controlled substance.

The Fourth Wave of an Epidemic?

Dr C. Michael White, professor at the University of Connecticut’s Department of Pharmacy Practice, warns that synthetic kratom products could trigger another surge in opioid addiction.

“This is the fourth wave of the opioid epidemic,” White said. “It could be a little blip or it could be a huge tidal wave.”

The kratom risks and regulation debate has prompted several Massachusetts communities to take preventative action. Belchertown became the first municipality in the state to ban kratom in early 2024. Since then, cities including Northampton, Lowell, and Marlborough have considered or implemented bans or regulations. The state legislature is weighing multiple bills addressing the substance.

Medical Examiner Data Reveals Fatal Connections

The Massachusetts Office of the Chief Medical Examiner has documented kratom’s presence in fatal cases. Through mid-2024, the substance was included as a cause of death for at least 68 people, either alongside other substances or as a contributory condition. In 2025, kratom or mitragynine appeared as a cause of death in nine cases through November, though never as the sole cause.

The state Department of Public Health does not currently track kratom-related overdoses or injuries, according to a department spokesperson, highlighting gaps in understanding the full scope of kratom safety concerns.

Personal Tragedy Drives Action

Dr Shelly Berkowitz, a partially retired family doctor in Northampton, knew nothing about kratom until spring 2025 when her 33-year-old son purchased it in downtown Northampton. After consuming it, he suffered a seizure.

“All of a sudden his eyes were rolling out of his head,” she recalled.

Her son subsequently used higher potency kratom products and was hospitalised for mental health issues and withdrawal symptoms. “He says he will never do it again,” Berkowitz said. “It’s disrupted our entire family.”

The experience motivated her to urge Northampton’s Board of Health to address kratom risks and regulation. The city responded by banning synthetic versions of the substance, with the prohibition taking effect on 1st October 2025.

Berkowitz criticised the marketing of these products. “It’s preying on people’s naivety for profit,” she said, noting that packages lack warnings about addiction potential whilst suggesting natural, health-conscious benefits.

Clinical Perspectives on Addiction Potential

Dr Ari Kriegsman, medical director at Springfield Opioid Treatment Programme and Carlson Detox Centre, has treated approximately seven people for kratom addictions over recent years.

“We’ve definitely seen people (for whom) it’s really impacted their life, to the point that they check themselves into a residential detox (centre) because they felt like they couldn’t stop it,” Kriegsman said.

He explained that kratom’s chemical makeup resembles suboxone, the medication used to treat opioid addictions. Both are “partial agonists,” making them much less likely to cause fatal overdoses compared to heroin or fentanyl. However, kratom safety concerns extend beyond overdose risk to dependency and withdrawal.

Withdrawal symptoms from kratom mirror those of heroin, including nausea, body aches, restlessness, anxiety, depression, and gastrointestinal issues. The similarity to other “petrol station drugs” like tianeptine, which also possesses opioid qualities, has raised additional red flags amongst healthcare professionals.

The Other Side: Chronic Pain Relief

Not everyone supports strict kratom risks and regulation measures. Amanda Rainer, a New Hampshire resident, has used kratom daily for over eight years to manage multiple chronic illnesses including Crohn’s disease and trigeminal neuralgia.

“I have a life back,” Rainer said, explaining that kratom allows her to function in situations that would otherwise be impossible due to pain.

Rainer’s interest in kratom began after her mother died from acute intoxication of morphine and tramadol following 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.”

She purchases kratom from online vendors she considers reputable rather than petrol stations, and maintains the same dosage level she’s used for nearly a decade. Unlike conventional pain medications that required increasing doses, Rainer says kratom consistently manages her pain without making her feel intoxicated.

Greg Gately, who serves kratom leaf tea at Root Awaking Kava Bar in Worcester, testified before state legislators in September 2025. Whilst opposing concentrated 7-OH products, which he’s dubbed “petrol station heroin,” he supports access to kratom leaf.

“Customers leave my bar with a little boost of energy and a little focus. That’s it,” Gately said, adding that he’s witnessed customers overcome pain issues through kratom use.

Legislative Responses Take Shape

State Senator Jacob Oliveira has co-sponsored legislation that would restrict rather than ban kratom sales. The proposed measures include labelling and testing requirements, prohibitions on packaging designed to appeal to children, and limits on 7-OH content.

State Representative Rodney Elliott filed a proposal in 2025 to classify kratom as a Class A controlled substance, placing it in the same category as opioids. Elliott, the former mayor of Lowell, questions why an FDA-unapproved substance remains available for sale.

“I think it’s dangerous,” Elliott said. “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?”

Holly Trouville supports Elliott’s approach. She’s pushing for a bill in her son’s name that would implement similar restrictions. “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.

The Path Forward

The debate over kratom risks and regulation reflects broader tensions between harm reduction, pain management access, and public health protection. Proponents of kratom emphasise its potential benefits for chronic pain sufferers and those seeking alternatives to prescription opioids. Critics point to fatalities, addiction cases, and the unregulated nature of products sold in retail settings.

Dr White’s Kratom Consumer Advocacy Council has proposed middle-ground regulations including certification that products contain 7-OH levels similar to natural leaf kratom, alongside age restrictions. This approach attempts to address kratom safety concerns whilst preserving access to less potent forms.

As Connecticut implements new regulations and Massachusetts communities continue evaluating their options, the kratom debate illustrates the challenges of responding to emerging substances that fall into regulatory grey areas. For families like the Trouvilles and the Berkowitzes, the urgency of action is personal and immediate.

The coming months will likely see further legislative developments as policymakers balance competing concerns about kratom risks and regulation, attempting to prevent harm whilst considering those who report genuine benefits from the substance.

Source: Mass Live