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San Mateo County on Tuesday became the first county in the Bay Area to ban the sale of kratom, a substance that state health officials say has been found to cause harm and addiction.
“There are known health risks due to kratom and its alkaloid derivatives, including overdoses, deaths and other adverse effects,” said San Mateo County Public Health Officer Dr. Kismet Baldwin-Santana at Tuesday’s Board of Supervisors meeting.
Anything that we can do to be proactive and prevent any overdoses and deaths, it would be much appreciated.”
Kratom is a tropical tree native to Southeast Asia that acts on opioid receptors and can produce stimulant and sedative effects, according to the U.S. Drug Enforcement Administration.
Kratom contains the alkaloid 7-hydroxymitragynine, or 7-OH, which can be extracted from the leaves and synthesized into highly concentrated products such as liquid extract shots, gummies, drink mixes, and tablets. It is sold at retailers like smoke shops and gas stations.
While often marketed as an herbal supplement, kratom products can lead to addiction and potential overdose, according to the California Department of Public Health. From 2020 to 2022, 27 people died in California due to kratom.
In recent years, exposure to kratom has surged across the country, according to the U.S. Centers for Disease Control and Prevention. The National Poison Data System, which tracks data from poison control centers nationwide, found that reports of kratom exposure increased by 1,200% in 2025 compared to 2015.
Kratom is not banned at the federal level, but the U.S. Food and Drug Administration has issued stark warnings against kratom and 7-OH use and does not regulate kratom products. Because kratom and 7-OH-containing products are not FDA-approved, they are illegal to sell as drug products.
“Customers face exposure to products with highly variable potency, zero standardized manufacturing oversight and well-documented links to severe addiction and overdose,” said Supervisor Ray Mueller.
There is also no comprehensive statewide law banning kratom.
The lack of explicit laws banning kratom have made enforcement challenging, but Gov. Gavin Newsom began escalating crackdowns on kratom sales this year through existing food and drug safety laws. There has been state legislation introduced to explicitly ban kratom sales for those under 21, but it is still underway.
“It’s created a frustrating gray area,” Mueller said.
Mueller, who introduced the ordinance, said he first became aware of local sales of kratom when he saw a large banner outside of a smoke shop in Menlo Park that was marketing the substance. He tried to get state authorities to step in, but months of delays in coordinating enforcement made it challenging.
“We had to wait,” Mueller said. “During that entire time, frankly, I was incredibly frustrated knowing that kids could walk into that shop and purchase.”
Supervisor Jackie Speier agreed that taking local action is needed to allow the county to circumvent possible enforcement delays from the state.
“The state may, in fact, through the Legislature, take action at some point,” she said. “But it’s also always slow, and the special interests are very powerful there. So I’m grateful to you for taking this action.”
A dozen members of the public spoke during public comment, urging the board to modify the ordinance to ban 7-OH products only and differentiate between natural leaf kratom and 7-OH.
They spoke about their personal testimonies using kratom leaf to help with issues like pain management.
“I spent years struggling to manage my chronic pain until I discovered whole leaf kratom powder in 2019,” said kratom advocate Jennifer Gillis at the meeting. “It truly gave me my life back. My story is not unique, and kratom has been a lifeline for so many people like me who just want to live meaningful lives.”
But both kratom leaf and 7-OH, the highly concentrated and synthetic version, are not FDA-approved and unregulated.
The Board of Supervisors voted 5-0 to approve the ban. The ordinance makes it a misdemeanor to sell or distribute both kratom and 7-OH products. Retailers in violation could lose permits to sell tobacco products and other county-issued licenses.
While some may be opposed to a blanket ban of all kratom products, the state could introduce legislation to make exceptions.
“In the future, the state may pass legislation to carve out exceptions, which will preempt the county ordinance adopted,” Mueller said. “But until that time, it’s an unacceptable risk to our community to wait.”
