San Mateo County moves to block kratom sales as officials warn of growing public health danger

San Mateo, California – A move that county leaders say is aimed at preventing deeper harm is now taking shape in San Mateo County, where supervisors have advanced a proposal to block the sale of kratom and related products in unincorporated areas.

Framed as a public health response rather than a routine regulatory change, the ordinance reflects growing concern over substances that officials say are becoming easier to find, more heavily marketed and increasingly dangerous in stronger forms.

The proposal, introduced Tuesday by Supervisor Ray Mueller and approved for introduction in a 5-0 vote, would ban the sale or distribution of kratom products as well as any item containing detectable levels of 7-hydroxymitragynine, also known as 7-OH. That compound occurs naturally in small amounts in the plant, but officials warned that it is now being concentrated or synthesized into far more potent products.

“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.”

County health leaders backed the measure, arguing that the risks are no longer theoretical. San Mateo County 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.”

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Although kratom is often promoted as a natural product and is sometimes associated with pain relief, mood support or easing opioid withdrawal, supervisors said the marketplace has changed dramatically. Products now appear in forms such as gummies, tablets, liquid shots and drink mixes, and are sold in gas stations, smoke shops and online marketplaces while being presented as wellness or dietary supplements.

In a letter to the Board, Stanford Medicine professor Dr. Bonnie Halpern-Felsher warned that sellers are using tactics that echo the promotion of nicotine and cannabis products.

“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,” she wrote.

The ordinance lays out a wide range of possible harms, including nausea, liver damage, addiction, seizures and respiratory depression, especially when combined with other substances. Supervisors also pointed to warnings from the U.S. Food and Drug Administration and rising poison control reports cited by the Centers for Disease Control and Prevention.

If adopted at a later final vote, violations could be treated as a public nuisance and bring fines of up to $1,000, jail time of up to six months, and possible permit or license revocation. The proposal also places San Mateo County alongside other California jurisdictions, including Los Angeles County, that have moved to tighten restrictions as concern around kratom and 7-OH continues to grow.