An op-ed published in the New Hampshire Bulletin by four practicing physicians is calling attention to what they describe as an unregulated, addictive, and dangerous drug that is widely available in convenience stores, gas stations, and vape shops across the state: kratom. Written by Drs. Yoona Chun, Theodora O'Leary, Eric Ouellette, and P. Travis Harker, the piece arrives as the New Hampshire Legislature prepares to debate Senate Bill 557, which would prohibit the sale of kratom products to anyone under 21 and establish a regulatory framework for the substance. An estimated 1.7 million Americans aged 12 and older use kratom each year. And while 21 other states have banned or restricted access, New Hampshire currently has no state laws governing its sale or distribution.
Kratom comes from a plant historically used as a tea in Southeast Asia, where its psychoactive ingredients occur naturally at low levels. However, the physicians note that modern kratom products are engineered to maximize potency and cause mind-altering effects. The drug has a dual pharmacological profile: it acts as a stimulant at low doses and binds to opioid receptors at higher doses. This combination increases its addictive potential and produces a complex withdrawal that is difficult to treat clinically. The FDA has not approved kratom as either a drug or a dietary supplement. Despite this, manufacturers skirt regulatory requirements by labeling products "not for human consumption" or "botanical specimen," while selling them in energy drinks, tonics, shots, powders, vapes, and pills with marketing language emphasizing words like "earth," "relaxation," and "life."
The physicians report seeing adolescents who begin using kratom to focus or relax and quickly develop dependence, exhibiting symptoms including irritability, anxiety, mood swings, joint pain, and withdrawal signs that closely mirror opioid withdrawal. They note that research aligns with their clinical experience: adolescents may face higher risk of addiction and long-lasting neurobehavioral consequences compared to adults. Equally concerning is kratom's impact on people in long-term opioid recovery. The physicians describe patients who maintained years of sobriety only to develop kratom dependence after well-meaning friends recommended it as a "non-addictive and natural" alternative for pain or insomnia. Some of these patients developed profound depression requiring hospitalization. Additionally, kratom complicates standard addiction treatment because it is not detected by most rapid drug screenings, leading to cases where undisclosed kratom use has triggered severe withdrawal symptoms lasting multiple days.
New Hampshire has attempted to regulate kratom before without success. SB 540 in 2016 proposed a total ban and failed. HB 333 in 2021 proposed comprehensive regulation including an 18-and-older purchase requirement and also stalled. The only local restriction exists in Franklin, which instituted a complete ban on kratom sales in 2019, and Nashua has taken separate action at the municipal level. Senate Bill 557, introduced by Sen. Altschiller and co-sponsored by a bipartisan group, takes a different approach. Formally titled the "Kratom Consumer Protection Act," the bill would prohibit sales to anyone under 21, establish product safety standards, and create a regulatory framework for kratom distribution in the state. The bill had its hearing on February 10, 2026.
The op-ed closes with three direct recommendations: that no one start using kratom, that people currently using it disclose that use to their physicians so treatment plans can account for it, and that the Legislature engage seriously with SB 557 as an opportunity to restrict access to minors and young adults whose developing brains are at the highest risk of long-term harm. "We strongly recommend that no one start using the drug," the physicians wrote, "as we agree with the FDA that kratom is not safe for human consumption."