For 14 years, Lora Romney has had a burning sensation on the top half of her face. The feeling, she says, is similar to a painful ice cream headache. One that never leaves. After being diagnosed with trigeminal neuralgia, a disorder that causes chronic facial pain attacks, she tried many doctors, and over 30 medications, but nothing alleviated the need for weekly visits to hospitals and clinics trying to find relief. 

Her chronic pain wasn’t even curbed by brain surgery attempting to ease her symptoms by moving an artery away from a nerve. She felt hopeless. A pain management treatment involving two opioids a day provided relief for about 10 hours, leaving her with the choice between a good night’s sleep, or a day out of bed. She couldn’t have both.

That was until she found kratom, a leaf native to Southeast Asia that, according to federal agencies, millions of Americans use to self-treat conditions including pain, coughing, diarrhea, anxiety, opioid use disorder or withdrawals. But, simultaneously, the plant has been responsible for addiction among Utahns and even death.

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“I ordered a sample pack of the powder, and I started taking it, and I was like, ‘oh my gosh,’ like, within 20 minutes my pain had dropped,” Romney said. “And I just couldn’t believe that I was getting the relief that I had wanted for so long.”

She dropped the opioids, kept the kratom powder and didn’t look back for nine years. She started volunteering for the American Kratom Association, an organization that has lobbied to protect kratom’s legality. She’s also the president at International Plant and Herbal Alliance, a nonprofit advocating for plant-based products. 

Now that a bill proposing to completely ban kratom is advancing in the Utah Legislature, Romney is worried about what her future will look like. At the same time, others are pleading for more regulation after losing family members to overdoses.

Republican and Democratic lawmakers are running three bills aimed to regulate kratom in the state, citing high addiction rates, strong withdrawal issues, deceptive practices, skyrocketing poison control calls related to the plant, and deaths. 

Those impacts stem from the passage of the 2019 Kratom Consumer Protection Act, a law establishing a regulatory framework for the plant, said Senate Majority Assistant Whip Mike McKell, R-Spanish Fork, who is sponsoring a total kratom ban proposal, the most sweeping legislation on the issue this year.

“Since we passed the Kratom Protection Act, we have had deaths in the state of Utah skyrocket,” McKell told the Senate on Friday. “And I think what we’ve learned is that kratom is a significant problem in the state of Utah.”

Kratom products are now found in gas stations and smoke shops throughout the state with little oversight. Some of them increase potency by artificially enhancing 7-hydroxymitragynine, or 7-OH, a naturally occurring alkaloid that’s only a minor constituent of the plant. That, experts say, gives the products a similar effect to opioids like morphine.  

With a 24-4 vote, McKell’s proposal received a first nod on the Senate floor. The bill needs another Senate vote before going to the House for consideration.

Natural vs. synthetic

Romney orders the natural leaf powder online, making sure she buys from reputable vendors. Every day she mixes the product into water and drinks it. It has a nasty, dried-leaf taste, she said, but she prefers that option over capsules, which take longer to take effect. 

But 7-OH products that come in tablets, gummies, drink mixes and shots, she says, aren’t as innocuous as the natural form she takes. 

“It’s so powerful, it doesn’t even register, compared to the powder kratom that I take,” she said. 

Utah’s current law forbids products containing the synthetic forms of 7-OH or mitragynine. The U.S. Food and Drug Administration has already recommended scheduling certain 7-OH products under the Controlled Substance Act. 

And, other 7-OH specific state laws may come this year, like another bill currently advancing through the Utah Legislature aiming to classify 7-OH a schedule I substance, the highest risk category.

But, McKell says mitragynine, the primary chemical compound in the kratom tree, which is substantially less potent than 7-OH, is also problematic. 

“When you take high amounts of kratom, it actually metabolizes into 7-OH in your body. So it has the exact same impact. The manufacturers and those that sell kratom, they know this,” McKell said, citing a study published by the American Chemical Society.

Also, making 7-OH out of pure kratom is also “pretty easy,” McKell said.  

Romney agrees that 7-OH needs to be banned, but she takes issue with putting the unadulterated leaf in the same bucket as synthetics. 

Emotions have run high during her visits to the Utah Capitol to advocate against a total kratom ban, especially after commenting in a Senate Business and Labor Committee hearing on McKell’s bill.

“He basically said, ‘well, we’ve heard from people today that are pain patients that have had some success with this, but basically, all they’re doing is trading one drug for the other,’” Romney said in tears. “I mean, he calls me a drug addict. He’s literally calling me someone who is a drug-seeking pain patient. That is just wrong. It’s wrong.”

Banning kratom in all forms, she said, would just lead people with substance abuse issues to jump to the next fix, but leave those experiencing chronic pain more vulnerable.

“It’s my life I’m losing. It’s the ability to work, take care of my family, to get out of bed,” she said, “and they don’t seem to think that that’s wrong.”

‘We had no idea’

In the same committee meeting, Lance Crump, an Eagle Mountain resident, described how his wife Britaney died of a kratom overdose in 2023. Like Romney, Crump’s wife battled chronic nerve pain, which for her appeared in her arms, shoulders and back. 

After all tests attempting to come up with a diagnosis came back negative, her family became hopeless and the excruciating pain remained a constant that over-the-counter medication could no longer alleviate. 

After watching a documentary about the plant, she found quick relief from taking a few kratom capsules.

“During this time, she was already on medications, but they weren’t really helping with the pain, but the kratom that she began to take definitely helped her,” Crump said. “The first couple of years it seemed to be fine, but then, the tolerance level started to build up.”

Doctors didn’t know enough about kratom to give her professional advice on it, and packages weren’t clear on how much she could have. After years of taking the capsules without much guidance, Britaney increased the frequency of her dose. 

Four years into her kratom use, she would nap constantly, had poor sleeping patterns and her reactive skills were dwindling, Crump said. Around the time she died, she would spend from $600 to $700 a month on kratom from online companies. Most of it was sold to her in an all-natural form, from what Crump could tell.

Two days after Thanksgiving of 2023, after acute stomach pains, Crump and their son tried to take her to the emergency room. But she couldn’t move and stopped breathing along the way. Efforts to revive her failed.

“It’s kind of hard. My kids and I, we’re in the same room and had to watch mom pass away there, and didn’t really know at that point in time what the cause was,” Crump said.

A toxicology report from the medical examiner showed that it was a clear overdose of kratom. All other prescriptions in her system were at normal levels. Crump noted his wife also took gabapentin, a dangerous mix to kratom.

Megan Broekemeier, an overdose fatality examiner at the Utah Department of Health and Human Services, told lawmakers the office hadn’t seen any kratom-related overdoses before 2014. Since then there has been a steady increase in deaths but the number is still relatively low, making up between 4% and 6% of all fatal drug overdoses in the state. Both mitragynine and 7-OH compounds were included in the data.

However, there has been documentation of deaths caused by mitragynine alone. A Tampa Bay Times investigation found that out of 587 kratom-related overdoses in Florida, 46 were attributed to the herb by itself.

From July 2020 through 2025, Utah counted 158 fatal overdoses involving kratom. About 94% of them involved at least one more substance, most commonly fentanyl, gabapentin, alcohol, methamphetamine and amphetamine.

“She was very religious in terms of making sure she took just what she was supposed to, but the kratom part was just like, OK, we don’t have anyone that’s prescribing telling her how much to take. And so at the end of the day, it was regulated by her, and she would take what she thought she needed to ease her pain or calm her nerves,” Crump said. “And, ended in a way that we had no idea.”

Despite the experience, Crump said he sympathizes with chronic pain patients and believes there’s a place in the world for kratom because it is effective. But not in the way it is currently available.

“If it’s just left up to the consumer to self regulate and figure out whether to take two pills or 10 pills, or take it once a day or 10 times a day … there are too many signs from what I witnessed that would tell me, no, it’s not a good idea,” he said. 

Do over

House Minority Whip Jennifer Dailey-Provost, D-Salt Lake City, who has worked on medical cannabis legislation in the state, tried to also work on kratom regulation last year after seeing the opioid-like characteristics of lab-enhanced 7-OH. 

“The industry refused to come to the table to compromise, to work on that bill, and through completely unsurprisingly shady mechanisms, they lied to legislators and the bill died,” she said.

While Dailey-Provost supports McKell’s total ban proposal, this year she’s also bringing her regulatory framework bill back — which would be moot if McKell’s bill passes. The proposal has been assigned to the House Business, Labor, and Commerce Standing Committee, with a public hearing scheduled for Monday.

Her bill sets more specific limits on kratom processors and retailers in the state, requiring them to register with the Department of Agriculture and Food and establishing that the product may not contain psychoactive substances. It also raises the age to buy kratom from 18 to 21 years old and imposes criminal penalties for violators. 

“There are people that sincerely have found true benefit in this, but I also I’m a public health professional, and for me, it comes down to relative risk, and the relative risk is shifting,” Dailey-Provost said. “The risk of people being harmed, even on pure leaf, is escalating, I believe, faster than the rate of people being helped with it.”

After hearing testimonies from people using kratom for chronic pain, McKell maintains his stance. To allow Utahns to legally use kratom for medical purposes, there must be a medical framework in place vetted by doctors and pharmacists, he said.

“My heart goes out to those that have chronic pain, but this is not the way to treat it, outside the supervision of professionals, putting this drug out in front, in a community, on the counter at the gas station,” McKell said. “I don’t think anybody thinks putting oxycontin on the gas station counter is a good idea, and that’s exactly what we’ve done. A lot of people call it gas station heroin.”

In his view, continuing to allow kratom use in the state would only come from repealing the Kratom Consumer Protection Act and starting over. Would he support that? It depends on the involvement — or lack thereof — of the kratom industry as it is today.

“Right now, it’s very clear to me that the industry is more concerned about profit than safety, and deaths have skyrocketed since we passed the Kratom Protection Act,” McKell said. “So allowing the same people to come back in, the same people that built that framework before, to build a new framework makes me very nervous.”