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Kratom was linked to 6 L.A. deaths and banned in the county. But the supplement’s actual health risks remain a mystery

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Kratom was linked to 6 L.A. deaths and banned in the county. But the supplement’s actual health risks remain a mystery

Recently, the Los Angeles County Public Health Department reported it had linked the deaths of six L.A. County residents over the last spring and summer to the use of kratom, a widely available but unregulated supplement sold as a remedy for all sorts of health issues.

The deaths prompted public health officials to announce Nov. 7 that they would red-tag and pull from store shelves all products containing either kratom or the synthetic alkaloid 7-Hydroxymitragynine, also known as 7-OH, which is derived from kratom. Both are currently unregulated and not approved for use in the United States or the state of California as a drug product, dietary supplement or an approved food additive, according to the U.S. Food and Drug Administration.

For the record:

10:16 a.m. Nov. 20, 2025A previous version of this article misspelled Dee Macaluso’s last name as Mascalusco.

Unsurprisingly, business owners who sell kratom feel that the health department has overstepped, going too far without understanding how the supplement is helping many L.A. residents. The deaths, they say, are not necessarily due to kratom products, but to interactions with other substances.

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Perhaps more important are the benefits that kratom users and some experts claim the drug provides. Many say the problem is with 7-OH — a highly concentrated, synthetic version of natural kratom that is subject to adulteration and fraudulent marketing — and that banning the sale of all kratom products could create an even more dangerous underground market of both kratom and 7-OH.

Indeed, many kratom sellers and users would welcome better regulation, so that they could continue to use the affordable, widely available substance as a way to treat physical pain and mental health issues with more confidence in the efficacy and safety of the products they are selling and buying.

During the months of April and July, a total of six L.A. County adults between the ages of 19 and 39 died with kratom and 7-OH in their bodies, along with other substances including alcohol, prescription sedatives and muscle relaxers, and cocaine.

In the medical examiner’s reports, the cause of death for five of the deceased was listed as a consequence of “mixed drug effects”; the sixth was listed as being caused by an overdose of cocaine.

The Times spoke with three different toxicologists to review these coroner’s reports and get a better understanding of what role kratom or 7-OH may have had in the deaths.

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What the experts told The Times is that while toxicologists have an understanding of the possible effect that kratom alone can have on the body, the picture becomes unclear when other drugs are introduced.

Kratom is an herbal extract made from the leaves of Mitragyna speciosa, a tree native to Southeast Asia. It is sold in smoke shops and online in a variety of forms including powders, pills and liquid extracts.

At low doses, kratom causes a stimulant effect with users reporting an uptick in energy. At high doses it creates a sedative effect, said Donna Papsun, a forensic toxicologist with NMS Labs.

Researchers say a majority of kratom users consume the plant to relieve pain. In some cases, people report using it effectively to treat opioid dependence. Others use it to alleviate mental health challenges such as anxiety and depression.

In the last few years, a synthetic version of kratom refined to its psychoactive compound 7-Hydroxymitragynine, or 7-OH, has grown in popularity. The much more potent form of the largely unregulated drug has become a concern for public health officials and advocates.

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But toxicologists say there isn’t enough research to provide a comprehensive understanding of what concentrations of kratom or 7-OH can be acutely toxic in the body when alone.

It’s likely they can also cause dangerous reactions when combined with other drugs that could amplify their effects, experts said, but the lack of research means doctors just don’t know what they are. That’s where the most concerning risks lie, said Craig Smollin, medical director of the San Francisco division of the California Poison Control System.

In cases where kratom and 7-OH are found in the bodies of a recent accidental death, typically toxicologists have found evidence of polysubstance use — when two or more drugs are taken together either intentionally or unintentionally.

“I don’t claim to have investigated all the reports about kratom deaths, but I haven’t seen too many reports of single-drug ingestions of kratom causing death,” Smollin said.

And while there’s an effective method to test for the quantity of kratom in the body, there isn’t a similarly accurate test for 7-OH. Current tests can only say whether or not it is present. In all six L.A. County deaths, it was.

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But, Papsun notes, when kratom is metabolized in the body, part of the breakdown includes 7-OH, which means it will likely show up in medical exams whenever kratom does.

Toxicology labs face significant challenges when trying to quickly develop tests for emerging drugs like 7-OH for use in post-mortem medical examinations, Papsun said. “Adding something to a scope of testing is not easy from a forensic point of view because you have to develop it, validate the test, have available commercial material and it has to be scientifically rigorous because these results can end up in court,” Papsun said.

A further challenge to testing for 7-OH, specifically, is that the compound is “incredibly unstable,” she said. It can be detected in the body at the time of death but by the time the sample is collected and tested, the compound may have started to break down already, leading to inaccurate results.

Robert Powers, a forensic toxicologist at the University of New Haven, agreed that it was difficult to tell whether kratom and 7-OH played a direct role in the L.A. County deaths. “Most of the problems that arise with this drug are in combination with other respiratory depressant type drugs: opiates, benzodiazepines, alcohol,” he said, though he added that the deaths are “not an easy picture” to understand.

That’s why, he said, the L.A. County health department’s move to pull these products off the shelves makes sense. “I think it’s reasonable to recognize that in these cases, kratom could have indeed played a contributory role. And I understand the interest in trying to limit the potential effects of this drug in those mixed cases, so I understand why people would be interested in controlling this drug.”

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Smollin, the San Francisco poison center director, concurred, pointing out how much the county still might not know about kratom and 7-OH.

That lack of information trickles down to consumers, who often rely on guidance from local, state and federal agencies about the risks of products like kratom and 7-OH.

Indeed, Dee Macaluso, 74, said she’s had to take it upon herself to seek out other sources of guidance, and experiment with different amounts of daily dosage to alleviate her symptoms of fatigue and trouble breathing from years of chronic lung illnesses.

When she learned of the county’s decision, “it scared me to death that they were going to pull” kratom products. “I told my husband, I don’t know what I’m going to do if I don’t have it and then I won’t be able to get out of bed, or paint or do the little bit that I can do,” she said.

Macaluso was an actor and comedian who in her 60s lived in Park City, Utah, but more recently moved to L.A. when her health declined due to pneumonia that progressed to debilitating infections in her lungs.

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Macaluso used to have an active lifestyle, but the damage to her lungs made it so she could barely go up and down the stairs of her Utah home without feeling winded. She also felt the elevation in Park City was straining her health — it’s one reason she chose to move to Los Angeles, which is mostly low-altitude.

She saw a number of specialists, but none offered any options that helped alleviate her symptoms. Then, she stumbled on a documentary that highlighted the benefits of kratom in regards to chronic pain and mental health. She decided to try it.

“I didn’t use it very often, but when I did I found that it helped so many of my issues,” Macaluso said.

She described the effect as a boost of energy that in turn gave her the motivation and strength to get out of bed. “This was much more of a subtle feeling of just relief from being in a state of someone who is unwell and tired,” Macaluso said. “I loved it and I still use it.”

As her illness has progressed, Macaluso has continued to rely on kratom whenever she knows she’ll have a long day or has to attend a function and be sociable.

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“It made me feel like my old self — smart mouth, funny and quick. I was a stand-up comic, I did all these things and I was becoming this old tired lady that got winded going up a few stairs and it pissed me off,” she said.

Macaluso doesn’t advocate for 7-OH but she doesn’t want kratom to be banned; she’d rather it be regulated and available to the public.

“I think the government should give us the leeway to educate ourselves,” she said. ”There’s always going to be people that misuse it but I don’t think that those of us who are using it responsibly and getting benefit from it should be penalized.”

Business owners like Abdullah Mamun, who started the company Authentic Kratom 12 years ago, agree with Macaluso’s perspective.

Authentic Kratom began as an e-commerce business based in Canoga Park, and has since grown into three brick-and-mortar locations in Canoga Park, Woodland Hills and Hollywood.

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Mamun believes 7-OH is a real risk, and that L.A. County should focus its efforts there. A blanket ban on all kratom products, however, is counterproductive, he said. First of all, based on what his customers have told him over the past decade or so, he believes “kratom doesn’t cure you, but it gives people the relief that they’re looking for and the ability to manage their pain.” Second, red-tagging kratom products would directly affect his Authentic Kratom and the livelihood of his seven full-time employees.

And he welcomes regulation on kratom products.

“We want them to be properly labeled for customers because people should know what they’re putting in their body,” he said.

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Owners of fire-destroyed Palisades mobile home park seek to displace residents for development deal

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Owners of fire-destroyed Palisades mobile home park seek to displace residents for development deal

For months, former residents of the Pacific Palisades Bowl Mobile Estates have feared the uncommunicative owners of the property would seek to displace them in favor of a more lucrative development deal after the Palisades fire destroyed the rent-controlled, roughly 170-unit mobile home park.

A confidential memorandum listing the Bowl for sale indicates the owners intend to do exactly that.

The memorandum, quietly posted on a website associated with the global commercial real estate company CBRE, says that the Palisades fire created a “blank canvas for redevelopment” at a site “ideally positioned for a transformative residential or mixed-use project.”

“I just thought, oh my god, this is so much propaganda and false advertising,” said Lisa Ross, a 33-year resident of the Bowl and a Realtor. “How can they even get away with printing this?”

Neither the current owners of the Bowl nor the real estate companies listed on the memorandum responded to requests for comment.

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The memorandum describes the current single-family residential zoning as “favorable” for developers; however, the city and mobile housing law experts have painted a different picture.

Fire debris at Pacific Palisades Bowl in January 2026.

(Myung J. Chun / Los Angeles Times)

“Multifamily and mixed-use development on this site is not allowed by existing zoning and land use regulations,” Mayor Karen Bass’s office said in a statement Wednesday, adding only low density single-family housing or reconstructing the mobile home park are currently allowed. “Mayor Bass will continue taking action and [work] with residents to restore the Palisades community.”

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City Councilmember Traci Park also reiterated her focus on getting the mobile home park rebuilt and allowing residents to return, with a spokesperson noting she is not entertaining the potential for any rezoning efforts from a developer.

Zoning changes typically require a city council vote and are subject to the mayor’s approval or veto.

Beyond the zoning laws, the site is also currently governed by a state law requiring cities to preserve affordable housing along the coast and a city ordinance protecting mobile home residents against sudden displacement.

Spencer Pratt, a resident of the Palisades and an outspoken supporter of the neighborhood’s mobile home community, criticized the mayor and the owners in a statement to The Times. “It’s unfortunate that Karen Bass has not advocated for mobile home residents impacted by the fire,” he said, “and that the current owner of the Bowl is ignoring good faith offers from residents to buy the property.”

The mayor’s office disputed this, noting Bass recently led a delegation of Palisadians, including mobile home owners, to Sacramento to advocate for recovery. “Mayor Bass’ priority is getting every Palisadian home — single-family homeowners, town home owners, renters, mobile home owners.”

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Los Angeles Mayor Karen Bass in Los Angeles on Jan. 7, 2026.

Los Angeles Mayor Karen Bass speaks during a private ceremony outside City Hall with faith leaders, LAPD officers and city officials to commemorate the one-year anniversary of the Eaton and Palisades fires on Jan. 7, 2026.

(Allen J. Schaben / Los Angeles Times)

Bass also advocated for the federal government to include the Bowl in its debris cleanup efforts; however, the Federal Emergency Management Agency ultimately refused to include it, unlike other mobile home parks impacted by the Palisades fire. Its reasoning: It could not trust the owners to rebuild the park as affordable housing.

Court rulings over the years found the owners routinely failed to maintain the infrastructure and worked to replace the park with an “upscale resort community.” Residents also accused the owners of attempting to circumvent rent control regulations.

After the fire, it ultimately took more than 13 months to begin cleaning up the debris.

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Ross said she approached the owners with independent mobile home park developers who were interested in buying the fire-destroyed lot and letting residents rebuild within months. She also approached the owners with a proposition that the former residents band together to buy the park. She heard nothing back.

“They don’t communicate,” Ross said. “It’s a feuding family. That’s also why we had so many problems with maintenance and with upgrades in the park.”

Pratt, who is running for mayor against Bass, also called on private developers like Rick Caruso to step in and save the Bowl. (Caruso’s team noted his rebuilding nonprofit is looking into how to help residents of the Bowl.)

Ross is a fan of Pratt’s proposition. “We need those kinds of people — we need Rick Caruso. That would be great,” Ross said. To sweeten the deal: “I’ll cook for him. I would make him all his favorite dishes.”

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A virus without a vaccine or treatment is hitting California. What you need to know

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A virus without a vaccine or treatment is hitting California. What you need to know

A respiratory virus that doesn’t have a vaccine or a specific treatment regimen is spreading in some parts of California — but there’s no need to sound the alarm just yet, public health officials say.

A majority of Northern California communities have seen high concentrations of human metapneumovirus, or HMPV, detected in their wastewater, according to data from the WastewaterScan Dashboard, a public database that monitors sewage to track the presence of infectious diseases.

A Los Angeles Times data analysis found the communities of Merced in the San Joaquin Valley, and Novato and Sunnyvale in the San Francisco Bay Area have seen increases in HMPV levels in their wastewater between mid-December and the end of February.

HMPV has also been detected in L.A. County, though at levels considered low to moderate at this point, data show.

While HMPV may not necessarily ring a bell, it isn’t a new virus. Its typical pattern of seasonal spread was upended by the COVID-19 pandemic, and its resurgence could signal a return to a more typical pre-coronavirus respiratory disease landscape.

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Here’s what you need to know.

What is HMPV?

HMPV was first detected in 2001, according to the U.S. Centers for Disease Control and Prevention. It’s transmitted by close contact with someone who is infected or by touching a contaminated surface, said Dr. Neha Nanda, chief of infectious diseases and hospital epidemiologist for Keck Medicine of USC.

Like other respiratory illnesses, such as influenza, HMPV spreads and is more durable in colder temperatures, infectious-disease experts say.

Human metapneumovirus cases commonly start showing up in January before peaking in March or April and then tailing off in June, said Dr. Jessica August, chief of infectious diseases at Kaiser Permanente Santa Rosa.

However, as was the case with many respiratory viruses, COVID disrupted that seasonal trend.

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Why are we talking about HMPV now?

Before the pandemic hit in 2020, Americans were regularly exposed to seasonal viruses like HMPV and developed a degree of natural immunity, August said.

That protection waned during the pandemic, as people stayed home or kept their distance from others. So when people resumed normal activities, they were more vulnerable to the virus. Unlike other viruses, there isn’t a vaccine for human metapneumovirus.

“That’s why after the pandemic we saw record-breaking childhood viral illnesses because we lacked the usual immunity that we had, just from lack of exposure,” August said. “All of that also led to longer viral seasons, more severe illness. But all of these things have settled down in many respects.”

In 2024, the national test positivity for HMPV peaked at 11.7% at the end of March, according to the National Respiratory and Enteric Virus Surveillance System. The following year’s peak was 7.15% in late April.

So far this year, the highest test positivity rate documented was 6.1%, reported on Feb. 21 — the most recent date for which complete data are available.

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While the seasonal spread of viruses like HMPV is nothing new, people became more aware of infectious diseases and how to prevent them during the pandemic, and they’ve remained part of the public consciousness in the years since, August and Nanda said.

What are the symptoms of HMPV?

Most people won’t go to the doctor if they have HMPV because it typically causes mild, cold-like symptoms that include cough, fever, nasal congestion and sore throat.

HMPV infection can progress to:

  • An asthma attack and reactive airway disease (wheezing and difficulty breathing)
  • Middle ear infections behind the ear drum
  • Croup, also known as “barking” cough — an infection of the vocal cords, windpipe and sometimes the larger airways in the lungs
  • Bronchitis
  • Fever

Anyone can contract human metapneumovirus, but those who are immunocompromised or have other underlying medical conditions are at particular risk of developing severe disease — including pneumonia. Young children and older adults are also considered higher-risk groups, Nanda said.

What is the treatment for HMPV?

There is no specified treatment protocol or antiviral medication for HMPV. However, it’s common for an infection to clear up on its own and treatment is mostly geared toward soothing symptoms, according to the American Lung Assn.

A doctor will likely send you home and tell you to rest and drink plenty of fluids, Nanda said.

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If symptoms worsen, experts say you should contact your healthcare provider.

How to avoid contracting HMPV

Infectious-disease experts said the best way to avoid contracting HMPV is similar to preventing other respiratory illnesses.

The American Lung Assn.’s recommendations include:

  • Wash your hands often with soap and water. If that’s not available, clean your hands with an alcohol-based hand sanitizer.
  • Clean frequently touched surfaces.
  • Crack open a window to improve air flow in crowded spaces.
  • Avoid being around sick people if you can.
  • Avoid touching your eyes, nose and mouth.

Assistant data and graphics editor Vanessa Martínez contributed to this report.

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After rash of overdose deaths, L.A. banned sales of kratom. Some say they lost lifeline for pain and opioid withdrawal

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After rash of overdose deaths, L.A. banned sales of kratom. Some say they lost lifeline for pain and opioid withdrawal

Nearly four months ago, Los Angeles County banned the sale of kratom, as well as 7-OH, the synthetic version of the alkaloid that is its active ingredient. The idea was to put an end to what at the time seemed like a rash of overdose deaths related to the drug.

It’s too soon to tell whether kratom-related deaths have dissipated as a result — or, really, whether there was ever actually an epidemic to begin with. But many L.A. residents had become reliant on kratom as something of a panacea for debilitating pain and opioid withdrawal symptoms, and the new rules have made it harder for them to find what they say has been a lifesaving drug.

Robert Wallace started using kratom a few years ago for his knees. For decades he had been in pain, which he says stems from his days as a physical education teacher for the Glendale Unified School District between 1989 and 1998, when he and his students primarily exercised on asphalt.

In 2004, he had arthroscopic surgery on his right knee, followed by varicose vein surgery on both legs. Over the next couple of decades, he saw pain-management specialists regularly. But the primary outcome was a growing dependence on opioid-based painkillers. “I found myself seeking doctors who would prescribe it,” he said.

He leaned on opioids when he could get them and alcohol when he couldn’t, resulting in a strain on his marriage.

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When Wallace was scheduled for his first knee replacement in 2021 (he had his other knee replaced a few years later), his brother recommended he take kratom for the post-surgery pain.

It seemed to work: Wallace said he takes a quarter of a teaspoon of powdered kratom twice a day, and it lets him take charge of managing his pain without prescription painkillers and eases harsh opiate-withdrawal symptoms.

He’s one of many Angelenos frustrated by recent efforts by the county health department to limit access to the drug. “Kratom has impacted my life in only positive ways,” Wallace told The Times.

For now, Wallace is still able to get his kratom powder, called Red Bali, by ordering from a company in Florida.

However, advocates say that the county crackdown on kratom could significantly affect the ability of many Angelenos to access what they say is an affordable, safer alternative to prescription painkillers.

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Kratom comes from the leaves of a tree native to Southeast Asia called Mitragyna speciosa. It has been used for hundreds of years to treat chronic pain, coughing and diarrhea as well as to boost energy — in low doses, kratom appears to act as a stimulant, though in higher doses, it can have effects more like opioids.

Though advocates note that kratom has been used in the U.S. for more than 50 years for all sorts of health applications, there is limited research that suggests kratom could have therapeutic value, and there is no scientific consensus.

Then there’s 7-OH, or 7-Hydroxymitragynine, a synthetic alkaloid derived from kratom that has similar effects and has been on the U.S. market for only about three years. However, because of its ability to bind to opioid receptors in the body, it has a higher potential for abuse than kratom.

Public health officials and advocates are divided on kratom. Some say it should be heavily regulated — and 7-OH banned altogether — while others say both should be accessible, as long as there are age limitations and proper labeling, such as with alcohol or cannabis.

In the U.S., kratom and 7-OH can be found in all sorts of forms, including powder, capsules and liquids — though it depends on exactly where you are in the country. Though the Food and Drug Administration has recommended that 7-OH be included as a Schedule 1 controlled substance under the Controlled Substances Act, that hasn’t been made official. And the plant itself remains unscheduled on the federal level.

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That has left states, counties and cities to decide how to regulate the substances.

California failed to approve an Assembly bill in 2024 that would have required kratom products to be registered with the state, have labeling and warnings, and be prohibited from being sold to anyone younger than 21.

It would also have banned products containing synthetic versions of kratom alkaloids. The state Legislature is now considering another bill that basically does the same without banning 7-OH — while also limiting the amount of synthetic alkaloids in kratom and 7-OH products sold in the state.

“Until kratom and its pharmacologically active key ingredients mitragynine and 7-OH are approved for use, they will remain classified as adulterants in drugs, dietary supplements and foods,” a California Department of Public Health spokesperson previously told The Times.

On Tuesday, California Gov. Gavin Newsom announced that the state’s efforts to crack down on kratom products has resulted in the removal of more than 3,300 kratom and 7-OH products from retail stores. According to a news release from the governor’s office, there has been a 95% compliance rate from businesses in removing the products.

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(Los Angeles Times photo illustration; source photos by Getty Images)

Newsom has equated these actions to the state’s efforts in 2024 to quash the sale of hemp products containing cannabinoids such as THC. Under emergency state regulations two years ago, California banned these specific hemp products and agents with the state Department of Alcoholic Beverage Control seized thousands of products statewide.

Since the beginning of 2026, there have been no reported violations of the ban on sales of such products.

“We’ve shown with illegal hemp products that when the state sets clear expectations and partners with businesses, compliance follows,” Newsom said in a statement. “This effort builds on that model — education first, enforcement where necessary — to protect Californians.”

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Despite the state’s actions, the Los Angeles County Board of Supervisors is still considering whether to regulate kratom, or ban it altogether.

The county Public Health Department’s decision to ban the sale of kratom didn’t come out of nowhere. As Maral Farsi, deputy director of the California Department of Public Health, noted during a Feb. 18 state Senate hearing, the agency “identified 362 kratom-related overdose deaths in California between 2019 and 2023, with a steady increase from 38 in 2019 up to 92 in 2023.”

However, some experts say those numbers aren’t as clear-cut as they seem.

For example, a Los Angeles Times investigation found that in a number of recent L.A. County deaths that were initially thought to be caused by kratom or 7-OH, there wasn’t enough evidence to say those drugs alone caused the deaths; it might be the case that the danger is in mixing them with other substances.

Meanwhile, the actual application of this new policy seems to be piecemeal at best.

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The county Public Health Department told The Times it conducted 2,696 kratom-related inspections between Nov. 10 and Jan. 27, and found 352 locations selling kratom products. The health department said the majority stopped selling kratom after those inspections; there were nine locations that ignored the warnings, and in those cases, inspectors impounded their kratom products.

But the reality is that people who need kratom will buy it on the black market, drive far enough so they get to where it’s sold legally or, like Wallace, order it online from a different state.

For now, retailers who sell kratom products are simply carrying on until they’re investigated by county health inspectors.

Ari Agalopol, a decorated pianist and piano teacher, saw her performances and classes abruptly come to a halt in 2012 after a car accident resulted in severe spinal and knee injuries.

“I tried my best to do traditional acupuncture, physical therapy and hydrocortisone shots in my spine and everything,” she said. “Finally, after nothing was working, I relegated myself to being a pain-management patient.”

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She was prescribed oxycodone, and while on the medication, battled depression, anhedonia and suicidal ideation. She felt as though she were in a fog when taking oxycodone, and when it ran out, ”the pain would rear its ugly head.” Agalopol struggled to get out of bed daily and could manage teaching only five students a week.

Then, looking for alternatives to opioids, she found a Reddit thread in which people were talking up the benefits of kratom.

“I was kind of hesitant at first because there’re so many horror stories about 7-OH, but then I researched and I realized that the natural plant is not the same as 7-OH,” she said.

She went to a local shop, Authentic Kratom in Woodland Hills, and spoke to a sales associate who helped her decide which of the 47 strains of kratom it sold would best suit her needs.

Agalopol currently takes a 75-milligram dose of mitragynine, the primary alkaloid in kratom, when necessary. It has enabled her to get back to where she was before her injury: teaching 40 students a week and performing every weekend.

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Agalopol believes the county hasn’t done its homework on kratom. “They’re just taking these actions because of public pressure, and public pressure is happening because of ignorance,” she said.

During the course of reporting this story, Authentic Kratom has shut down its three locations; it’s unclear if the closures are temporary. The owner of the business declined to comment on the matter.

When she heard the news of the recent closures, Agalopol was seething. She told The Times she has enough capsules of kratom for now, but when she runs out, her option will have to be Tylenol and ibuprofen, “which will slowly kill my liver.”

“Prohibition is not a public health strategy,” said Jackie Subeck, executive director of 7-Hope Alliance, a nonprofit that promotes safe and responsible access to 7-OH for consumers, at the Feb. 18 Senate hearing. “[It’s] only going to make things worse, likely resulting in an entirely new health crisis for Californians.”

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