Canton public health officials quietly blazing a trail

By Jay Turner

As convenience stores and gas stations across the commonwealth were busy clearing their shelves of any Kratom products amid an emergency statewide ban that took effect late last month, retailers in Canton were already well ahead of the curve thanks to stringent local health regulations enacted several months prior.

Unanimously approved by the Canton Board of Health in September 2025 and officially enacted this past April, the town’s regulation of the controversial plant and its derivatives left no room for ambiguity — expressly prohibiting the manufacture, distribution and sale of Kratom “in any of its forms.”

Canton’s Annual Health Fair, a popular town tradition, returns on Saturday, October 3. (Above) Young attendees visit the teddy bear clinic at last year’s health fair.

Anyone found to be in violation of the order faces a $300 fine for each offense, and repeat violators are subject to a suspension and potential revocation of all BOH-issued permits.

At the time it was approved, Canton was one of only five municipalities in the state to implement an all-out ban on Kratom, joining Belchertown, Lowell, Chelmsford, and Dracut. Several Massachusetts towns have since followed suit, while a number of others have adopted local restrictions or held hearings on the topic, prompting pushback from affected retailers, advocacy groups that tout its medicinal value, and even some healthcare providers who fear the unintended consequences for those grappling with dependency issues.

For health officials in Canton, however, the decision to be proactive with a Kratom ban boiled down to one simple question: Do the benefits of regulation outweigh the costs of doing nothing?

“We really just follow the science,” noted longtime BOH member and current chairperson Dr. Julie Goodman. “We don’t believe in regulation for regulation’s sake. It should only be there if it’s really going to promote public health.”

Perhaps as a result of this mindset, combined with the under-the-radar nature of their role and a remarkable ability to ignore any outside noise, Canton’s Board of Health has quietly raced to the forefront on a number of key issues in recent years — everything from raising the minimum age to purchase tobacco to banning flavored nicotine products to the permanent elimination of tobacco permits for new sellers.

Beyond these pioneering policy changes, the Canton Health Department, under the leadership of Public Health Director Meg Goldstein, has also established itself as a trailblazer in adult vaccine administration, launching the commonwealth’s first and only no-cost municipal vaccination program for uninsured or underinsured residents of any age.

“Meg is amazing, and so is the whole Health Department,” said Goodman, who is the longest serving Board of Health member with 18 years of service under her belt. “I think having events like the Annual Health Fair and having vaccines accessible to all residents is so important, and all the credit goes to Meg and her team.”

At the same time, Goodman said she’s very proud of the work that the board has done on the regulatory side, although even that, she said, has largely been a team effort, with major contributions from the likes of former health director John Ciccotelli and BOH members both past and present, including current members Dr. Alan Rapoport and Anjali Schutt.

In the case of their landmark tobacco regulations from 2013-14, which made Canton just the fourth town in Massachusetts to raise the tobacco purchase age from 18 to 21 — years before it was federally mandated — Goodman said they were moved to consider such a policy change based on the lobbying efforts of two local pediatricians, Dr. Jonathan Winickoff and Dr. Lester Hartman.

“The town of Needham had raised their purchase age to 21 a few years earlier, and [Winickoff and Hartman] were going from town to town telling local boards of health about this,” recalled Goodman. “The things that stuck with me from their presentation was the effects of nicotine on young people’s brains, which are still developing until they reach their mid-20s, and the reduction in access if people couldn’t buy tobacco products until they were 21 — because if they’re available at 18, then anybody in high school with a friend that age had access.”

Not only did they ultimately go forward with the age increase, but board members took the added step of banning the sale of various other “nonmedical” nicotine products that seemed to target young people, including flavored blunt wraps, snus, and dissolvable tablets.

And while they considered banning the sale of all e-cigarettes and vaping products at that time, they eventually made good on that decision six years later, becoming one of the first municipalities in the country to enact a total ban on the sale of all such products while also doing away with the few remaining flavored products allowable for sale, including menthol and mint. (Massachusetts approved a statewide ban on these flavors several months later.)

As for the more recent Kratom ban, both Goodman and Goldstein said it was Canton’s school nurses who brought the matter to their attention in a letter sent to the board in August 2025. Heeding the nurses’ concerns about the health effects of Kratom, its potential for abuse, and availability over the counter at several local stores, health officials went right to work drafting new regulations, approving an all-out ban on the substance less than six weeks later.

In a public statement issued ahead of the BOH vote, Goldstein noted that Kratom, which is derived from the leaves of a tropical evergreen tree native to Southeast Asia, produces both “stimulant and sedative effects when orally ingested in tablet, capsule, or liquid form,” and while not a traditional opioid, its active ingredients act on the same receptors in the brain and produce “opioid-like” effects.

“The possibility for abuse and emerging patterns of non-medical use establish Kratom as a dangerous substance and requires immediate policy intervention to address this emerging threat to Canton residents,” Goldstein noted at the time.

Since Canton approved its Kratom ban, Goldstein said she has heard from health officials in a number of other communities that are interested in pursuing the same course of action. “I provided them with our template and the information that we gave to our retailers,” she said. “I also did a webinar and an in-person panel through the Mass. Environmental Health Association and got a lot of questions about our process, so we were definitely able to provide some guidance to other towns.”

With the subsequent passage of a temporary statewide ban, which classifies all forms of Kratom as a Schedule I drug for a period of one year, Goldstein said health officials are cognizant of the risk of withdrawal symptoms and are offering free resources for anyone who is struggling with physical dependency.

Another top priority of the Health Department is the adult vaccine program, and Goldstein, who was recently recognized by MassDPH for public health innovation, would love to see more Canton residents take advantage of this no-cost option — especially older residents who cannot afford Medicare Part D.

“Here in Massachusetts, the Vaccines for Children (VFC) program provides free vaccines for all residents up to age 19, but if you’re older than that and do not have health insurance, then the cost of many vaccines can be astronomical,” said Goldstein. “What makes our program unique is that we offer no-cost vaccinations to any adult Canton resident, and to my knowledge, we are the only town in the commonwealth that offers something like this.”

Goldstein said the funding for the program is directly tied to the volume of flu vaccines they administer (via insurance reimbursements and savings on bulk purchases). Therefore, the more people who get their flu shots at a town-sponsored clinic, the more vaccines the Health Department can afford to purchase for those without coverage. Currently, the department offers a number of 19+ vaccines, including RSV, COVID, Tdap, Hepatitus B, Pneumonia, Shingles and Influenza.

After hosting their first flu clinic of the season at the Canton Senior Center earlier this week, the Health Department is now gearing up for a family flu clinic that’s being offered in conjunction with the town’s Annual Health Fair on Saturday, October 3 at Canton High School. Sign-ups and more information can be found on the town’s vaccine page at town.canton.ma.us/859/Vaccine-Information-and-Clinics.

“I honestly can’t say enough about our Health Department and the work that they do,” said Goodman. “They take care of so much and keep everything running smoothly, and we in turn have been able to do some big things with the tobacco and Kratom regulations.”

“I really feel lucky to live in a town like Canton, where it’s clear that citizens really do care about public health.”

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