ATLANTA (AP) — Dana and John Pope had never heard of kratom before their 23-year-old son, Ethan, was found dead on the kitchen floor in his apartment last December with his puppy by his side.

Extracted from the leaves of a tropical tree native to Southeast Asia, kratom is used to make capsules, powders and liquids and is marketed as an aid for pain, anxiety and drug dependence. In Georgia and some other states, it's often sold at gas stations and smoke shops.

A Georgia Bureau of Investigation autopsy found that Ethan Pope died from mitragynine intoxication and had no alcohol or illegal drugs in his system. Mitragynine is a psychoactive compound in kratom, according to the U.S. Food and Drug Administration.

Dana and John Pope have filed a wrongful death lawsuit against about a dozen people, companies and organizations connected to the manufacturing, marketing and sale of kratom.

They don’t know how long their son had been using kratom, but he must have been experiencing adverse effects, Dana Pope said at a news conference Thursday. In his apartment, they found a to-do list with one task that stuck out: Stop taking kratom.

The lawsuit was originally filed in May and an expanded version was filed earlier this week. The lawyers who filed the suit said they want to send a message that kratom is unsafe for human consumption.

“The kratom industry claims that it is a natural, completely safe substance that can lead to greater health and well-being," lawyer Matt Wetherington said. “However, even if that were true, the kratom that is sold in the United States is ultra-concentrated and is more similar to heroin or other opioids.”

Proponents of kratom say it's a safe, natural herbal supplement that can help manage pain and ease the effects of opioid withdrawal.

Ethan Pope bought bottles of O.P.M.S. Liquid Kratom in the days before his death. Liquid kratom shots are especially dangerous, “because they are intended to provide consumers with higher concentrations of mitragynine, substantially increasing the risk of overdose and death,” the lawsuit says.

The lawsuit alleges that producers of kratom illegally import it by misclassifying it as an agricultural product and have begun producing, marketing and selling concentrated forms of kratom.

Kratom acts as a stimulant in low doses and a sedative at high doses. It can be addictive and can cause hallucinations, delusions and confusion, according to the U.S. Drug Enforcement Administration.

The FDA has not approved any uses for kratom and “continues to warn consumers not to use any products labeled as containing kratom." It issued an import alert in 2014 allowing the seizure of kratom as an unapproved drug.

in a report released in 2019 that kratom was a cause in 91 overdose deaths in 27 states. While most of those who died had also taken heroin, fentanyl or other drugs, kratom was the only substance detected in seven of the deaths.

The defendants in the lawsuit were negligent in their “duty to prevent foreseeable injuries arising from the use of their products,” the lawsuit says. That duty includes making truthful statements about the risks and side effects of kratom and ensuring that the product is consistent in its purity and potency, it states.

Ethan Pope used the kratom products for their intended purpose and the defendants “did not provide adequate warnings and instructions that an ordinary consumer would expect, and the inadequate warnings made the kratom products more dangerous than an ordinary consumer would expect,” the lawsuit says.

Optimized Plant Mediated Solutions, or O.P.M.S., which the lawsuit says manufactured the kratom that Ethan Pope used, is named as a defendant. The company did not immediately respond to a request for comment submitted Thursday via a form on its website.

The lawsuit also alleges that the American Kratom Association, a trade organization, invites consumers to rely on “false, misleading, and materially incomplete medical claims” regarding kratom. It has pushed legislation in numerous states that it says is meant to protect consumers but that actually facilitates the selling of an unpredictable and dangerous drug, said Drew Ashby, a lawyer for the Popes.

“It is unfortunate and disappointing that Georgia is one of the few states in the country that allows this to be sold legally with actual legislation,” Ashby said, referencing a 2019 law that restricted the sale of kratom to people over 18 and implemented labeling requirements that the lawsuit says are not followed.

Daniel Delnero, a lawyer for the association denied the claims against it.

“The American Kratom Association is a consumer advocacy group dedicated to education and responsible use of Kratom. It was improperly added to this lawsuit, and we will vigorously defend the spurious claims against it,” he said in an emailed statement.

The lawsuit asks for damages and seeks a jury trial.

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