Several Mississippi lawmakers want to criminalize the use of kratom—a plant that’s become increasingly popular in the United States for its opioid-like effects—and advocates are prepared to speak up.

What is kratom?

Kratom is a tree in the coffee family that originates in Southeast Asia and has been used in traditional medicine in Thailand, Indonesia and several other countries for more than a century.

Known for its stimulant- and opioid-like properties, kratom’s growing popularity is largely due to testimonials from users who say it’s a natural alternative to prescription painkillers and antidepressants, and can help treat opioid withdrawal symptoms. It lacks federal regulation, despite an attempt in 2016 by the Drug Enforcement Administration to ban kratom—a decision reversed due to an outpouring of comments from users who said their lives would be drastically affected without it.

Advocates stress that kratom isn’t a drug or synthetic substance, and is non-habit-forming if taken in normal doses. “If taken in excess, continuously over long periods of time, Kratom consumers may experience dependence, similar to caffeine dependence,” according to the American Kratom Association.

It is legal in most of the United States, with the exception of Alabama, Arkansas, Indiana, Rhode Island, Tennessee, Wisconsin and Vermont. Some cities have banned its use, including Washington D.C.

Why are lawmakers trying to make kratom illegal?

In a nation gripped by a powerful opioid epidemic, many lawmakers argue the legality of opioid-like substances could perpetuate addiction and even serve as a gateway to painkillers and/or heroin use.

In November 2017, the U.S. Food and Drug Administration warned against the use kratom as treatment for opioid addiction.

“At a time when we have hit a critical point in the opioid epidemic, the increasing use of kratom as an alternative or adjunct to opioid use is extremely concerning,” said FDA Commissioner Scott Gottlieb.

Researchers say banning kratom could do more harm than good in curbing the epidemic. Clinical psychologist Marc Swogger said in a 2016 Washington Post article that criminalizing kratom is “insane” as its users are often “in pain or addicted” to other drugs.

“Those are two groups that need options for improving their situations,” Swogger told the Post. “Without those options, I’m not sure what they’re going to do. Will they begin to take heroin? Will they show up for treatment and get the appropriate treatment?”

Fifteen overdose deaths involving kratom were documented in the U.S. between 2014-2016 compared to around 30,000 overdose deaths in 2015 alone tied to prescription painkillers and/or heroin. Swogger said in every kratom-related case, users had “either taken other drugs, too, or had a history of alcohol or heroin abuse that also could have caused or contributed to the death.”

If enacted, SB 2475 would make kratom a Schedule 1 substance in Mississippi.