This week, the Food and Drug Administration issued an advisory about kratom, an herbal supplement that’s used to treat pain, anxiety, depression and addiction.

The FDA warns that kratom has similar effects to the narcotics in opioids, and carries similar risks of abuse. But those who use the botanical say it’s a safe, alternative treatment that helps people.

Kratom is a plant that grows in southeast Asia. Proponents say it has broad healing properties, and is an alternative treatment for opioid use disorder. But the FDA says there’s no reliable evidence to back that claim, and that kratom can actually cause harm.

Over the past several years, calls to poison control centers involving the herbal supplement have increased tenfold in the U.S. Calls to the Northern New England Poison Center, which serves Maine, New Hampshire and Vermont, have also seen an uptick, but the overall numbers are small.

“In 2016, we had 16 human poisonings, and in 2017, we’ve had 14 so far,” says Dr. Karen Simone, director of the poison center.

Kratom isn’t Simone’s top concern, but she says it’s an up-and-coming public health issue. It’s considered a controlled substance in 16 countries, and several states have banned it.

“Kratom is a little bit of a messy plant. It has multiple substances in it that can cause various effects,” she says.

In smaller doses, it can cause stimulation, agitation and aggression. In higher doses, Simone says, its effects are similar to opioids.

“Individuals are attempting to stop opioids and switch to this. And when they do that, after a month or a year or a certain period of time, they decide, ‘OK, I want to stop taking kratom,’ and they have trouble, and within hours to a couple of days, they start getting very uncomfortable withdrawal effects that are very similar to what you’d have when you stop an opioid right away,” she says.

In the face of the nationwide opioid epidemic, the FDA is concerned kratom could expand the problem. But Joshua Thompson says he has had a different experience.

“Kratom is something that’s helped me out. It’s changed my life,” he says.

Thompson says he’s battled addiction, and tried treatments such as methadone and Suboxone. But he says kratom was the only thing that helped. He now owns Maine Kratom Co., which sells herbal supplements.

Currently, Thompson uses the botanical occasionally for back pain, and says he’s appalled by the FDA advisory.

“I think that we should be allowed to make our own choices when it comes to things like this,” he says. “If there’s no logical or legitimate evidence supporting that it’s bad or harmful, then there’s no reason to act like it is.”

Simone says there’s enough evidence to show that people can get sick from kratom, and that’s good reason to be wary. She also acknowledges that kratom’s properties suggest that it could be helpful for certain treatments. But it should be manufactured synthetically, she says, to better control and study its effects.

In the meantime, Simone says the increasing use of kratom points to a larger problem.

“What we have right now is an unfortunate situation of a lot of people addicted to opioids. They’re not all of them able to get into treatment, and they want to treat themselves, and they want to try to do it in a cheaper way, and this is going to look like a viable option for them,” she says.

Until treatment is more widely available, Simone says, more people will likely use kratom, regardless of the FDA advisory.

This report appears as part of a media partnership with Maine Public.