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

Extracted from the leaves of a tropical tree that grows in Southeast Asia, kratom is used to make capsules, powders and liquids and is marketed as a pain, anxiety and drug addiction treatment. In Georgia and some other states, it is often sold at gas stations and smoke shops.

An autopsy conducted by the Georgia Bureau of Investigation found that Ethan Pope died of mitrogynine intoxication and had no alcohol or drugs in his system. Mitrogynine is the psychoactive compound in kratom, according to the US Food and Drug Administration.

Dana and John Pope have filed a wrongful-death lawsuit against about a dozen people, companies and organizations associated with the production, marketing and sale of kratom.

They don’t know how long their son had been using kratom, but he must have been experiencing side effects, Dana Pope said at a news conference Thursday. In his apartment, they found a to-do list with one task sticking 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 lawsuit said they wanted to make the word that kratom is unsafe for human consumption.

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

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

Ethan Pope bought bottles of OPMS liquid kratom days before his death. Liquid kratom injections are particularly dangerous “because they are designed to provide users with higher concentrations of mitrogynine, which significantly increases the risk of overdose and death,” the lawsuit states.

The lawsuit alleges that kratom manufacturers are illegally importing it, misclassifying it as an agricultural product, and have begun manufacturing, marketing and selling concentrated forms of kratom.

Kratom acts as a stimulant in low doses and a sedative in high doses. According to the US Drug Enforcement Administration, it can be addictive and can cause hallucinations, delusions, and confusion.

The FDA has not approved any use of kratom and “continues to warn consumers not to consume products labeled as containing kratom.” In 2014, it issued an import warning, allowing kratom to be seized as an unapproved drug.

U.S. health officials said in a report released in 2019 that kratom was responsible for 91 overdose deaths in 27 states. While most of the dead also took heroin, fentanyl or other drugs, kratom was the only substance detected in the seven deaths.

The Centers for Disease Control announced Wednesday that the U.S. will set a grim record of 107,000 overdose deaths in 2021.

The defendants in the suit negligently failed to fulfill their “duty to prevent foreseeable harm arising from the use of their products,” the suit 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 said.

Ethan Pope used the kratom products as intended, and the defendants “failed to provide adequate warnings and instructions that the average consumer would expect, and the inadequate warnings made the kratom products more dangerous than the average consumer would expect,” the suit says.

Optimized Plant Solutions, or OPMS, which the lawsuit claims produced the kratom used by Ethan Pope, is named as a defendant. The company did not immediately respond to a request for comment sent Thursday through a form on its website.

The lawsuit also alleges that the American Kratom Association, a trade organization, encourages consumers to rely on “false, misleading and incomplete medical claims” about kratom. He has pushed legislation in many states that he says is intended to protect consumers but actually makes it easier to sell an unpredictable and dangerous drug, said Drew Ashby, Pope’s attorney.

“It’s a shame and a disappointment Georgia is one of the few states in the country that allows it to be sold legally under current law,” Ashby said, referring to a 2019 law that restricted the sale of kratom to people over 18 and enforced labeling requirements that , as stated in the lawsuit, are not fulfilled.

Daniel Delnera, a lawyer for the association, denied the allegations against her.

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

The lawsuit seeks damages and a jury trial.