The crackdown on opioids has caused people to seek out alternatives for pain and other issues.
One of the alternatives is kratom, an over-the-counter product that some experts and others consider as dangerous as heroin or morphine.
Kratom is a tropical plant that grows in Thailand and other parts of southeast Asia. It has made its way to the United States, marketed as an herbal supplement.
Puff 'N Stuff in Lancaster has a variety of kratom products on the shelves. The manager said they're good sellers.
"A lot of people are trying to get away from opiates in general or prescription drugs and things like that. People want to have a safer and less harmful alternative," said Ryan Leese.
But there are no FDA-approved uses for kratom. The agency said it has properties that expose users to the risks of addiction, abuse and dependence.
"In actuality, this is something really dangerous," said Dr. Mike Reihart, a Lancaster General Health emergency physician.
Reihart said kratom acts like a stimulant at low doses, but at high doses it becomes an opioid like heroin or morphine.
"All the complications of opiates are related to kratom, which can include respiratory depression and death. As a matter of fact, kratom's potency of opiate effect is about 13 times that of morphine," Reihart said.
In 2016, the Drug Enforcement Administration considered making kratom a controlled substance to avoid an imminent hazard to public safety. That has yet to happen.
A man who didn't want to be identified spoke to WGAL about his kratom use. The recovering heroin addict said a fellow worker brought it to his attention.
The man would mix the powder in water every day and drink it.
"I was taking upwards of 60 grams a day," he said.
When asked if he thought it was as addictive as heroin in his case, he answered, "Yes, I 100% believe that. It was the only thing on my mind, how I was going to continue."
The man's girlfriend, who also didn't want to be identified, called it legal heroin.
"I think it's a real problem. I think it's probably our next epidemic, and the fact that it's legal makes it even worse," she said.
She thinks kratom should be regulated or banned.
Her boyfriend went to rehab. The 31-year-old said he is feeling good about it, but is not out of the woods yet.
Kratom is banned in six states.
The Pennsylvania House passed a resolution last year urging the FDA to recognize the state's concern with kratom's safety and the current distribution and sale of kratom as a drug replacement, supplement or food. The resolution also urged the FDA to promptly consider guidelines and protocols for the safe use of kratom.