CHESAPEAKE, Va. (WAVY) — A local emergency room doctor says because the plant extract kratom is unregulated, he’s not surprised to learn that the Centers for Disease Control has linked it to more than two dozen cases of salmonella.

Dr. Ben Fickenscher has studied the history and effects of opioids and is a member of the Hampton Roads Heroin Working Group. In a statement to 10 On Your Side, he says without regulation, kratom distributors do not need to make guarantees of purity, the absence of dangerous fillers, or the product’s potency.

The CDC issued a warning Tuesday, linking kratom to cases of salmonella in 20 states affecting 28 people, including two cases in North Carolina. The agency is recommending that people not use kratom in any form – powder, pills, capsules, leaves or tea.

CDC says no common brands or suppliers have been identified across the 28 cases of salmonella.

The American Kratom Association represents kratom users and says it has concerns about the CDC report and its recommendation to stop using kratom.

“There are 1.3 million cases of salmonella each year — many from eggs, peanut butter, and meat — yet the CDC does not recommend Americans stop consuming those products,” said AKA Board Chairman Dave Herman.

READ: AKA Statement on CDC Report, FDA Release

You can purchase kratom legally in smoke shops.

In the fall of 2016, the FDA wanted to regulate kratom as a drug with high potential for abuse. The proposal generated 23,000 public comments, with more than 9 out of every ten saying leave kratom alone, because it has benefits not found elsewhere.

Fickenscher says kratom deserves further study based on the number of people who claim its benefits.

Earlier this month the FDA said kratom was essentially an opioid. The AKA has called past public health warnings against the extract, which has been grown in Asia for centuries, “bad science”.

Dr. Ben Fickenscher’s statement on kratom