State and local health officials have issued a warning about a synthetic pot in Illinois that has caused users to experience severe bleeding. 
 
 On Friday, the Illinois Department of Public Health reported that 32 people in the past few weeks visited emergency rooms with severe bleeding after using a synthetic cannabinoid product. That’s up from the 22 cases the state reported just the day before. 
 
 The department also released a geographic breakdown, reporting eight cases in Chicago, four in suburban Cook County and one each in Will, DuPage, Kane and McLean counties. The hot spot seems to be the Peoria area, with Tazewell County reporting 10 cases and neighboring Peoria County six. 
 
 Most of those affected were in the Chicago area, but health officials warned the contaminated products also could be present elsewhere across the state, said department spokeswoman Melaney Arnold. 
 
 The health department said Thursday that symptoms have included bleeding from the eyes and ears. On Friday, officials clarified that while this can happen, those affected in Illinois have reported other symptoms, like coughing up blood, blood in urine, bloody noses, bleeding gums and, for women, heavier than usual menstrual flow. 
 
 Though synthetic pot has long been considered dangerous, severe bleeding is not a known side effect, said Dr. Melissa Millewich, an emergency room physician at Advocate Good Samaritan Hospital in Downers Grove. 
 
 “This bleeding is not expected, at least in such a significant population so quickly,” she said. 
 
 Despite a statewide ban, Arnold said manufacturers could be slightly tweaking the molecular makeup of the products as a way to “get around” the law, allowing for them to be sold legally. They are also sold on the street, she said, and those experiencing the bleeding said they obtained the products in convenience stores and from dealers and friends. 
 
 Health officials reported 32 people who experienced the symptom since March 7, and they continue to track the situation, Arnold said. So far, there are no deaths reported. 
 
 A change in the latest formula could be behind the new, dangerous symptom, Millewich said. Because health officials don’t know the exact makeup of the products, it’s unclear what’s causing the bleeding, she added. 
 
 While there have been no such cases at Good Samaritan’s ER, Millewich said, synthetic pot, often called “fake weed,” “K2” or “spice,” has previously displayed life-threatening symptoms like kidney failure, along with psychosis. 
 
 “People don’t realize how dangerous this is,” she said. 
 
 The man-made substance is a mixture of hundreds of chemicals, often called cannabinoids because they affect the same brain cell receptors as the main ingredient in marijuana. Cannabinoids are sometimes sprayed on plant material for smoking, or are sold as liquids to be vaporized and inhaled in e-cigarettes and other devices, the health department’s warning said. The products are also sometimes referred to as herbal or liquid incense. 
 
 Recent patient reports of severe bleeding led health officials to warn the public not to use any synthetic cannabinoid products. 
 
 While those affected by the outbreak admitted using cannabinoids, it’s been difficult to determine their exact source for the substance, Arnold said. 
 
 Dr. Nirav Shah, director of the public health department, says there’s an erroneous perception that synthetic cannabinoids are a safe and legal alternative to marijuana. 
 
 Shah says they're unsafe because it's difficult to know what chemicals they contain or what an individual's reaction will be. 
 
 A Centers for Disease Control and Prevention study found there’s also an association between teens who use synthetic pot and a heightened risk for violent behavior, risky sex and abuse of other drugs. 
 
 Anyone who uses these drugs and experiences unexplained bleeding or bruising is advised to call 911 or have someone take them to an emergency room. 
 
 Associated Press contributed. 
 
 kthayer@chicagotribune.com 
 
 Twitter @knthayer ||||| In a rapid series of progressively escalating press releases by the Illinois Department of Public Health, it appears that a dangerous synthetic cannabinoid product called K2, spice, synthetic marijuana, legal weed or fake weed has now claimed its latest victim in an outbreak currently totaling 38 people whose severe bleeding is linked to exposure of this substance. The state division just announced the first death in this cluster. Over recent days, the toll of those harmed continues to increase with all being hospitalized for spontaneous excessive bleeding, including but not limited to coughing up blood, urinating blood, bloody stools, bleeding from the eyes, ears, nose and gums. 
 
 Illinois government officials warn that these items were sold by convenience stores and dealers or obtained from friends. They have issued this advisory: 
 
 “If you have purchased any of this product in the past month, do not use it. If you have used any of these products, and start experiencing severe, unexplained bleeding or bruising, please have someone take you to the hospital immediately or call 911. Do not walk or drive yourself. Tell your health care providers about the possible link between your symptoms and synthetic cannabinoid use.” 
 
 What are synthetic cannabinoids? 
 
 The agency goes on to inform about the varying misperceptions people have with respect to synthetic cannabinoids and their falsely perceived safety. As per their description, they are human-made, unregulated mind-altering chemicals that fall under a drug category called new psychoactive substances (NPS). These substances are sprayed on dried plant material for smoking or sold in liquid form to be used in vaporizing devices. 
 
 They are sold and used recreationally under many names (e.g. herbal or liquid incense, K2, Spice, Black Mamba, Bombay Blue, Genie, Zohai, among others). Often pitched as being able to mimic the effects of cannabis because the chemical makeup is similar to those in the marijuana plant, the marketing of synthetic cannabinoids as synthetic “pot” can be deceptive and untrue. Synthetic cannabinoids have been found to impact the brain with greater potency, be volatile and life-threatening. 
 
 What is causing the internal bleeding (and now death) in Illinois? 
 
 According to the Chicago Tribune, 
 
 “Consumption of synthetic cannabinoids previously has caused serious health problems such as seizures and kidney failure, but the side effect of severe bleeding is tied to the recent outbreak, said Dr. Patrick Lank, a medical toxicologist who works at Northwestern Memorial Hospital.” The article goes on to reveal “three of the hospitalized people tested positive for brodifacoum, more commonly known as rat poison.” 
 
 You may be familiar with the drug coumadin - a blood thinning medication used to treat clots and prevent stroke - whose generic name is warfarin. Brodifacoum is often called a “superwarfarin” because it is extremely powerful with a long duration of action. 
 
 Rat poison notoriously contains ingredients that have anticoagulant properties - or substances that impede someone’s ability to clot effectively. This particular compound antagonizes Vitamin K (which is necessary for proper clotting) and has an especially long half-life, so treatment for poisonings requires high doses at regular, continuous intervals for protracted periods of time. Over-the-counter options are not good enough given the severity of the problem and the urgency needed to correct it. And, therapies are mostly helpful when initiated before extensive bleeding and blood loss takes place. 
 
 Once someone loses their ability to clot a cascade of untoward events follows. With such internal bleeding and blood loss, a person can go into shock, suffer a stroke, cardiac events, loss of consciousness and death. 
 
 The bottom line… 
 
 Efforts to liken synthetic cannabinoids to the active ingredient in marijuana by calling the products synthetic “pot” or “marijuana” are misleading misnomers. These “products” contain many highly potent, dangerous chemicals and you are taking big risks when using them. 
 
 ADDENDUM (4/2/18, 8pm) 
 
 The Illinois Department of Public Health now reports 2 deaths, 56 cases and expects these numbers to rise. See their link here for daily updates on this outbreak.
– Synthetic pot is causing a bloody mess in the Chicago area. "What we are seeing is people are coming in with various types of bleeding,” CBS Chicago quotes the chief medical officer of the Illinois Department of Public Health as saying. “Whether it’s nose bleeds, bleeding from their gums, bleeding in their urine. Very severe bleeding that’s prompting them to go to the emergency room.” Officials have reported 22 people taken to the ER with severe bleeding connected to synthetic cannabinoid products since March 7, the Chicago Tribune reports. In addition to the above symptoms, fake weed users are bleeding from their eyes and ears, as well as coughing up blood. Officials say there have so far been no deaths connected with the synthetic pot. While synthetic pot can present a host of health risks, severe bleeding is not a known side effect. “This bleeding is not expected, at least in such a significant population so quickly,” says one area ER physician. The director of toxicology for the NorthShore University HealthSystem tells NBC Chicago the tainted synthetic pot—which is typically made of hundreds of chemicals—could contain some sort of blood thinner or anticoagulant. Patients have reported getting synthetic pot from dealers, friends, and convenience stores, and officials are trying to identify a single product linking the cases. Officials seized some synthetic pot—also known as K2 and spice—from a Chicago mini-mart, but no arrests have been made. Officials warn that while most of the bleeding has been in the Chicago area, the tainted synthetic pot may have spread throughout the state.