One of the biggest dangers involved with using so-called designer drugs? One tweak to one chemical and something that’s illegal and potentially unsafe could slip past regulators and into the hands of consumers. Such is the case for a form of synthetic marijuana known as “spice,” that’s been linked to an uptick in illnesses and hospitalizations that has health officials and experts around the country worried.

Public health officials and poison-control experts from New York to Colorado are sounding the alarm over spice, which could encompass any number of kinds of synthetic marijuana currently on the market.

According to a report by USA Today, just last week poison centers around the country received 1,900 calls from people looking for help after having a bad experience with these drugs, which is four times the number of calls made last year at the same time.

New York’s Gov. Andrew Cuomo issued a health alert earlier this month after emergency departments in that state reported more than 160 patients coming in during a nine-day period linked to synthetic cannabinoids, while Alabama had 137 emergency department visits in 18 days related to the drugs. Those are just a few examples, with other states also reporting dramatic increases in illnesses linked to spice.

If you’re unfamiliar with these designer drugs, spice packets are often sold at gas stations and the like, labeled as potpourri or incense and warning that they’re “not for human consumption.” Smoking the contents of the packets — often leaves sprayed with synthetic drugs can lead to a high that’s supposed to mimic marijuana.

Because of that link to marijuana, people often think spice is safe, one doctor tells USA Today, though symptoms he’s treated include one batch that indicated it had been laced with PCP. Overdose symptoms can include kidney failure, rapid heartbeat, agitation, and hallucinations.

“It’s really the kitchen sink. It’s really like playing Russian roulette,” he said.

Federal regulators have tried to get a handle on the situation, banning 26 different types of the synthetic drugs… but all it takes is one molecule and the drug can change, making it harder to ban. To that end: In 2009, when spice started to become popular, federal officials counted two kinds of synthetic cannabis. In 2012, there were 51 different types.

Hospitalizations from synthetic pot spike, officials say [USA Today]

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