Health officials have noticed sharp rise in visits to emergency rooms and calls to poison control centers nationwide. They are afraid that more potent and dangerous variations of a popular drug called spice have reached the nation’s streets, resulting in many deaths.

According to the American Association of Poison Control Centers, in the first three weeks of April, state poison control centers have received around 1,000 reports of adverse reactions to spice, which are more than double the total received from January through March. Spice is the street name for a family of synthetic substances that mimic the effects of marijuana

The organization said the cases have appeared four times as frequently this year as in 2014. On Thursday alone, the officials received 172 reports, by far the most in one day this year.

This month, Health departments in Alabama, Mississippi and New York issued alerts about more spice users being rushed to hospitals, after experiencing extreme anxiety, violent behavior and delusions. Some of the cases even resulted in death. Arizona, Florida, New Jersey and Texas have also faced similar increases.

Health officials said they know the total number of fatalities nationwide this year. Mark Ryan, the director of the Louisiana Poison Center, said that on Wednesday, a person died in Louisiana and two others were in intensive care.

Dr. Ryan said they had one hospital in the Baton Rouge area that saw more than 110 cases in February. He added, “There’s a large amount of use going on. When one of these new ingredients — something that’s more potent and gives a bigger high — is released and gets into distribution, it can cause these more extreme effects”.