After new and dangerous side effects of synthetic marijuana usage were recently reported in five states, New York’s Department of Health issued an advisory to hospitals about new dangers associated with the drug.

The reports were out of Illinois, Maryland, Wisconsin, Indiana and Missouri, and described an outbreak of patients with severe bleeding after consuming rat-poison-laced synthetic marijuana. No cases have been reported in New York.

Synthetic marijuana is often sold under the street name “spice” or “K2.” It is marketed as legal and often contains plant material coated by chemicals, which are supposed to mimic the effects of naturally grown marijuana.

Hospitals, emergency rooms and urgent-care centers were all warned in the DOH advisory to be aware of patients with severe bleeding. Health care professionals are asked in the advisory to report suspected synthetic marijuana usage to the DOH and their local Poison Information Center.

Under current law, an owner of an establishment or anyone else possessing, distributing, selling or offering the drug for sale will face a fine up to $500 and/or up to 15 days in jail. The state can also revoke a store’s liquor or lottery license if it sells synthetic marijuana.