SPRINGFIELD — Illinois state health officials say a second person has died who bled severely after using synthetic marijuana.

The Illinois Department of Public Health also said Monday that it has reports of 56 people in the Chicago area and central Illinois who have experienced severe bleeding after using the substance, often referred to as Spice, K2 or fake weed. All of the cases required hospitalization and nine of the cases tested positive for an anticoagulant often used as rat poison.

The department didn’t provide additional information about the two deaths, citing confidentiality.

IDPH Director Nirav Shah is strongly urging people not to use synthetic marijuana. The agency is investigating but Shah says without more information they don’t know how much contaminated product is circulating or where. The department is working with local and federal health authorities.

–Associated Press