A strong, potentially contaminated drug is being blamed for a swathe of incidents in Rotorua over the past two days - with ambulance, police and hospital staff dealing with multiple patients believed to have taken the drug.
Rotorua ambulance officers have been called to 11 incidents involving 15 patients in the last 24 hours who were possibly affected by psychoactive substances.
Rotorua Hospital has been put on alert, while local police have taken to Facebook today to urge anyone using synthetic cannabis to stop immediately and seek help, saying any use of the drug is potentially life-threatening.
However police could not confirm whether the incidents were related to the "bad batch" of the drug that has been linked to 10 deaths in Auckland in recent months.
St John ambulance officers attended 11 incidents involving 15 people in Rotorua between 1.40pm yesterday and 10.30am today where patients were "possibly affected by psychoactive substances".
Five of the patients were transported by ambulance to Rotorua Hospital, two in serious condition and three were in moderate condition.
St John territory manager Steve Lynch said many of the remaining patients were attended to by ambulance officers and remained with police after being treated.
"Some of these patients were behaving aggressively and were obviously suffering the ill-effects of drug intoxication of some sort.
"Our people notified Rotorua Hospital emergency department yesterday afternoon that there could be an influx of patients displaying symptoms brought on by the use of a drug or drugs so that the hospital could be prepared.
"St John does not have facilities to identify what drugs people have used and rely on patients to tell us what they've used so that our people can treat them correctly and effectively."
Ambulance and police staff were called to another incident in a carpark on Lake Rd this afternoon.
Four people in a parked car appeared to be unconscious or under the influence of a substance.
Emergency services roused them and struggled to get one onto a stretcher. Another was helped into the ambulance.
All four appeared to be slow, disoriented and confused.
Dr Peter Freeman, Lakes DHB clinical director emergency and medical management services, said seven people had been seen in the Rotorua Hospital emergency department this week suffering from the effects of the drug - one on Tuesday, Wednesday and Thursday and four today.
"There is no doubt that there is a very strong and potentially contaminated 'product' now being distributed locally that causes immediate vomiting, loss of consciousness and violent behaviour.
"I strongly advise people to keep away from synthetic cannabis - it is potentially very much more dangerous than marijuana."
Senior Sergeant Denton Grimes said since the start of this week police had noticed a big jump in synthetic-related call outs.
Peter Dunne, Associate Minister of Health, said he was sad to hear reports of serious adverse drug reactions "which could quite possibly been avoided had the Psychoactive Substances Act been allowed to continue as intended".
"I have asked the Ministry of Health to take a more active role on this issue, despite it effectively being a police enforcement issue, and they have established an expert advisory group to understand what is driving the increase in events reported.
"This will include testing product samples if obtained and analysing data from patients.
"I have heard reports that this is a 'bad batch'. Well frankly, I do not believe there is such a thing as a good batch of these substances.
"We live in a global market in which technological advances mean the production of a never-ended array of new psychoactive substances is a harsh reality.
"I cannot emphasise strongly enough, that users of these substances should stop using them."
Rotorua MP Todd McClay said parents needed to look out for their children and talk to them about the significant dangers that synthetic drugs posed.
Mr McClay said synthetic drugs were made illegal in 2014, however, they were still available through the illicit drug trade and drug dealers.
"These are very dangerous, untested drugs that can and do harm. I ask parents to talk to their children and make sure family members and friends are aware that synthetic drugs can be deadly."
Mr McClay said he was talking to police locally who will be doing everything they can to identify the people peddling this poison.
"Synthetic drugs are dangerous. If anyone knows anything about who is supplying them please inform Crimestoppers on 0800 555 111 before more people are harmed," Mr McClay said.
Te Utuhina Manaakitanga general manager Donna Blair said people should not risk their health or their life by using synthetics.
Ms Blair said the drugs could leave people incapacitated or dead.
"Robbing people of senses, motivation, adding extra stress on family and friends," she said.
"There are smaller numbers accessing our service but that does not reflect that there is an increase of people using."
Synthetic cannabinoids refer to a growing number of man-made mind-altering chemicals that are either sprayed on dried, shredded plant material so they can be smoked (herbal incense) or sold as liquids to be vaporised and inhaled in e-cigarettes and other devices (liquid incense).
These chemicals are called cannabinoids because they are related to chemicals found in marijuana plants. Because of this similarity, synthetic cannabinoids are sometimes misleadingly called "synthetic marijuana" or "fake weed", and they are often marketed as "safe" legal alternatives to that drug.
In fact, they may affect the brain much more powerfully than marijuana. Their actual effects can be unpredictable and, in some cases, severe or even life-threatening.
Synthetic cannabinoids are included in a group of drugs called "new psychoactive substances" (NPS). They are unregulated, and are newly available on the market, intended to copy the effects of illegal drugs.
Synthetic cannabinoids act on the same brain cell receptors as delta-9-tetrahydrocannabinol (THC), the mind-altering ingredient in marijuana. So far, there have been few scientific studies of the effects of synthetic cannabinoids on the human brain, but researchers know that some of them bind more strongly than marijuana to the cell receptors affected by THC, and may produce much stronger effects. The resulting health effects can be unpredictable.