MILWAUKEE (AP) — Wisconsin health officials report the first death in the state linked to a recent surge in people using synthetic marijuana.

The Wisconsin Department of Health Services on Wednesday confirmed a death in Milwaukee County related to the use of synthetic marijuana, often called fake weed, K2 and spice.

The Milwaukee County medical examiner’s office says a 33-year-old woman died July 1 of complications from ingesting rat poison, and that drugs including synthetic marijuana, methadone and cough suppressant were a contributing factor.

Health officials say overall, Wisconsin has seen 45 cases of people getting sick from using synthetic marijuana since March, including 37 confirmed cases and 8 probable cases. Counties with confirmed cases include Dane, Milwaukee, Outagamie and Rock.

Fake marijuana contains chemicals that produce a marijuana-like high.