Emergency services in Stoke-on-Trent say they are dealing with a city-wide "epidemic" of incidents relating to the use of monkey dust.
They say over the last two years they have been seeing a substantial rise in the number of people using the illegal substance in the city, and other areas in North Staffordshire - but incidents have escalated this summer.
Figures from Staffordshire Police show they are receiving an average of 10 or more calls a day related to monkey dust, with 950 incidents in the last three months alone.
PC Rich Frost, a police response officer in the city, says it transforms the users - who can but up the substance for as little as £2.
He said: "When you are trying to restrain them it's like you are dealing with someone who thinks they are the Incredible Hulk, the strength is unbelievable."
West Midlands Ambulance Service Paramedic Ann Armstrong says one user tried to set her trousers on fire while she was treating him.
She said: "I had an incident where I went to two people who were on monkey dust, and they were running in and out of traffic.
"Not only are they a danger to themselves, they are a danger to the public.
"It is like an epidemic."
Consultant Dr Chris Pickering, from Royal Stoke University Hospital, says the first patient that spat at him was on monkey dust.
He said: "We used to see drugs of recreation, we are now seeing this as a drug of abuse.
"The only way to calm them is sedation and we are talking massive doses - anaesthetic-type doses to allow them to start to come down."
Chief Superintendent Jeff Moore said: "The drug is highly addictive and highly unpredictable, meaning emergency services can often struggle to provide the appropriate treatment to those under the influence.
"Every user acts differently, displaying behaviour that is volatile and dangerous to both the user and emergency services personnel responding. The level of resource required is often far greater than we have experienced before with some suffering the effects of use for several days.
"Working with our partners we must improve education and prevention efforts to stop people taking the drug in the first place, but we also need to identify more effective ways to treat those already under the influence."
The city council commissioned Community Drug and Alcohol Service (CDAS) have appointed a panel to look into new psychoactive substances (NPS) and associated issues, with a particular focus on monkey dust.
We are also told the CDAS currently has no waiting lists to access support.
Council leader Ann James, who is also cabinet member for health and social care, said: "Stoke Recovery Service also provides support in the community to help people to become and remain drug and alcohol free and is building a visible recovery community of people to encourage and inspire others to address substance misuse.
"The services work closely with GPs and a wide range of other agencies to ensure people address the issues that cause them to use drugs as well as supporting them to overcome dependency."