CINCINNATI (AP) — Officials in several states are scrambling to deal with a series of heroin overdose outbreaks affecting dozens of people and involving at least six deaths.

The spikes in Indiana, Kentucky, Ohio and West Virginia over the past few days have seen rescue workers rushing from scene to scene to provide overdose antidote drugs.

It’s unclear if one dealer or batch is responsible for the multistate outbreak. But the spikes reflect the potency of heroin now flooding the Midwest.

Police in Cincinnati on Friday asked for the public’s help in identifying the source of the heroin behind an estimated 78 overdoses in two days.

One person died in Mount Sterling, Kentucky, following a series of 12 heroin overdoses within hours of each other on Wednesday.