The Tox Lab

The Tox Lab is a podcast dedicated to exploring the science of toxicology and its real-world implications. Each week we aim to break down complex research, investigate real-life cases, and discuss emerging trends in toxicology.

Disclaimer: All opinions are our own.

Find us on instagram: @the_tox_lab
Email us here: thetoxlab@gmail.com

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S1 · E91
Monday · 35 min
Episode 91: Toxicology Results - What Does the Number Actually Mean?
This week on The Tox Lab, we're taking a closer look at one of the most challenging parts of toxicology: interpreting the results. If we give you a number, can you tell us what it means? We begin by exploring why interpreting a toxicology result is rarely as simple as comparing a concentration with a reference value. We discuss the range of clinical, analytical, pharmacological, and contextual information needed to understand what a result actually means, as well as the biases that can influence the way toxicology results are interpreted. We then turn to recent published work evaluating the performance of AI and large language models in toxicology interpretation. Can these tools accurately interpret toxicology results, or do they reflect the same pitfalls seen when results are considered without sufficient clinical context? We explore some of the common errors and limitations reported in the literature when AI is applied to toxicology result interpretation. Finally, we examine the use of reference intervals in toxicology and ask whether they can really help clinicians interpret drug concentrations. We discuss why reference intervals are not always straightforward and why context matters when deciding whether a toxicology result is clinically significant. Join us as we explore the complexities of toxicology result interpretation, the risks of relying on numbers without context, and whether AI could actually help us make sense of toxicology results. Hope you enjoy! Links to the papers we discussed: https://www.tandfonline.com/doi/full/10.1080/15563650.2026.2698028 https://www.sciencedirect.com/science/article/pii/S0379073826001052?via%3Dihub https://pmc.ncbi.nlm.nih.gov/articles/PMC13152082/ Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
S1 · E90
August 17 · 39 min
Episode 90: Fentanyl: Toxicity, Testing and Interpretation
This week on The Tox Lab, we're taking a closer look at fentanyl, exploring its clinical use, toxicological risks, and the analytical challenges associated with detecting and interpreting fentanyl exposure. We begin by examining fentanyl patch-related deaths reported in England, Wales and Northern Ireland, including cases highlighted through Prevention of Future Deaths reports. We discuss how fentanyl patches can contribute to fatal toxicity and consider what these cases can tell us about preventing future deaths. We then turn to the laboratory, exploring fentanyl immunoassay cut-offs and why the concentration used to define a positive result matters. We discuss the importance of understanding and clinically assessing analytical cut-offs in different toxicological scenarios, rather than treating a single threshold as universally applicable. Finally, we examine 4-ANPP, a minor metabolite of fentanyl that is also an important precursor and impurity associated with illicit fentanyl manufacture. We explore whether detecting 4-ANPP could help distinguish between exposure to pharmaceutical fentanyl and illicitly manufactured fentanyl, and consider the challenges in interpreting this marker. Join us as we explore fentanyl toxicity, analytical interpretation, and the challenges of distinguishing different sources of fentanyl exposure, and consider what these findings mean for clinical and forensic toxicology. Hope you enjoy! Links to the papers we discussed: https://bpspubs.onlinelibrary.wiley.com/doi/10.1002/bcp.70525 https://academic.oup.com/jat/article-abstract/50/5/bkag025/8658822?redirectedFrom=fulltext https://academic.oup.com/jat/article-abstract/50/3/bkaf111/8415903?redirectedFrom=fulltext Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
S1 · E89
August 10 · 19 min
Episode 89: Absinthe: Thujone, Toxicity and the Myths of the Green Fairy
This week on The Tox Lab, we're diving into the world of absinthe, the infamous "Green Fairy". We begin by exploring what absinthe actually is, from its botanical origins and traditional preparation to its rise in popularity and the myths that eventually surrounded it. We discuss why absinthe became associated with hallucinations, madness, and toxicity, and how these stories contributed to its controversial reputation and prohibition. We then turn to the toxicology of absinthe and examine thujone, the compound often identified as the toxin responsible for "absinthism". We explore how thujone affects the central nervous system, what the evidence actually tells us about thujone toxicity, and whether reported cases of absinthe-related illness can really be attributed to the compound itself. We also take a closer look at what is known about thujone exposure and toxicity in general, discussing how neurological symptoms can arise at high doses and why interpreting reports of adverse effects is challenging when modern toxicological data is limited or based on experimental models rather than real-world exposure. Finally, we bring these threads together by separating fact from fiction, unpacking some of the most persistent myths surrounding absinthe, including whether it truly causes hallucinations and what ultimately led to its bans in many countries. Join us as we explore the chemistry, pharmacology, and toxicology of absinthe, and ask whether the notorious "Green Fairy" really deserved its dangerous reputation, or if its legacy is more myth than science. Hope you enjoy! Links to papers we discussed: https://pmc.ncbi.nlm.nih.gov/articles/PMC1475830/ https://ift.onlinelibrary.wiley.com/doi/epdf/10.1111/1750-3841.14273 Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
S1 · E88
August 3 · 18 min
Episode 88: Decongestants - When Nasal Sprays and Eye Drops Become Toxic
This week on The Tox Lab, we're taking a look at the dark side of decongestants and exploring how seemingly harmless over-the-counter nasal sprays and eye drops can cause severe toxicity. We begin by discussing the pharmacology of imidazoline decongestants, including their effects on alpha-adrenergic receptors and how systemic exposure can lead to cardiovascular and central nervous system toxicity. We then examine a fatal case involving xylometazoline, in which exposure was associated with a haemorrhagic stroke. We explore the possible mechanisms underlying this rare but serious complication, including the effects of sympathomimetic decongestants on vascular tone and blood pressure. Finally, we turn to tetrahydrozoline, an ingredient found in products such as Visine eye drops and some nasal decongestants. We discuss accidental and intentional ingestions, severe bradycardia, hypotension, CNS depression, and cardiac conduction abnormalities, as well as the challenges associated with recognising and detecting tetrahydrozoline toxicity. We also explore the darker forensic history of tetrahydrozoline, including its involvement in cases of drug-facilitated sexual assault and murder, and consider why the role of these compounds in unexpected deaths and criminal investigations may be underestimated. Join us as we examine how everyday over-the-counter decongestants can cause coma, profound cardiovascular toxicity, and even death, and explore the toxicological and forensic challenges posed by compounds that are not routinely included in standard drug screening. Hope you enjoy! Links to the papers we discussed: https://onlinelibrary.wiley.com/doi/abs/10.1111/1556-4029.15416 https://link.springer.com/article/10.1007/s12024-023-00680-9 https://pmc.ncbi.nlm.nih.gov/articles/PMC8118060/ Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
S1 · E87
July 27 · 28 min
Episode 87: Wastewater Analysis: Can Sewage Detect Emerging Drug Trends?
This week on The Tox Lab, we're diving into wastewater-based epidemiology and exploring how wastewater analysis can be used to monitor drug use and emerging drug trends. We begin by discussing the UK national wastewater analysis programme and examining what wastewater data revealed about the use of commonly encountered recreational drugs in 2022. We explore what these measurements can tell us about population-level drug use and how wastewater analysis can provide a different perspective from more traditional sources of toxicological data. We then turn to the use of wastewater analysis for monitoring novel psychoactive substances, discussing the detection of emerging compounds including nitazenes and xylazine. Finally, we examine the recent detection of N-propionitrile chlorphine, also known as cychlorphine, in wastewater in the United States. We discuss what these findings may tell us about the emergence of this novel synthetic opioid and the potential for wastewater monitoring to identify new substances as they begin to appear in the illicit drug supply. Join us as we explore how wastewater analysis is being used to monitor drug use, track emerging synthetic opioids and novel psychoactive substances, and consider whether wastewater could play an increasingly important role in early warning systems, harm reduction, and public health. Hope you enjoy! Links to papers we discussed: https://onlinelibrary.wiley.com/doi/10.1111/add.70398 https://pubs.acs.org/doi/10.1021/acsestwater.5c01173?ref=PDF https://pmc.ncbi.nlm.nih.gov/articles/PMC12319643/ https://pubs.acs.org/doi/10.1021/acs.estlett.6c00529 Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
S1 · E86
July 20 · 17 min
Episode 86: Silver Toxicity: Medical Uses, Argyria and Anaemia
This week on The Tox Lab, we're discussing silver toxicity and the toxicological consequences of using silver outside its established medical applications. We begin by exploring the legitimate uses of silver in medicine, including wound dressings, topical preparations, and antimicrobial coatings on medical devices. We then turn to the claims surrounding colloidal silver, including its promotion as a treatment for a wide range of conditions despite a lack of evidence supporting many of these uses. We then examine argyria, a condition caused by the accumulation of silver in the body that can lead to permanent blue-grey discolouration of the skin. We discuss the case of Paul Karason, better known as "Papa Smurf", and explore how his use of colloidal silver made him one of the most recognisable examples of the potential consequences of long-term silver exposure. Finally, we examine a case of severe anaemia associated with colloidal silver ingestion, discussing the potential mechanisms of toxicity and the challenges of recognising the role of alternative and unregulated products in serious clinical presentations. Join us as we explore the medical uses, alternative claims, and toxicological consequences of silver exposure, and consider how a substance with legitimate applications in medicine can become harmful when used in ways that are not supported by the evidence. Hope you enjoy! Link to papers we discussed: https://jamanetwork.com/journals/jamadermatology/fullarticle/2214158 https://onlinelibrary.wiley.com/doi/10.5694/mja2.52687 https://www.sciencedirect.com/science/article/pii/S221475002300104X?via%3Dihub Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
S1 · E85
July 13 · 23 min
Episode 85: Benzodiazepines and Alcohol: Does Cross-Tolerance Work Both Ways?
This week on The Tox Lab, we're discussing cross-tolerance, focusing on the relationship between benzodiazepines and alcohol. We begin by exploring how alcohol acts at the GABA-A receptor, the neuroadaptations that occur with chronic alcohol use, and why the sudden cessation of alcohol can lead to withdrawal. We then discuss why benzodiazepines are the mainstay of treatment for alcohol withdrawal and the pharmacological basis for their effectiveness. We then turn to the concept of cross-tolerance, examining how long-term alcohol use can influence the response to benzodiazepines, and whether chronic benzodiazepine use provides similar cross-tolerance to the effects of alcohol. We discuss the pharmacological mechanisms underlying these interactions, the similarities and important differences between the two drugs, and why cross-tolerance is only partial. Finally, we consider the clinical implications of these findings, including why combining alcohol and benzodiazepines remains particularly dangerous despite any degree of tolerance. Join us as we examine the pharmacology, clinical toxicology, and misconceptions surrounding benzodiazepine and alcohol cross-tolerance, and consider what these interactions mean for patient care and overdose risk. Hope you enjoy! Link to papers we discussed: https://pmc.ncbi.nlm.nih.gov/articles/PMC3321276/ https://journals.healio.com/doi/10.3928/00485713-20251202-02?__cf_chl_f_tk=QOyw_fXXLTUEXO4ZHEuX5s6eAN_jQeaCPemdwZ_Ygdc-1783254633-1.0.1.1-n9t5ECBcZIAn9EM4ia88JllcRLiCinRKSrG5LRy3D94 Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
S1 · E84
July 6 · 19 min
Episode 84: MDMA: Why Does Toxicity Differ Between People?
This week on The Tox Lab, we’re discussing MDMA, examining its pharmacology, toxicity, and the factors that influence individual susceptibility to harm. We begin by exploring how MDMA works, focusing on its effects on serotonin release, reuptake, and signalling, and the pharmacological mechanisms responsible for its desired effects and adverse reactions. We then examine a case of severe MDMA toxicity resulting in hyperthermia and multi-organ failure, discussing the clinical features, management, and the toxicological mechanisms underlying these life-threatening complications. Finally, we turn to the role of the polymorphic enzyme CYP2D6 in MDMA metabolism, examining how genetic variation and MDMA-induced inhibition of CYP2D6 can influence drug concentrations, toxicity, and the risks associated with repeat dosing and drug interactions. Join us as we examine the pharmacology, clinical toxicology, and pharmacogenetics of MDMA, and consider what these findings mean for understanding both its desired effects and its potential harms. Hope you enjoy! Links to the papers we discussed: https://pmc.ncbi.nlm.nih.gov/articles/PMC11470468/pdf/main.pdf https://pmc.ncbi.nlm.nih.gov/articles/PMC3495276/pdf/fgene-03-00235.pdf https://analyticalsciencejournals.onlinelibrary.wiley.com/doi/10.1002/dta.2605 Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
S1 · E83
June 29 · 23 min
Episode 83: Grey Market Peptides – BPC-157, Melanotan II and Toxicity
This week on The Tox Lab, we’re discussing grey market peptides and examining the growing interest in these compounds for performance enhancement, recovery, and cosmetic purposes. We begin by exploring peptides linked to musculoskeletal healing, focusing on BPC-157 and the evidence surrounding its proposed effects. We discuss the claims made about these compounds, the current state of the research, and the challenges of separating marketing from scientific evidence. We then turn to melanotan II, examining its pharmacology, patterns of use, and a rare case of priapism associated with its administration. Finally, we discuss the broader risks associated with grey market peptides, including product quality, dosing uncertainty, adverse effects, and the challenges posed by purchasing compounds from unregulated online sources. Join us as we examine the evidence, harms, and controversies surrounding grey market peptides, and consider what their increasing popularity means for toxicology, public health, and consumer safety. Hope you enjoy! Links to the papers we discussed: https://link.springer.com/article/10.1007/s12178-025-09990-7 https://academic.oup.com/smoa/article/9/1/100298/6956707 https://www.health.vic.gov.au/health-alerts/toxicity-linked-to-unapproved-peptide-retatrutide Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
June 25 · 1 hr 16 min
EUDA 2026 Drug Report Livestream
Bonus Episode: EUDA European Drug Report 2026 Livestream This is the recording of our YouTube livestream from the 9th June, where we unpacked the 2026 EUDA Drug Report. Join us as we explore some of the key findings from the report, discuss emerging drug trends across Europe, share our insights, and answer your questions. We hope you enjoy! Link to the 2026 EUDA Drug Report: https://www.euda.europa.eu/publications/european-drug-report/2026_en Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
S1 · E82
June 22 · 28 min
Episode 82: Gabapentin and Pregabalin – Effectiveness, Trends and Toxicity
This week on The Tox Lab, we’re discussing gabapentinoids and examining the use, effectiveness, and toxicological considerations surrounding gabapentin and pregabalin. Originally developed as anti-epileptic medications, gabapentinoids have become widely used for the treatment of neuropathic pain and a range of other conditions. We begin by examining prescribing trends and discussing the evidence surrounding their effectiveness, including whether these drugs are as beneficial as once thought in all patient groups. We then explore some of the adverse effects associated with gabapentinoids and discuss the risks associated with their use alongside other central nervous system depressants, including opioids and benzodiazepines. Finally, we turn to the forensic and toxicological aspects of gabapentinoid use, examining their involvement in driving under the influence of drugs cases and post-mortem investigations. We discuss what these findings tell us about the increasing prevalence of gabapentinoids and their role in drug-related deaths. Join us as we examine the benefits, limitations, and toxicological considerations surrounding gabapentin and pregabalin, and consider what their growing use means for patients and healthcare systems. Hope you enjoy! Links to the papers we discussed: https://pmc.ncbi.nlm.nih.gov/articles/PMC11626918/ https://shmpublications.onlinelibrary.wiley.com/doi/full/10.1002/jhm.70286 https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkag040/8703238?redirectedFrom=fulltext https://www.sciencedirect.com/science/article/pii/S037907382100150X?via%3Dihub Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
S1 · E81
June 15 · 26 min
Episode 81: Alexander Shulgin – The Man Who Shaped Modern Psychedelics
This week on The Tox Lab, we’re discussing the life and work of one of the most influential figures in psychedelic chemistry, Alexander “Sasha” Shulgin. From his early career at Dow Chemical to his pioneering work with psychoactive compounds, Shulgin’s career helped shape the modern landscape of psychedelic research. We discuss his fascination with psychedelics, his meticulous approach to self-experimentation, and his synthesis and investigation of hundreds of compounds, including his role in the rediscovery of MDMA and the publication of PIHKAL and TIHKAL. Join us as we examine the science, stories, and controversies surrounding Alexander Shulgin, and consider how one chemist helped shape our modern understanding of psychedelic drugs. Link to Shulgin's laboratory notebooks: https://www.erowid.org/library/books_online/shulgin_labbooks/ Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
S1 · E80
June 1 · 36 min
Episode 80: Novel Benzodiazepines – Emerging Trends and Analytical Challenges
This week on The Tox Lab, we’re discussing novel benzodiazepines and examining recent trends in their emergence and detection. We begin by exploring the origins of novel benzodiazepines, including how these compounds have entered the drug market and the factors contributing to their continued appearance. We then turn to a paper from the Society of Forensic Toxicologists (SOFT) Novel Psychoactive Substances Committee, examining trends in novel benzodiazepine detections between 2021 and 2025. We discuss findings from post-mortem investigations, clinical presentations, driving under the influence of drugs cases, and drug-facilitated crime, highlighting the compounds most commonly encountered, including bromazolam, etizolam, and desalkylgidazepam, and how patterns have changed over time. We also explore the analytical challenges associated with novel benzodiazepines, including their detection and identification in toxicology laboratories, the limitations of routine testing, and the difficulties associated with interpreting toxicological findings when limited pharmacological, toxicological, and concentration data are available. Join us as we examine the evolving landscape of novel benzodiazepines, consider the challenges they present for forensic and clinical toxicology, and discuss what these trends may tell us about the future of the drug market. Hope you enjoy! Links to the paper we discussed: https://academic.oup.com/jat/advance-article/doi/10.1093/jat/bkag026/8662327?searchresult=1 https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkag027/8663758?redirectedFrom=fulltext Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Check out our new website: https://thetoxlab.co.uk/ Support us here: https://buymeacoffee.com/thetoxlab
S1 · E79
May 25 · 25 min
Episode 79: Kava – Tradition, Benefits and Toxicity
This week on The Tox Lab, we’re discussing kava and examining its history, use, and potential toxicological effects. We begin by exploring the history of kava and its longstanding cultural and social significance, before discussing reported benefits associated with its use and the reasons it continues to gain popularity. We then turn to potential harms associated with kava, examining cases of acute liver injury and acute interstitial nephritis linked to its use, before discussing a fatal case involving kava ingestion and the toxicological considerations surrounding these reports. Join us as we examine the evolving story surrounding kava, from its traditional use and perceived benefits to the clinical and toxicological challenges associated with its increasing use. Links to the papers we discussed: https://pmc.ncbi.nlm.nih.gov/articles/PMC12405834/pdf/DAR-44-1601.pdf https://doi.org/10.1155/crgm/3914876 https://onlinelibrary.wiley.com/doi/10.1111/nep.70051 http://dx.doi.org/10.1016/j.forsciint.2015.01.032 Check out our new website: https://thetoxlab.co.uk/ Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Support us here: https://buymeacoffee.com/thetoxlab
S1 · E78
May 18 · 19 min
Episode 78: Strange Things in Strange Places – Poison Dart Frogs, Navalny and Epibatidine
This week on The Tox Lab, we’re discussing poison dart frogs and the alkaloid epibatidine. We begin by examining recent reports surrounding the death of Alexei Navalny and the suggestion that epibatidine may have been involved. We then discuss poison dart frogs and the toxins found within them, including the discovery and isolation of epibatidine. From there, we explore its potent analgesic properties, how it acts at nicotinic acetylcholine receptors, and what makes it both pharmacologically interesting and highly toxic. Finally, we examine attempts to develop epibatidine analogues as novel analgesics and explore the evolutionary question of how poison dart frogs themselves avoid poisoning. Join us as we examine the pharmacology, toxicity, and evolving story surrounding epibatidine, and consider how a toxin derived from poison dart frogs became linked to drug development, toxicology, and international headlines. Hope you enjoy! Links to the papers we discussed: https://www.gov.uk/government/news/joint-statement-by-the-uk-sweden-france-germany-and-the-netherlands-on-alexei-navalnys-death https://pubs.rsc.org/en/content/articlelanding/2000/np/a900728h https://www.science.org/doi/epdf/10.1126/science.aan5061 Check out our new website: https://thetoxlab.co.uk/ Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Support us here: https://buymeacoffee.com/thetoxlab
S1 · E77
May 11 · 21 min
Episode 77: Novel Synthetic Opioids – An Update on Emerging Trends
This week on The Tox Lab, we’re back with a long-awaited update on novel synthetic opioids. We begin by discussing the April 2026 UNODC announcement on the increasingly varied forms in which synthetic opioids are being encountered, including vapes, powders, and counterfeit tablets marketed as benzodiazepines, oxycodone, and MDMA. We then turn to the emergence of orphine analogues in both the UK and the US, discussing recent reports and trends associated with these compounds. Finally, we examine a clinical case involving N-propionitrile chlorphine (cychlorphine), exploring the toxicological features and the challenges these emerging opioids present for clinicians, laboratories, and public health systems. Join us as we examine the changing landscape of novel synthetic opioids, consider what these developments may mean for toxicology, harm reduction, and public health, and discuss where the market may be heading next. Hope you enjoy! This episode is very kindly sponsored by Cayman Chemical. Check out their Synthetic Opioid Analytical Standards Panel here: https://www.caymanchem.com/product/44436/synthetic-opioid-analytical-standards-panel-1 Links to papers we discussed: https://www.unodc.org/LSS/Announcement/Details/973e194e-f8d6-4b4e-8aca-166aaec4ac7c https://www.polizei.bayern.de/aktuelles/pressemitteilungen/100413/index.html https://onlinelibrary.wiley.com/doi/10.1111/dar.70081 https://assets.publishing.service.gov.uk/media/69f3343fab602a88957eef2b/Seventh_addendum_to_the_ACMD_report_on_the_use_and_harms_of_2-benzyl-benzimidazole__nitazene__and_piperidine_benzimidazolone__brorphine-like__opioids_FINAL.pdf https://www.cfsre.org/nps-discovery/public-alerts/increase-in-fatal-overdoses-linked-to-novel-synthetic-opioid-n-propionitrile-chlorphine-cychlorphine https://www.tandfonline.com/doi/full/10.1080/15563650.2025.2594070 Link to our paper on N-pyrrolidino Isotonitazene: https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkag027/8663758?redirectedFrom=fulltext Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Support us here: https://buymeacoffee.com/thetoxlab
S1 · E76
May 4 · 24 min
Episode 76: Naloxone - Access, Harm Reduction and Disparities
This week on The Tox Lab, we are taking a look at the role of naloxone in risk taking behaviours, harm reduction and disparities surrounding naloxone access. We begin by discussing a study looking at the expansion of naloxone access laws in the United States, exploring whether increased availability is associated with changes in heroin use among adolescents. We then turn to a commentary paper examining the benefits and limitations of educating school children recognise an opioid overdose and administer naloxone. Finally we discuss a paper investigating disparities in naloxone uptake amongst different ethnic and racial groups, and between individuals who inject versus smoke substances. Join us as we explore the impact of naloxone access, education, and disparities, and consider what these findings mean for harm reduction and public health. Hope you enjoy! Links to the papers we discussed: https://www.sciencedirect.com/science/article/abs/pii/S0955395923000294 https://onlinelibrary.wiley.com/doi/abs/10.1111/josh.70089 https://pubmed.ncbi.nlm.nih.gov/41428846/ Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Support us here: https://buymeacoffee.com/thetoxlab
S1 · E75
April 27 · 26 min
Episode 75: Kratom Is Changing - New Semi-Synthetic Compounds & Rising Harm
A year after we first took a look at mitragynine (kratom), we are back with an update episode looking at how the landscape surrounding mitragynine is evolving. We begin by examining poison centre data, exploring trends in reported exposures in the US and internationally, and the increase in its use. We then discuss a case involving semi-synthetic mitragynine derivatives, including 7-hydroxymitragynine and mitragynine pseudoindoxyl, highlighting the clinical features including dose escalation, and challenges associated with withdrawal. Finally, we turn to reports of combined use of kratom and kava, and consider how this may influence toxicity and withdrawal. Join us as we examine emerging data, evolving patterns of use, and the clinical implications of mitragynine and its derivatives, and consider what these findings mean for toxicology and public health. Hope you enjoy! If you'd like us to cover an episode on Kava, please let us know in the comments! Links to the papers we discussed: https://www.cdc.gov/mmwr/volumes/75/wr/mm7511a1.htm https://www.cureus.com/articles/467977-severe-early-onset-withdrawal-following-intentional-use-of-mitragynine-pseudoindoxyl-a-case-report-and-emerging-clinical-considerations#!/ https://www.cdc.gov/mmwr/volumes/75/wr/pdfs/mm7512a1-H.pdf https://journals.lww.com/journaladdictionmedicine/abstract/9900/kava_potentiated_withdrawal_in_persons_using.687.aspx Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Support us here: https://buymeacoffee.com/thetoxlab
S1 · E74
April 20 · 18 min
Episode 74: Codeine – Pharmacogenetics, Breastfeeding and the 2006 Lancet Case
This week on The Tox Lab, we’re examining the controversial 2006 Lancet paper on codeine and fatal opioid toxicity in a breastfed infant. We begin by introducing the paper and the case at its centre, in which an infant developed fatal opioid toxicity following exposure to codeine via breast milk. We then explore the proposed mechanism, focusing on the role of CYP2D6 metabolism and how variability in this pathway may lead to higher-than-expected morphine concentrations. We also discuss the limitations and criticisms of the paper, including questions around causality, alternative explanations, and the extent to which pharmacogenetics alone can account for the outcome. Finally, we consider the wider impact of this publication, including changes to clinical guidance, prescribing practices, and the ongoing debate around codeine use in breastfeeding individuals. Join us as we examine the pharmacology, pharmacogenetics, and controversy surrounding this landmark case, and consider what this means for clinical toxicology and patient safety. Hope you enjoy! Links to the papers we discussed: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)69255-6/abstract https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00245-X/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140673608612544/abstract https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.1882 Link to the New Yorker Article : https://www.newyorker.com/magazine/2026/02/02/did-a-celebrated-researcher-obscure-a-fatal-poisoning Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Support us here: https://buymeacoffee.com/thetoxlab
April 13 · 29 min
Episode 73: Pesticides – Flowers, Food and Forensics
This week on The Tox Lab, we’re examining pesticides and their role in toxicology. We begin by discussing a study investigating pesticide exposure in florists, highlighting occupational risks and the potential for chronic low-level exposure. We then turn to a paper analysing pesticide residue levels in commonly consumed fruits, including kiwifruit and bananas, and consider what this may mean for dietary exposure. Finally, we discuss a study examining pesticide-related fatalities in Turkey, exploring the clinical and toxicological features associated with these cases. Join us as we explore the occupational, environmental, and clinical aspects of pesticide exposure, and consider what these findings mean for toxicology and public health. Hope you enjoy! Links to the papers we discussed: https://pmc.ncbi.nlm.nih.gov/articles/PMC5451977/ https://www.sciencedirect.com/science/article/abs/pii/S0273230026000103?via%3Dihub https://link.springer.com/article/10.1007/s12024-026-01220-x Disclaimer: All opinions are our own. Find us on instagram: @the_tox_lab Email us here: thetoxlab@gmail.com Support us on: https://buymeacoffee.com/thetoxlab

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