The Tox Lab

This week on The Tox Lab, we’re taking a closer look at death cap mushrooms following the recent conclusion of the Erin Patterson case.

We explore the toxicology of Amanita phalloides, from the mechanism of amatoxins to the clinical course of poisoning and the challenges of treatment. We also look at poison centre data from California to understand how often suspected exposures are reported—and how they present in real-world cases.

Join us as we unpack the toxicology of one of the world’s deadliest mushrooms.

Hope you enjoy!

Linked to the paper we discussed:

https://www.tandfonline.com/doi/full/10.1080/15563650.2023.2276674

Disclaimer: All opinions are our own.

Find us on instagram: @the_tox_lab

Email us here: [email protected]

This week on The Tox Lab, we’re diving into novel nitazene metabolites in post-mortem toxicology.

We discuss findings from our own paper identifying metabolites of protonitazene in post-mortem casework, and highlight the variability in metabolites identified and what this might mean for identifying nitazene exposure. We also examine a post-mortem case report on 5-amino and 5-acetamido metonitazene which discusses if their presence may be the result of metabolism or instability within the sample.

Join us as we unpack the complexity of interpreting nitazenes in the post-mortem setting.

Hope you enjoy!

Links to the papers we discussed:

https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaf042/8128869

https://academic.oup.com/jat/article-abstract/48/9/691/7747396?login=false

https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaf070/8203075?redirectedFrom=fulltext

Disclaimer: All opinions are our own.

Find us on instagram: @the_tox_lab

Email us here: [email protected]

In this week's episode, we’re exploring the role of AI in toxicology. From large language models supporting drug identification to machine learning tools navigating the vast datasets produced by high-resolution mass spectrometry, we look at how artificial intelligence could be integrated into toxicological workflows.

We also discuss the limitations — including bias in training data, challenges with messy or incomplete datasets, and the importance of expert oversight in clinical and forensic applications.

Join us as we unpack the promise and pitfalls of AI in the evolving world of toxicology.

Hope you enjoy!

Link to the letter we discussed: https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaf036/8123742?redirectedFrom=fulltext&login=false

Disclaimer: All opinions are our own.

Find us on instagram: @the_tox_lab

Email us here: [email protected]

This week on The Tox Lab, we're diving into the world of α2 adrenergic receptor agonists. We explore how xylazine, when combined with heroin, can both potentiate drug-seeking behaviour after abstinence and attenuate heroin consumption and motivation during use.

We also review a study investigating naloxone and atipamezole as potential treatments for fentanyl–xylazine toxicity and examine two forensic case studies detailing tizanidine and medetomidine concentrations to support interpretation in toxicology casework.

Join us as we unpack the clinical, toxicological, and forensic implications of this increasingly encountered drug class.

Note: In this episode, we mentioned tizanidine acting on imidazole receptors (26:58) when we meant imidazoline receptors!

Hope you enjoy!

Links to papers we discussed:

https://www.sciencedirect.com/science/article/abs/pii/S0091305725000991

https://www.tandfonline.com/doi/full/10.1080/29947448.2025.2493044

https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaf056/8165439?redirectedFrom=fulltext&login=false

https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaf040/8127063?redirectedFrom=fulltext&login=false

Disclaimer: All opinions are our own.

Find us on instagram: @the_tox_lab

Email us here: [email protected]

This week, we’re talking about the toxic combination of cocaine and alcohol. We explore the formation of cocaethylene, and the role both cocaine and cocaethylene play in arrhythmias and other cardiac complications. We also examine potential mechanisms of liver injury linked to cocaine use—and how alcohol may amplify this effect.

Join us as we break down the pharmacology and clinical consequences of this high-risk pairing.

Hope you enjoy!

Links to the papers we discussed:

https://academic.oup.com/jat/article-abstract/43/3/155/5363995?redirectedFrom=fulltext

https://www.mdpi.com/2077-0383/13/5/1475

https://link.springer.com/article/10.1007/s10565-024-09901-5

Disclaimer: All opinions are our own.

Find us on instagram: @the_tox_lab

Email us here: [email protected]

This week on The Tox Lab, we're taking a closer look at tianeptine—a drug originally developed as an antidepressant, but now making headlines as “gas station heroin” due to its opioid-like effects and increasing misuse across the U.S.

We explore a compelling clinical case of high-dose tianeptine withdrawal, examine national poison control data highlighting common symptoms and severity of presentations, and discuss a recent outbreak in New Jersey involving cases of acute toxicity linked to contaminated tianeptine products.

Tune in as we break down the pharmacology, patterns of harm, and public health concerns surrounding this emerging substance.

Hope you enjoy!

Links to the papers we discussed:

https://pmc.ncbi.nlm.nih.gov/articles/PMC11254389/

https://link.springer.com/article/10.1007/s13181-024-01053-6

https://pmc.ncbi.nlm.nih.gov/articles/PMC11933608/

Disclaimer: All opinions are our own.

Find us on instagram: @the_tox_lab

Email us here: [email protected]

Why is chocolate dangerous for dogs? What makes lilies so toxic to cats? In this episode of The Tox Lab, we explore the fascinating (and sometimes surprising) toxicology of common substances that can harm our pets.

From household foods to ornamental plants, we break down the mechanisms behind these poisons, species-specific sensitivities, and what clinicians, pet owners, and toxicologists need to know when it comes to animal exposures.

Join us as we unpack the science behind pet poisoning cases and why everyday items might not be so harmless to our furry companions.

Hope you enjoy!

Disclaimer: All opinions are our own.

Find us on instagram: @the_tox_lab

Email us here: [email protected]

This week, we dive into the European Drug Report 2025, breaking down the latest data on drug trends across Europe.

From rising cocaine detections and shifting cannabis use patterns to ongoing concerns around heroin, MDMA, synthetic stimulants, and the growing presence of novel psychoactive substances — we explore the substances making headlines and what they mean for toxicologists, clinicians, and policymakers.

Join us as we unpack the key findings, highlight what’s new (and what’s not), and examine the wider implications for public health and toxicology.

Hope you enjoy!

Read the full EUDA 2025 report here: https://www.euda.europa.eu/publications/european-drug-report/2025_en

Disclaimer: All opinions are our own.

Find us on instagram: @the_tox_lab

Email us here: [email protected]

In this episode, we dive deep into the world of methamphetamine enantiomers—those chemically identical but biologically distinct mirror-image molecules. We examine a paper that looks at the suitability of the 20% D-methamphetamine cutoff used to indicate illicit methamphetamine use in the US, and some of the challenges associated with enantiomer testing.

We also break down the differential respiratory effects of methamphetamine enantiomers when co-administered with fentanyl—a combination increasingly seen in overdose cases—and what this means for clinical and forensic interpretation. Plus, we take a data-driven look at how these enantiomers are showing up in real-world contexts, from seized drug samples to blood samples of impaired drivers in Iceland.

Hope you enjoy!

Links to papers we discussed:

https://academic.oup.com/jat/article-abstract/36/6/399/791636?redirectedFrom=fulltext&login=false

https://pmc.ncbi.nlm.nih.gov/articles/PMC11015966/

https://academic.oup.com/jat/article-abstract/48/6/456/7675298?redirectedFrom=fulltext&login=false

Disclaimer: All opinions are our own.

Find us on instagram: @the_tox_lab

Email us here: [email protected]

In this week's episode, we explore the growing world of delta-8 THC—how it compares to delta-9 THC, what recent research reveals about its effects when consumed orally, and what those differences might mean for users. We also discuss a pediatric case involving the accidental ingestion of delta-8 THC gummies, highlighting the clinical presentation, management, and the testing challenges that can arise.

Hope you enjoy!

Links to papers we discussed:

https://doi.org/10.1016/j.drugalcdep.2025.112676

https://pmc.ncbi.nlm.nih.gov/articles/PMC8594112/

https://www.sciencedirect.com/science/article/abs/pii/S0376871625001371?via%3Dihub

Disclaimer: All opinions are our own.

Find us on instagram: @the_tox_lab

Email us here: [email protected]