Journal of Medical Toxicology最新文献

{"title":"Naloxone Dosing and Hospitalization for Nitazene Overdose: A Scoping Review.","authors":"Jonathan C Berger, Alec D Severe, Mohamed S Jalloh, Alex F Manini","doi":"10.1007/s13181-025-01059-8","DOIUrl":"10.1007/s13181-025-01059-8","url":null,"abstract":"<p><strong>Introduction: </strong>Nitazene compounds are high potency, synthetic opioids, recently detected in the United States illicit opioid supply. This is a scoping review to summarize the available body of literature on naloxone and hospitalization reports in response to nitazene compound overdose.</p><p><strong>Methods: </strong>This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) extension for Scoping Reviews. PubMed, ProQuest, and Google Scholar were accessed. Articles were limited to full-text peer-reviewed publications appearing in scholarly journals between January 2018 and December 2024. Total naloxone dose (in mg, primary outcome) and total length of stay (LOS, in hours, secondary outcome) were recorded.</p><p><strong>Results: </strong>Of 109 articles screened, 103 were excluded (44 non-human; 35 no nitazene exposure, 9 no naloxone administered, 9 post-mortem data only, 3 non-overdose, 2 non-English, and 1 full text unavailable), leaving 6 articles included. Data were described on 19 distinct patients with nitazene compound overdose (meto-, isoto-, proto-, and eto-nitazene), all of whom had naloxone data, and 10 of whom had LOS data. Median total naloxone doses were the following: metonitazene 6.00mg; etonitazene 3.06mg; isotonitazene 3.00mg; protonitazene 1mg (p=0.4). Mean hospital LOS were the following: metonitazene 360 hours; etonitazene 122.25 hrs; isotonitazene 32.67 hrs; protonitazene 20 hrs.</p><p><strong>Conclusion: </strong>This scoping review reveals a paucity of data on nitazene compound overdoses and identifies a gap in our current opioid crisis response. Most nitazene cases reviewed involved hospitalization, had high naloxone dosing, and relatively long LOS. Differences in naloxone dose and hospital LOS could underscore the unpredictable and potent nature of these substances.</p>","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"276-283"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on Tianeptine Exposures Reported to United States Poison Centers, 2015-2023.","authors":"William Rushton, Jessica Rivera, Scott Harris","doi":"10.1007/s13181-025-01058-9","DOIUrl":"10.1007/s13181-025-01058-9","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"294-295"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excellence in Review-Appreciation for Journal of Medical Toxicology's 2024 Peer Reviewers.","authors":"Howard A Greller, Mark B Mycyk","doi":"10.1007/s13181-025-01062-z","DOIUrl":"https://doi.org/10.1007/s13181-025-01062-z","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biostatistics and Epidemiology for the Toxicologist: Information Bias-Differential and Non-Differential Misclassification (Part I).","authors":"Elise Perlman, Sanjay Mohan, Mark K Su","doi":"10.1007/s13181-024-01044-7","DOIUrl":"10.1007/s13181-024-01044-7","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"78-80"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Groundbreaking Research from NIDA Addressing the Challenges of the Opioid Epidemic.","authors":"Nora Volkow, Leslie R Dye","doi":"10.1007/s13181-024-01041-w","DOIUrl":"10.1007/s13181-024-01041-w","url":null,"abstract":"<p><p>The 2024 ACMT Ward and Ryan Donovan Memorial Fund lecture was presented by Dr. Nora Volkow, the director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health (NIH). This article in an edited version of her keynote address during ACMT's 2024 Annual Scientific Meeting. During the course of her talk, Dr. Volkow discussed the historical factors contributing to the ongoing global opioid epidemic, examined the evidence behind different front-line and policy strategies used to battle the opioid epidemic, and highlighted the importance of recent cultural changes that support more deliberate screening for substance use disorders and pathways for initiating treatment of opioid use disorders in vulnerable populations. An urgent need exists to improve inclusion of social and structural determinants of health in implementation science addressing opioid use disorders, with better attention to special populations, including Native American Indians and Alaskan Natives, African Americans, those over 65 years of age, and teenagers.</p>","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"69-77"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NPDS Coding: An Opportunity for Quality Improvement.","authors":"Anthony Jaworski","doi":"10.1007/s13181-024-01039-4","DOIUrl":"10.1007/s13181-024-01039-4","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"101-102"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on the Donovan Memorial Lecture: Addiction and Recovery as a Continuum.","authors":"Leslie R Dye","doi":"10.1007/s13181-024-01042-9","DOIUrl":"10.1007/s13181-024-01042-9","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"1-8"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tianeptine Exposures Reported to United States Poison Centers, 2015-2023.","authors":"Mustafa Quadir, Natalie I Rine, Jaahnavi Badeti, Hannah L Hays, Nichole L Michaels, Jingzhen Yang, Gary A Smith","doi":"10.1007/s13181-024-01053-6","DOIUrl":"10.1007/s13181-024-01053-6","url":null,"abstract":"<p><strong>Introduction: </strong>Tianeptine is an atypical tricyclic antidepressant not approved for medical use in the US but is found in dietary supplements. This study investigates single-substance tianeptine exposures reported to US poison centers.</p><p><strong>Methods: </strong>We analyzed cases involving tianeptine reported to the National Poison Data System from 2015 to 2023.</p><p><strong>Results: </strong>There were 892 single-substance tianeptine exposures reported to US poison centers from 2015 to 2023, and the rate of exposures increased 1,400% from 2015 to 2023, including a 525% increase from 2018 to 2023. Most exposures were associated with moderate (51.5%) or major (12.0%) effects, and 40.1% required medical admission, including 22.9% to a critical care unit. Individuals 50 years and older were more likely to experience major effects (RR: 1.70, 95% CI: 1.13-2.56) or require medical admission (RR: 1.43, 95% CI: 1.20-1.72) than younger individuals. Tianeptine abuse accounted for 40.1% of exposures and was more likely to be associated with moderate or major effects (RR: 1.18, 95% CI: 1.06-1.31) than exposures not attributed to abuse. Withdrawal accounted for 22.5% of tianeptine exposures. Tianeptine exposure rates were highest in the US South. Alabama enacted legislation to regulate tianeptine as a controlled substance in 2021. Alabama's tianeptine exposure rate increased by 1,413.7% from 2018 to 2021, followed by a 74.6% decrease from 2021 to 2023, while the rate in other southern states continued to increase.</p><p><strong>Conclusions: </strong>This study demonstrates the toxicity and rapid increase of tianeptine exposures reported to US poison centers. Uniform regulation of tianeptine across all states may offer an important strategy to help mitigate this public health problem.</p>","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"30-41"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACMT Position Statement: No Evidence that Tampons Cause Metal Poisoning.","authors":"Mehruba Anwar Parris, Maryann Mazer-Amirshahi, Diane P Calello, Andrew I Stolbach","doi":"10.1007/s13181-024-01047-4","DOIUrl":"10.1007/s13181-024-01047-4","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"106-107"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Laboratory Confirmed Drugs in Acute Recreational Drug Toxicity Presentations to an Urban Hospital in London, UK, 2016/17 versus 2019/20.","authors":"Caitlin E Wolfe, Lachlan J Sund, John Rh Archer, Ashley Rowe, Simon Hudson, David M Wood, Paul I Dargan","doi":"10.1007/s13181-024-01051-8","DOIUrl":"10.1007/s13181-024-01051-8","url":null,"abstract":"<p><strong>Introduction: </strong>Novel Psychoactive Substance (NPS) use is increasingly prevalent and is often associated with severe acute recreational drug toxicity (ARDT). 258 UK deaths were attributed to NPS use in 2021. Confirmatory testing which identifies NPS is limited by expense and timeliness. We aimed to identify NPS and other recreational drugs in a sample of 1000 ARDT presentations to a central London hospital in 2019/20 and to compare these drugs to those identified from a previous cohort in 2016/2017.</p><p><strong>Methods: </strong>We prospectively enrolled 1000 serum samples from ARDT presentations to St Thomas' Hospital between February 2019 and February 2020. Serum samples were deidentified and underwent qualitative analysis via mass spectrometry. Results were returned at the conclusion of testing and statistical analysis performed using 'R' (R Foundation for Statistical Computing).</p><p><strong>Results: </strong>Twenty-eight unique NPS were detected in 2019/20, compared to 31 in 2016/17. Eight new NPS were detected in 2019/20: four benzodiazepines, two synthetic cannabinoid receptor agonists, one cathinone and one ketamine-analogue. No NPS opioids were detected in either cohort. Cannabis (16%,11% p = 0.02), ketamine (12%,7% p < 0.01) and opioids (57%,24% p < 0.01) were detected significantly more frequently in 2019/20 than in 2016/17, while alcohol (22%,49% p < 0.01), cathinones (1%,15% p < 0.01), GHB (14%,20% p < 0.01) and MDMA (9%,18% p < 0.01) were detected less frequently.</p><p><strong>Conclusions: </strong>Studies that utilise confirmatory testing to detect NPS in presentations of ARDT provide important information for public health interventions. More NPS benzodiazepines and fewer NPS cathinones were detected in 2019/20, following temporal trends of forensic detection throughout Europe and reinforcing the importance of identifying emerging drugs.</p>","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"25-29"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}