The Tox Lab

This week on The Tox Lab, we continue our discussion on GHB, focusing on its role in forensic toxicology. We begin by examining a study investigating GHB in drug‑facilitated crime in Paris, highlighting patterns of reported incidents and toxicological findings. We then turn to post‑mortem toxicology, discussing the challenges of interpreting GHB concentrations after death and exploring research ai...

This week on The Tox Lab, we’re examining GHB, its use, and the harms associated with it. We begin by exploring what GHB is and how it works, before turning to a study from Australia examining trends in use over a 10-year period and the associated increase in harms. We then discuss a qualitative study focusing on GHB use among individuals identifying as heterosexual, exploring patterns of use, mot...

This week on The Tox Lab, we’re taking a closer look at poison centre data and how it can be used to identify drug trends and support toxicovigilance efforts. We begin by discussing a study analysing data from six European poison centres in the Netherlands, Freiburg, Austria, Sweden, Switzerland and the UK. The paper examines reports involving the eleven most commonly encountered recreational drug...

This week on The Tox Lab, we’re taking a closer look at one of the world’s oldest drugs, alcohol, and some of the fatal complications associated with chronic misuse. We discuss several cases that highlight the complex and sometimes unexpected consequences of long-term alcohol use, including hypokalaemic rhabdomyolysis, sudden unexpected death in individuals with alcohol misuse, and a fatal case of...

This week on The Tox Lab, we’re exploring dopamine agonists and their role in the development of impulse-related conditions such as gambling disorder, hypersexuality, and hobbyism. We cover a couple of case studies where dopamine agonists have led to these behavioural changes before discussing a review paper that examines the role of these medications in the development of addiction and gambling d...

This week on The Tox Lab, we’re discussing tetrodotoxin, the potent neurotoxin most commonly associated with pufferfish. We cover a clinical case of tetrodotoxin poisoning following ingestion of pufferfish stew, which initially followed the expected progression of symptoms before the emergence of unusual neurological features. We then turn to alternative sources of tetrodotoxin, including its pres...

This week on The Tox Lab, we’re taking a closer look at CBD and its effects on sleep. CBD is widely marketed for insomnia and sleep disturbance, but what does the evidence actually show? In this episode, we begin by examining survey data demonstrating that some individuals report improvements in sleep with CBD use. We then unpack the pharmacology, focusing on CBD’s inhibition of adenosine uptake a...

This week on The Tox Lab, we’re taking a closer look at monoamine oxidase inhibitors and their interactions with other substances. We begin by revisiting how MAOIs work and why inhibition of monoamine oxidase can create significant risks when combined with other drugs. Using a recent review paper as our guide, we explore reported interactions between MAOIs and commonly used psychoactive substances...

This week on The Tox Lab, we’re exploring the stability of nitazenes in post-mortem samples and what this means for toxicological interpretation. We discuss a recent study we have been involved in, from the unusual toxicology findings that first raised questions through to controlled stability experiments in animal models. We also examine data from the National Programme on Substance Use Mortality...

This week on The Tox Lab, we’re taking a closer look at bupropion and its distinctive toxicity profile in overdose. We explore a case of bupropion overdose to examine the often complex clinical presentation, including seizures and cardiovascular complications, as well as the challenges of management and potential longer-term consequences. We then unpack the mechanism underlying bupropion-associate...

This week on The Tox Lab, we’re taking a closer look at quaaludes and their modern analogues. Once synonymous with a particular era of drug use, quaaludes have largely disappeared from the illicit market. But have they really gone away? We explore the history of methaqualone, how and why it fell out of use, and what has appeared in its place. We then dive into a review examining a wide range of me...

This week on The Tox Lab, we’re exploring naloxone and its effectiveness in the context of novel synthetic opioid overdoses. Naloxone remains a cornerstone of opioid overdose management, but the emergence of highly potent synthetic opioids has raised important questions about whether standard approaches are still sufficient. We discuss clinical nitazene exposure data from Australia, examining the...

This week on The Tox Lab, we’re exploring early warning systems and their growing role in toxicology and public health. We break down the core principles that underpin early warning systems, before focusing on how these frameworks are applied to drug early warning systems aimed at identifying emerging substances and harms. We then discuss a recent paper examining the value of incorporating experie...

Welcome back to The Tox Lab! We are kicking off 2026 by exploring drugs that disrupt metabolism and the consequences that can follow. In this episode, we focus on compounds that alter glucose metabolism and the interplay between toxicology and biochemistry. We discuss a fatal case of metformin toxicity and the analytical and interpretive challenges involved in recognising this diagnosis. We then t...

This week on The Tox Lab, we’re closing out the year with a festive twist as we explore the link between marzipan, bitter almonds, and cyanide. We take a closer look at the chemistry linking cyanide to almonds and discuss a case of intentional bitter almond ingestion. We then turn to National Poisons Information Service data to examine patterns of cyanide exposure, clinical outcomes, and the antid...

This week on The Tox Lab, we’re taking a closer look at serotonin and its intriguing role in both depression and epilepsy. We review recent data examining the seizure risk associated with different classes of antidepressants and what this means for clinical decision making. We then explore a case report in which sertraline, an SSRI, appeared to have an anti-seizure effect, challenging some long-he...

This week on The Tox Lab, we are examining the growing evidence around cannabis and cardiovascular risk. We start with a recent systematic review and meta-analysis that explores whether cannabis use is linked to higher rates of cardiovascular disease. We break down the strength of the data and discuss what the current evidence can and cannot tell us. We then move onto research investigating how TH...

This week on The Tox Lab, we’re diving into the emerging world of “space oil”, the anesthetic drug etomidate, which has begun appearing in the recreational drug supply across parts of Asia and beyond. We explore several cases involving etomidate vaping, where repeated exposure led to adrenal insufficiency due to its potent inhibition of 11β-hydroxylase. We also discuss a fatal ingestion case, high...

This week on The Tox Lab, we’re taking a closer look at organophosphates, a diverse group of compounds used everywhere from agriculture to chemical warfare. We walk through two real-world poisoning cases: an accidental exposure from a head lice treatment and an intentional ingestion of phorate, illustrating just how wide the spectrum of organophosphate toxicity can be. Along the way, we break down...

This week on The Tox Lab, we’re exploring a series of fascinating and unusual poisoning cases, each with its own toxic twist. From hair straightening treatments and bearded fireworms to midodrine, isotocyanozene, and sodium azide, we discuss the mechanisms, clinical presentations, and toxicological challenges behind each case. Join us as we unpack what these cases reveal about the diverse and some...

This week on The Tox Lab, we’re turning our attention inward to errors in toxicology. From calibration and maintenance mistakes to reporting issues and even instances of fraud, we unpack how things can go wrong in the analytical process and what that means for the credibility of our field. We explore the real-world consequences of these errors and most importantly, what we can learn from them to s...

This week on The Tox Lab, we’re discussing brorphine — a novel synthetic opioid that briefly appeared on the drug market around 2020. We explore its emergence and pharmacology, including data on its activity at the µ-opioid receptor. We also discuss one of the few documented case studies describing an individual presenting for detoxification following brorphine use. Finally, we review recent resea...

This week on The Tox Lab, we’re celebrating our 50th episode — and one whole year of toxicology talk! 🎉 Join us as we look back on some of our most memorable moments from the past year, revisit a few topics with new updates, and share what’s next for The Tox Lab. Whether you’ve been here since episode one or you’re just joining us, thank you for being part of our growing community of toxicologist...

This week on The Tox Lab, we’re revisiting one of history’s most infamous poisons — arsenic. Once dubbed the king of poisons, arsenic still poses real risks today. We discuss recent research on arsenic in the water supply and how prenatal exposure may influence birth outcomes in the United States. We also review two unusual cases of intentional elemental arsenic ingestion, exploring the unexpected...

This week on The Tox Lab, we’re embracing autumn and diving into the fascinating, and sometimes dangerous, world of mushrooms. We explore ten years of mushroom exposure data reported to the UK National Poisons Information Service, examining the species most often involved and the mechanisms behind their toxicity. We also take a look at commercial products containing mushrooms and discuss a paper s...