Archive for January 2017

Anterograde amnesia and bilateral hippocampus ischemia: is it caused by substance abuse?

January 26, 2017, 11:51 pm

Bilateral hippocampal ischemia on MRI [Source: MMWR]

Diffusion weighted MRI findings in patient with unusual amnestic syndrome — Massachusetts, 2012
[Source: MMWR]


Cluster of an Unusual Amnestic Syndrome — Massachusetts, 2012-2016. Barash JA et al. MMWR Morb Mortal Wkly Rep 2017;66:76-79

Full Text

Late in 2015 a Boston neurologist reported a cluster of 4 cases of anterograde amnesia associated with MRI evidence of bilateral hippocampal ischemia. After …

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Is commercial kratom being spiked with a naturally occurring potent opioid

January 24, 2017, 2:15 pm



Suspected Adulteration of Commercial Kratom Products with 7-Hydroxymitragynine. Lydecker AG et al. J Med Toxicol 2016;12:341-349.


This well done paper provides — among other things — a helpful short review kratom, a psychoactive product  derived from the Mitragyna speciosa plant.

M speciosa contains more than 40 distinct alkaloids. The primary alkaloid — mitragynine — is an …

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TPR Podcast Episode #13: Naloxone in the Age of Carfentanil

January 18, 2017, 10:33 pm

In this “Lucky 13” episode of the TPR podcast, Steven and Leon discuss naloxone, and address the following issues: 1) Does the concept of a “heroin overdose patient” have meaning anymore in this age of U-47700, fentanyl, and carfentanil? 2) Given the adulteration of both heroin and counterfeit prescription medications with extremely potent synthetic opioids, do we have to reconsider our entire approach to opioid overdose patients? 3) Can past medical literature guide us in our management of these patients?(Hint: the answer is no.) 4) What medical toxicology paper do Steve and Leon — in an unusual state of agreement — feel was the best to appear in 2016? For the Show Notes and links to articles discussed in the Podcast, click "Read more" below.

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The 7th Annual Alexander Awards: The Best Tox Reading of 2016

January 1, 2017, 4:59 pm

 Alexander Gettler

Alexander Gettler

When TPR began giving out the annual Alexander Awards for best long-form writing in the field of toxicology, the eligibility criteria included the requirement that “entries must be fully and freely accessible” on the web. After 2016 — a remarkably truth-impaired year scarred by fake news and unchallenged mendacity — supporting aggressive, unbiased, fearless journalism appears to us …

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