Naloxone (Narcan) reverses the opioid component of overdoses but does not act against adulterants like xylazine or medetomidine. By Dr. Alberto Augsten, Toxicologist and Psychopharmacologist The overdose crisis in New York has evolved. It is no longer only about fentanyl: a new generation of adulterants — led by xylazine ("tranq") and, more recently, medetomidine — is reshaping the clinical landscape and pushing emergency services, hospitals, and addiction-treatment programs

Children are particularly vulnerable to mold exposure and poor indoor air quality. Dehumidifiers and HEPA purifiers are key tools for prevention. By Dr. Alberto Augsten, Toxicologist and Psychopharmacologist Mold is everywhere. It is a normal part of the natural environment, breaking down organic matter outdoors. But when mold colonizes the inside of our homes — in damp basements, behind drywall, under sinks, around windows, in HVAC systems — it can quietly affect the health

Farmworkers face some of the highest occupational exposures to glyphosate and other agricultural herbicides. By Dr. Alberto Augsten, Toxicologist and Psychopharmacologist Glyphosate is the most widely used herbicide in the world. Marketed since 1974 — most famously as Roundup — it is sprayed on crops, parks, school grounds, golf courses, and home gardens across the United States and Latin America. It is also one of the most controversial chemicals in modern toxicology. What t

A certified activated carbon or reverse osmosis filter is one of the most practical ways to reduce PFAS in drinking water at home. By Dr. Alberto Augsten, Toxicologist and Psychopharmacologist Per- and polyfluoroalkyl substances (PFAS) are a family of more than 12,000 synthetic chemicals used since the 1940s in non-stick cookware, water- and stain-resistant fabrics, food packaging, firefighting foams, cosmetics, and countless industrial applications. They are called "forever

Beta-blockers and calcium channel blockers are foundational therapies in cardiovascular medicine, widely prescribed for hypertension, arrhythmias, heart failure, and ischemic heart disease. Despite their therapeutic benefits, both drug classes carry significant risk in overdose, producing profound cardiovascular collapse that can rapidly become life-threatening. Whether due to intentional ingestion or accidental exposure, toxicity from these agents represents a true medical e

Lithium remains one of the most effective and enduring treatments in psychiatry, particularly for bipolar disorder. Its ability to reduce suicide risk and stabilize mood is unmatched in many respects. However, lithium’s narrow therapeutic index and complex pharmacokinetics create a well-recognized risk of toxicity. While most clinicians are familiar with acute lithium toxicity, fewer appreciate a rare but devastating complication: SILENT syndrome—Syndrome of Irreversible Lith

Acetaminophen, widely marketed as Tylenol, is one of the most commonly used over-the-counter analgesics and antipyretics in the world. Its accessibility and perceived safety have made it a household staple. However, acetaminophen is also the leading cause of acute liver failure in the United States, a distinction that underscores a critical paradox in modern pharmacology. Whether through a single intentional overdose or repeated supratherapeutic ingestion, acetaminophen toxic

What It Is, Why Officials Were Concerned, and What Happens If You're Exposed

Plants are often perceived as safe, natural, and inherently benign. In reality, the botanical world contains some of the most potent toxins known—agents that have shaped human history as poisons, medicines, and ritual substances. Today, plant toxicity remains highly relevant, with exposures ranging from accidental pediatric ingestions to intentional self-harm, herbal supplement misuse, and foraging errors. For clinicians and first responders, recognizing plant-based toxidrome

Alberto Augsten, PharmD, MS, BCPP, DABAT | Augsten Consulting, LLC A new research letter in JAMA Pediatrics (Kleinman et al., March 2026) compared buprenorphine-naloxone and methadone for opioid overdose prevention in Ontario youths aged 15 to 24 with opioid use disorder (OUD). The findings, and the published responses they generated, carry direct implications for cases involving adolescent overdose, prescribing-standard disputes, and medical negligence claims tied to substan

“Poppers” are widely perceived as harmless recreational agents—marketed as room deodorizers, leather cleaners, or liquid incense. In reality, these products contain alkyl nitrites, a class of volatile vasodilators that can produce rapid physiologic effects and, in certain contexts, life-threatening toxicity. While often used for brief euphoria or smooth muscle relaxation, the risks are frequently underestimated by both users and clinicians. What Are Poppers? Poppers typically

Snake venom is among the most pharmacologically complex substances produced by any living organism. It is a biochemical weapon refined over millions of years of evolution — a mixture of proteins, enzymes, peptides, and small molecules capable of immobilising prey, defending against predators, and in some cases, beginning the digestive process before a meal is even swallowed. For toxicologists, pharmacologists, and environmental health scientists, snake venom represents one of

In the mid-twentieth century, Minamata Bay in Japan's Kumamoto Prefecture became the site of one of the worst environmental health disasters in history — a tragedy that would come to symbolize the catastrophic consequences of industrial mercury pollution and the failure of governments and corporations to protect human life. The Source of the Contamination From the late 1940s through the 1950s, the Chisso Corporation discharged methylmercury-laden wastewater directly into Mina

It blooms in shades of white, yellow, and peach — hanging like soft bells from sprawling branches. In South Florida yards, along fences, and in neighborhood gardens, Brugmansia — commonly known as Angel's Trumpet — is a familiar and stunning sight. But behind that beauty is one of the most toxic plants accessible to children in the region, and most families have no idea. What Is Angel's Trumpet? Angel's Trumpet (Brugmansia spp.) is a flowering plant native to South America th

Few substances in history have earned as fearsome a reputation as arsenic. Known for centuries as the "king of poisons" and the "poison of kings," arsenic occupies a uniquely sinister place in the story of human civilization. Its tasteless, odorless, and nearly colorless properties when dissolved made it the ideal instrument of covert murder for hundreds of years, and its legacy has shaped the development of modern forensic toxicology. What Is Arsenic? Arsenic is a naturally

Stimulant overdoses from cocaine and methamphetamine represent a growing component of the overdose epidemic, distinct from opioid-related deaths. These drugs cause overdose through entirely different mechanisms—via cardiovascular and neurological pathways—making them particularly deadly when combined with other substances. Understanding Stimulant Pharmacology Cocaine and methamphetamine are psychostimulants that increase dopamine, norepinephrine, and serotonin in the brain, c

Benzodiazepines and barbiturates are classes of medications designed to treat anxiety, insomnia, and seizures. However, their high potential for abuse, dependency, and overdose has made them significant contributors to drug-related mortality. This is especially true when these substances are combined with other central nervous system depressants like opioids and alcohol. The Role of Benzodiazepines and Barbiturates in Treatment Benzodiazepines, commonly referred to as "benzos

The opioid crisis represents one of the most devastating public health emergencies in modern history. Prescription opioids and illicit opioids like fentanyl have become the leading cause of overdose deaths across North America, fundamentally transforming treatment approaches and social policy worldwide. Understanding Opioids and Their Mechanism Opioids are a class of drugs that bind to opioid receptors in the brain, reducing pain perception and creating euphoric effects. From

Driving under the influence (DUI) cases often hinge on complex scientific evidence. Among the critical experts in these cases are forensic toxicologists. Their role in toxicology analysis for DUI is essential to understanding the presence and impact of substances in the body. This article explores the importance of forensic toxicologists in DUI defense cases, the nature of toxicology analysis, and how their expertise supports legal professionals and healthcare organizations.

Dopamine, often called the "motivation molecule," plays a crucial role in our ability to feel driven, find pleasure in activities, and maintain focus. When dopamine levels are disrupted, as often occurs in depression, the consequences can be profound. This article explores the neurobiology of dopamine, how depression affects dopamine function, and what this means for motivation and engagement with life. Understanding Dopamine Dopamine is a neurotransmitter—a chemical messenge