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The Poison Lab: Daily Summaries Delivered
by Clinical Toxicology LLC
Dive into the captivating world of poisons with The Poison Lab! Hosted by Clinical Toxicologist Ryan Feldman (@EMPoisonPharmD), who has over a decade of managing poisoning and drug overdose via poison centers and in the emergency department. Also occasional co-hosted by his robo cohost Toxo! (@LabPoison). This show unpacks the fascinating history, cutting-edge science, and life-saving medical management of toxins from around the globe. From stories of those impacted to expert insights from pioneers in poisoning treatment, each episode brings you closer to understanding the poisons that lurk in plain sight.
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- 2 days ago43 min
A Morel Dilemma: Episode 2 — Investigations and Falsehoods
As reports of severe illness and death come in, the Bozeman outbreak moves from medical mystery to full public health investigation. Local and state investigators race to identify the source, shut down the risk, interview patients, collect food samples, and figure out whether anyone else could still be in danger.The early signal points toward one unlikely ingredient: morel mushrooms. But for toxicologists, that raises more questions than answers. Morels are supposed to be edible. Rapid vomiting and diarrhea usually suggest foodborne illness, not a deadly mushroom poisoning. So investigators have to ask the question that will drive the rest of the series: is the morel really the culprit, or is something else hiding in the meal?In Episode 2 of A Morel Dilemma, we meet the public health team on the front lines, hear how the outbreak was contained, and begin testing the first theories behind what made diners so sick.
- 2 days ago33 min
A Morel Dilemma: Episode 1 — Outbreak in Bozeman
A deadly outbreak begins with a single meal at a sushi restaurant in Bozeman, Montana. Within hours, diners develop severe nausea, vomiting, and diarrhea. Some collapse. Two people die. At first, it looks like food poisoning, but investigators quickly notice one strange ingredient connecting many of the sick patients: morel mushrooms.In the first episode of A Morel Dilemma, we meet the people caught in the earliest moments of the outbreak and begin following the investigation as it unfolds in real time. What starts as a suspected restaurant-associated illness quickly becomes a much stranger question: how could a prized edible mushroom, eaten for centuries, suddenly be linked to death?This is not a retrospective summary. It is the beginning of a poisoning mystery, told the way investigators experienced it: with urgency, uncertainty, and more questions than answers.
- 4 days ago4 min
Introducing: A Morel Dilemma
Available June 3rd- A deadly outbreak begins at a sushi restaurant in Bozeman, Montana. Diners develop rapid, severe gastrointestinal illness. Some collapse. Two people die. And the only clue pointing investigators toward a cause is also the hardest one to believe: morel mushrooms.A Morel Dilemma is a serialized outbreak investigation from The Poison Lab, following the story in real time as clinicians, toxicologists, public health officials, mycologists, and families try to answer one unsettling question:How could a prized edible mushroom suddenly be linked to death?This is a story about poisoning, public health, uncertainty, and the uncomfortable process of discovering that something we thought we understood may be far more complicated than it seemed.A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Game!The Poisonus Fungus Amongus Children's Book!Full book reading (6 minutes!)Tox trinkets (Rep the show at home!)Reach the showEmail: Toxtalk1@gmail.comMore Show ResourcesRyan's Medical Games and ResourcesShow Website
- 1 weeks ago1h 16m
Gas Station Heroin? Kratom, Regulation, and Recovery — A Co-Broadcast with the Kratom Sobriety Podcast
In this special co-broadcast episode, The Poison Lab joins forces with The Kratom Sobriety Podcast for a deeper conversation about kratom, regulation, addiction, recovery, and what poison center data can tell us about real-world harm.Kratom is a plant-derived substance that contains mitragynine and 7-hydroxymitragynine, compounds with opioid-like effects. It is sold in many forms, including powders, capsules, drinks, tonics, and concentrated extracts, often in gas stations, smoke shops, and online. For many people, kratom is encountered with little warning about its risks, including dependence, withdrawal, and toxicity.Study NewsThis episode grew out of our newly published study in Addiction, which examined kratom-related poison center calls across states with different legal approaches: states with bans, states with kratom consumer protection acts, and states with no specific regulation.The study began with a real policy question in Wisconsin: is the public better protected by prohibition, by regulated access, or by leaving kratom largely unregulated? As clinical toxicologists and poison center clinicians, our goal was not to write policy, but to add objective data to a debate that often moves faster than the evidence.Ryan discusses how that question led to a broader debate within medical toxicology and poison center circles: What are the harms of prohibition? What are the risks of unfettered access? Is regulation safer than a ban? And what can poison center data actually tell us about those questions?After the study was published, people reached out from several directions: journalists, policymakers, people concerned about the risks of prohibition, and people who had experienced harm from easy access to kratom. That included the team behind The Kratom Sobriety Podcast, who wanted to talk about the study and the lived experience of kratom dependence and recovery.The conversation highlights both the data and the human side of the issue: people who developed kratom dependence, struggled to stop, and found their way into recovery. The episode explores why policy decisions around kratom are so difficult, why easy access to opioid-like substances can be dangerous, and why lived experience matters alongside epidemiologic data.Topics covered include:What kratom is and why it is often called a “gas station drug”Mitragynine, 7-hydroxymitragynine, and opioid-like effectsKratom dependence, withdrawal, and recoveryHow poison centers track emerging substancesDifferences between state bans, consumer protection acts, and unregulated accessWhat poison center data can and cannot tell usWhy kratom policy is more complicated than “ban it” versus “leave it alone”The importance of listening to people with lived experienceThis episode is a longer-form conversation about science, policy, toxicology, and recovery. It is not medical advice, and it is not meant to tell any individual person what they should do. But it is meant to bring more evidence, nuance, and humanity into a debate that needs all three.If you or someone you know is struggling with kratom or any substance use, help is available. In the United States, you can contact the SAMHSA National Helpline at 1-800-662-HELP.ExtrasFree to read version of the study News articles about the studyUS Kratom Use Surges 65-Fold in 13 YearsCalls to poison centers over 'natural' supplement have skyrocketed by 6,500% since 2010Kratom Use Soars in US, Alters Lives Dramatically | Mirage NewsKratom use is surging in the US, with life-changing consequences, study reveals<a href="https://www.e
- 4 weeks ago2 min
Outbreak: 75 Fatalities After a Funeral Poisoning in Mozambique
In this episode of The Poison Lab Outbreak, Ryan talks with Dr. Alaina Steck about a devastating mass poisoning in Mozambique that began at a funeral and ultimately sickened more than 200 people, with a fatality toll of over 70.Early reports blamed crocodile bile. Others suspected intentional poisoning. But as the investigation unfolded, the clinical picture, timeline, and exposure history did not fit neatly with the early theories.Dr. Steck, then a medical toxicology fellow at Emory, joined a CDC-supported outbreak investigation team sent to Mozambique. She walks through what it was like to investigate the outbreak on the ground, including the overwhelmed rural health center, limited medical records, scarce biological and environmental samples, early toxicologic hypotheses, and the eventual role of comparative food testing in identifying the cause.This episode explores the real-world uncertainty of outbreak investigation: incomplete data, competing theories, community fear, and the importance of epidemiology, toxicology, public health, and analytical chemistry working together.Topics CoveredMass poisoning investigation in rural MozambiqueEarly reports of crocodile bile and suspected intentional poisoningClinical presentations including GI symptoms, seizures, pulmonary edema, liver injury, kidney injury, and multisystem diseaseChallenges of interpreting sparse medical records during a mass casualty eventHow toxicologists approach possible intentional poisoningWhy exposure history and timing matter in outbreak investigationThe importance of control samples in analytical testingLessons for clinicians, poison centers, and public health teamsGuestDr. Alaina SteckMedical toxicologist, Emory UniversityFormer medical toxicology fellow involved in the CDC-supported investigation of the Mozambique outbreakResources (Spoilers)Outbreak paperU.S. CaseInstagram @tox_talk • Twitter @LabPoison • Email toxtalk1@gmail.comDisclaimer: The Poison Lab is for educational purposes only and does not provide medical advice. If you suspect a poisoning, contact your local poison center. In the U.S., call 1-800-222-1222.A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Game!The Poisonus Fungus Amongus Children's Book!Full book reading (6 minutes!)Tox trinkets (Rep the show at home!)Reach the showEmail: Toxtalk1@gmail.comMore Show ResourcesRyan's Medical Games and ResourcesShow Website
- May 4, 20261h 6m
Rebroadcast: Phenibut. The emerging drug you don’t know about (yet)
Phenibut is an emerging and unfamiliar drug taking hold in the US that is readily available online and legal to obtain. It acts as a GABA-B agonist and carries risks of dependency and withdrawal. In this episode Ryan interviews phenibut users as well as experts involved in phenibut treatment. They explore the history, current trends, toxicity, and management of phenibut, a novel GABA-B agonist. He is joined by guest Dr. Matthew Stanton PharmD and Dr. Benjamin Weston MD who listen in to an audio documentary that includes clips from Dr. Janessa Graves PhD and Dr. Erica Liebelt MD who wrote a recent report on increasing phenibut exposures, Dr. Dan McCabe MD who is the author of the largest published phenibut case series, and Elliot, a recovered phenibut user who we would like to sincerely thank for sharing his story of use and recovery.+Update- a systematic review of phenibut withdrawal treatment strategies authored by the poison lab host himeself, Ryan!+More on St Anthony's fire CDC MWR Study documenting increased poison center exposures (Dr. Graves & Dr. Liebelt) Phenibut case series from Dr. McCabe All published cases of phenibut withdrawal, reported baclofen regimens, clinical outcomes, multimodal therapiesTHEORETICAL UNTESTED Phenibut withdrawal treatment schema (Not tested, not intended as treatment, intended to stimulate discussion and highlight key considerations in managing withdrawal)A Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Game!The Poisonus Fungus Amongus Children's Book!Full book reading (6 minutes!)Tox trinkets (Rep the show at home!)Reach the showEmail: Toxtalk1@gmail.comMore Show ResourcesRyan's Medical Games and ResourcesShow Website
- Feb 11, 20261h 40m
If I had a Nickel (Mystery Case) & Toxicologist vs The internet (#13) with Dr. Damilola Idowu-Ellsworth
In this episode of The Poison Lab, host Ryan Feldman is joined by medical toxicologist Damilola Idowu‑Ellsworth for a fast-moving, case-heavy conversation packed with clinical pearls, listener participation, and classic toxicology weirdness.The show opens with listener guesses for the previously released mystery case before diving headfirst into a rapid-fire series of Stump the Toxicologist cases—questions pulled straight from the internet and real-world toxicology problem-solving. Along the way, Ryan and Dami cover everything from rodenticides and drug-testing myths to how to clean a benzodiazepine bottle, plus one of the most toxic substances you’ve probably never heard of.One lucky listener also wins a copy of Poisonous Fungus Amongus, and a shout-out to the newly released second edition featuring photography from expert mycologists.Skip the listener guesses and jump straight to the mystery toxin: 38:15Mystery toxin caseThe rest of the episode is Dr. Idowu and Ryan discuss the topics below. Looking for timestamps? Join the supporting member feed!Looking for time stamps for the rest of the show? Join as a supporting memberStump the Toxicologist – Case Discussions(Looking for timestamps? Join the supporting member feed!)Case #1 A methemoglobinemia, renal failure inducing enemaCase #2Wide-complex dysrhythmia from an over-the-counter topicalBonus - Paper from Ryan on the topical toxicity (or lack there of) of this productCase #3Black stools, seizures, high sodium and low potassium after trying to beat a drug test.Case #4GCS 15 and normal vitals… until they’re not — delayed seizures, neurologic collapse, and a toxicologic time bomb.Paper from Ryan on this tricky toxic time bombInternet & Listener QuestionsDo GLP-1 agonists release toxins from fat and how might that impact drugged driving laws with THC?Why do sedatives make you twitch?Not all benzos are XanaxWhat shape is a ketamine crystalA Morel DilemmaSupport the showReview the show where ever your listeningGet Messages from Toxo (Join the Newsletter!)Join as a supporting memberAd free episodesBonus content and early accessDiscounts and give aways on GOTA PICCEM Mushroom card gameThe GOTTA PICCEM Poisonous Mushroom Game!The Poisonus Fungus Amongus Children's Book!Full book reading (6 minutes!)Tox trinkets (Rep the show at home!)Reach the showEmail: Toxtalk1@gmail.comMore
- Feb 4, 20261 min
Poison Lab Update: Mushroom Poisoning Radio Roundup
Hey everybody, you’re listening to The Poison Lab—well, almost.We’ve got a new episode coming next week, but we’re running a little behind on our usual release schedule because… life happens. That said, if you’re looking for some toxicology content right now, I’ve got you covered.Recently, I had the chance to appear on two local and state radio shows talking about one of my favorite topics: mushroom poisoning 🍄—and both were an absolute blast.🌱 Garden Talk (Call-In Episode) (Ryan starts @ 1 hour and 14 min)The first appearance was on Garden Talk, a fun, live call-in show where we covered:Mushroom poisoning basicsListener questionsMy game GOTTA PICCEMThe book Poisonous Fungus Among UsIt was lively, unpredictable, and a great example of how curious people are about mushrooms once you open the door.📻 Local Health Update Radio SegmentAfter that, I joined a local radio health update to talk specifically about mushroom poisoning from a public-health perspective. It’s always interesting to hear how radio hosts approach such a niche topic—and how quickly it turns into something broadly relevant.🔬 Want a Quick Toxicology Fix?If you’re itching for some Poison Lab content while you wait for the next full episode, these two appearances are a great place to start.And don’t worry—we’ll be back next week with a full episode and answers to our mystery case.Thanks, as always, for listening.Hope to see you there.— Ryan
About The Poison Lab
Dive into the captivating world of poisons with The Poison Lab! Hosted by Clinical Toxicologist Ryan Feldman (@EMPoisonPharmD), who has over a decade of managing poisoning and drug overdose via poison centers and in the emergency department. Also occasional co-hosted by his robo cohost Toxo! (@LabPoison). This show unpacks the fascinating history, cutting-edge science, and life-saving medical management of toxins from around the globe. From stories of those impacted to expert insights from pioneers in poisoning treatment, each episode brings you closer to understanding the poisons that lurk in plain sight.
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