The current article compiles relevant scientific research related to poisonings that were published within the past 7 days(December 13 to 17, 2025). The article will provide an overview, including background, epidemiology, toxicology, prevention, and harm reduction for poisonings. The articles selected for inclusion in this week's update provide evidence for clinicians, public health practitioners, and policymakers about how heavy metals are related to acute poisoning, opioid overdose prevention programs, as well as rare toxic exposures. A brief review of the selected articles and their major points will be provided below.

Nickel; a metal with threats to human health, focusing on its intoxication mechanisms

Nickel (Ni), while present in many environments and industries, can be an environmental health hazard. Both soluble and insoluble nickel compounds contain a variety of potential toxicities that could affect human health via breathing, eating, touch, and exposure to chemicals. Additionally, they have the potential to negatively impact a child's growth and development. Healthcare professionals should test patients who are potentially exposed to nickel by collecting blood and urine samples early in the course of their treatment. Patients who show evidence of having been exposed to higher levels of nickel may benefit from treatment with chelators such as diethyldithiocarbamate (DDC) and disulfiram and through supportive care for allergic contact dermatitis. Furthermore, environmental remediation technologies emerging from the use of nanoparticles to eliminate nickel from the environment indicate the necessity for preventive approaches in addition to clinical management of nickel-associated health hazards.

https://pubmed.ncbi.nlm.nih.gov/41399878/

Naloxone Availability, Testing Drugs for Potency, and Solitary Use: Unpacking the Determinants of Overdose Prevention Behaviors

This article shows that overdose prevention behaviors among people who use opioids do not occur as a single package, and individuals may practice one strategy without adopting others. The findings highlight the strong role of social and demographic factors: Black participants were more likely to test drug potency, women were less likely to use drugs in settings where naloxone was available. Overall, the study argues that effective overdose prevention must go beyond expanding naloxone access and instead focus on tailored, equity-centered harm reduction approaches that strengthen social connections and reflect real-world patterns of drug use.

https://pubmed.ncbi.nlm.nih.gov/41404930/

Epidemiologic Trends in Pediatric Lead Poisoning at Freestanding Children's Hospitals, 2016-2023

This report examined data from the 2016-2023 National Pediatric Hospital and indicates that the United States continues to have severe and expensive issues related to lead poisoning in children, resulting in many hundreds of hospitalizations and emergency visits each year. There are clear disparities in experiencing lead poisoning; children of black, Asian, or multi-racial descent, children enrolled in public insurance programs, children living in rural areas, and children residing in areas with low childhood opportunity have higher rates of emergency hospitalizations related to lead poisoning. The report emphasises that lead poisoning continues to be a risk for children's health, but lead poisoning also represents a long-standing structural and socioeconomic divide in society that requires a targeted prevention strategy for those most at-risk communities rather than only a reliance on clinical detection and treatment of lead-poisoned children.

https://pubmed.ncbi.nlm.nih.gov/41401830/

Opioid Overdose, Naloxone Administration, and Survival Outcomes in Puerto Rico: A Retrospective Analysis, 2019-2023

This study analyzed opioid overdose mortality in Puerto Rico between 2019 and 2023 and demonstrates how important it is for Puerto Rico to utilize naloxone as a lifesaving drug. The study indicates that at least in Puerto Rico, most of the people who die as a result of an opioid overdose are men in their middle ages and that most incidents occur in public places during the afternoon. Most importantly, the data indicate that people who received naloxone—and in particular received multiple doses—have a much higher survival rate compared to those who did not receive naloxone. Based on these results, the researchers recommend expanding geographically targeted distribution of naloxone and increasing the level of engagement within local communities within Puerto Rico as effective, evidenced-based strategies to decrease opioid overdose fatalities.

https://pubmed.ncbi.nlm.nih.gov/41401089/

Prostaglandin E1 Infusions for Duct Dependent Congenital Heart Defects Can Cause Severe Ethanol Intoxication

(Note: I did not have access to the full text of the article. This summary is based on the article’s title, related prior studies, and general medical knowledge)

Prostaglandin E1 (alprostadil) is routinely used to maintain ductus arteriosus patency in newborns with duct-dependent congenital heart defects, which is critical before surgical correction. Several recent publications indicate that infants receiving PGE1 infusions may develop symptoms of severe ethanol toxicity. PGE1 formulations contain ethanol, yet infants’ ability to metabolize alcohol is limited. Thus, clinicians should carefully observe for signs of alcohol toxicity when providing continuous PGE1 infusion to infants and apply their clinical judgment to eliminate or reduce the risk of administering an ethanol-containing product whenever possible by switching to a non-ethanol product or modifying the dosing schedule.

https://pubmed.ncbi.nlm.nih.gov/41401022/

Characteristics of 76,113 Acute Poisoning Cases Registered in Emergency Medical System of Tehran Province; A Cross-sectional Study

An examination of the Tehran province emergency medical service (EMS) data from 2022–2024 indicated 76,113 acute poisoning incidents based on a retrospective review of available data. Acute poisoning predominantly affected young adults, males and individuals with a history of mental illnesses and/or substance use disorders. Oral ingestion was the most common method of poisoning. Most people who suffered an acute poisoning lived in a private home; therefore, the drug responses indicated that naloxone and atropine were the two most frequent antidotes, as well as that acute poisonings were primarily treated by EMS responders. This paper has also demonstrated that there are geographic and seasonal patterns related to acute poisoning and that prevention strategies, public education, and prehospital emergency services should be focused in high-risk geographic areas.

https://pubmed.ncbi.nlm.nih.gov/41399333/

Managing a deliberate 2,4-dinitrophenol overdose: A case report

Highly toxic, 2,4-dinitrophenol (DNP) was originally employed as an effective weight loss substance before being banned in many countries around the world. Due to its ability to disrupt mitochondrial function, the compound induces hyperthermia, promotes an increased metabolic rate through glycolysis, and ultimately leads to death. However, even though use of DNP is prohibited in most parts of the world, its prevalence in online retail continues to drive the rise in DNP poisoning cases. A recent case involving an individual who survived a purposeful overdose of DNP demonstrates the necessity for timely, coordinated management of this potentially fatal problem. Elements of effective management include aggressive cooling strategies and high-volume mechanical ventilation to control CO₂ levels and maintain normal body temperature.

https://pubmed.ncbi.nlm.nih.gov/41392340/

The Bottom Line

This week's studies cover some of the continuing issues being encountered related to poisoning prevention, treatment, and public health, plus how important it is to have a focus on targeted treatment options, early identification of the problem, and joint reactions by the medical community. To improve the lives of many different people with poisoning problems, we must monitor the latest developments in these areas so we can take action.