About Lewis Nelson, MD

Professor and Chair
Department of Emergency Medicine
Director, Division of Medical Toxicology
Rutgers New Jersey Medical School

Synthetic cannabinoid use reaches new heights: K2 is not just a mountain on the China-Pakistan boarder

K2You are working a shift in the emergency department, and you hear the ambulance sirens. EMS is bringing you two patients, friends from a nearby shelter. Per report, the two men were “smoking drugs” together outside of the shelter. Bystanders noted that the 29-year-old man became increasingly agitated, shouting, banging on the door, and threatening his other shelter mates, while the other, a 50-year-old man, laid down on the sidewalk. EMS also reports picking up these patients in an area known for high “K2” use.


By |2017-03-05T14:18:46-08:00Apr 27, 2016|CME, Tox & Medications|

Fentanyl: Adding Fuel to the Fire in the North American Opioid Epidemic

FentanylDrug poisoning is now the leading cause of injury death in the United States,1 with opioids accounting for up to 40% of these deaths. In the U.S., prescription opioid death rates have more than quadrupled since 1999, and death rates exceed those due to motor vehicle crashes.2 Similar trends in opioid exposure and death rates in Canada suggest that it is not far behind. Prescriptions for opioid analgesics paralleled a rise in opioid abuse and fatalities between 2002 and 2010, leveling off between 2011 and 2013,3 only to rise again in 2014.4 Among the more frequently misused opioids nationwide are oxycodone and hydrocodone (the most widely prescribed drug in the U.S.) in their various formulations, and methadone, but a “rising star” in the epidemic in many regions is fentanyl.


By |2018-10-28T21:25:24-07:00Feb 29, 2016|Tox & Medications|

Considering a Medical Toxicology Fellowship?

Toxicology canstockphoto7742894 partialEvery year, EM residents ponder whether to do a fellowship. In the ALiEM Chief Resident Incubator, a handful are very interested in a medical toxicology fellowship, but I woefully am unqualified to provide any advice. So in a “phone a friend” moment, I boldly sent out an email requesting advice and insights. I received two amazing replies from Dr. Lewis Nelson (NYU) from a fellowship director’s perspective and Dr. Annie Arens (UCSF) from a fellow’s perspective.


By |2016-11-11T19:37:19-08:00Jul 23, 2015|Medical Education, Tox & Medications|
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