Substances bought at gas stations and convenience stores present unique challenges in the ED, Elizabeth Tracey reports

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Tianeptine, or gas station heroin, is the latest entry to the list of substances purveyed online and at gas stations and convenience stores, that are drugs with abuse potential and are completely unregulated. When someone overdoses or otherwise reacts badly to them, doctors in the ED may struggle to figure things out. That’s according to Michael Fingerhood, a substance use disorders expert at Johns Hopkins.

Fingerhood: A lot of times they're hard to identify, like we see somebody presents to the emergency department with some delirium or confusion or paranoia and you know that they use something but our typical drug screens don't detect, they don't keep up with where people are out on the street, so unless someone tells us use kratom or tianeptine or a synthetic cannabinoid we don't know, it becomes harder and harder you wind up treating agitation and paranoia and delirium and then hope that once they're improved that they tell you what they used.  :30

That’s provided they do improve, Fingerhood notes. At Johns Hopkins, I’m Elizabeth Tracey.