Why the Tennessee Poison Center is Drowning in Calls Over Bootleg Weight-Loss Medications

There is no dramatic ringing of phones inside the Tennessee Poison Center. They make chirping sounds. A constant, medical noise reverberated through fluorescent-panel-lit cubicles. But in the last year, the calls have started to pile up into something more serious: nurses complaining of constant nausea, worried spouses reporting uncontrollable vomiting, and emergency doctors asking for advice after patients miscalculated an injection intended to aid in weight loss.

There is a perception that the current weight-loss craze is a logistical issue rather than a medical discovery. Semaglutide medications, such as Ozempic and Wegovy, have gained widespread recognition and are discussed in hair salons and gym locker rooms due to their potential medical and cultural benefits. Nearly 3,000 calls about semaglutide exposure have been reported to poison control centers across the country this year, which is about 1,500% more than a few years ago. Tennessee’s statistics, which increased from zero cases in 2017 to dozens each year, reflect this trend.

The urgency of these calls cannot be explained by popularity alone. Access seems to be the more fundamental problem. Patients have been forced to choose between injections given at medical spas, vials that require exact self-measurement, and compounded versions mixed by pharmacies due to the monthly costs exceeding $1,000 and sporadic shortages that have tightened supply. Exact dosages are administered by the manufactured pen devices. On the other hand, syringes ask patients to act as pharmacists in their own kitchens. According to toxicologists, that is where errors occur.

The majority of callers report symptoms like nausea, diarrhea, constipation, and stomach pain that seem surprisingly commonplace. However, when dosage mistakes are made, these effects can worsen rapidly. Some patients need intravenous fluids before their symptoms go away because they are weak and dehydrated when they arrive at emergency rooms. It’s difficult to ignore how a medication intended for weekly convenience turns dangerous when converted into milliliters and relying on speculation as you watch this happen.

The most common pattern, according to doctors, is therapeutic errors, or unintentional overdoses. They were responsible for about three-quarters of poison center cases in Tennessee. There is a subliminal message in that statistic: these are regular people misjudging a syringe line, not careless users seeking thrills.

There is now a parallel health economy outside of conventional clinics. Quick access is advertised by medical spas. Startups in telehealth promise simplified prescriptions. Testimonials on social media detail significant changes in a matter of months. Drugs seem to have slipped from medical treatment into lifestyle infrastructure, joining apps for intermittent fasting and protein powders in the cultural quest for bodily control.

The change has been sped up by public disclosures and celebrity endorsements. Diet companies once battled to normalize the use of weight-loss drugs, but Oprah Winfrey’s admission that she uses them as a maintenance tool added a layer of normalization. In the meantime, insurers and employers are rushing to control expenses, sometimes requiring diet plans before granting coverage. The market for obesity treatments appears to have the potential to change healthcare spending for decades, according to investors.

However, the transformation appears less glamorous in poison centers. Patients who obtained injections through friends, internet discussion boards, or clinics operating in regulatory gray areas call in. Off-brand or compounded semaglutide may pose safety risks, according to the FDA, and Novo Nordisk has taken legal action against companies that sell illegally marketed or counterfeit goods. The number of compounded versions that contain the listed ingredients or their concentrations are still unknown.

One toxicologist likened the situation to the early days of blood-glucose monitoring at home, when gadgets promised autonomy but necessitated rigorous training. Now, scale makes a difference. Semaglutide prescriptions have increased by over 900% in recent years, mostly due to the desire to lose weight. Widespread use inevitably leads to misuse, which happens due to misunderstanding rather than malice.

Something cultural is also revealed by the calls. In America, attempts to lose weight have always wavered between self-control and desperation. Every era creates a shortcut and then discovers its limitations, from gastric bypass surgery to grapefruit diets. Although semaglutide may be a long-lasting treatment, the hysteria surrounding it seems familiar: urgency and hope combined with price and scarcity.

Toxicology experts in Nashville are still responding to inquiries with cool accuracy. What was the injection amount? When did the symptoms begin? Is the patient conscious? It’s a methodical, nearly routine task. However, the increasing number of calls points to a larger concern: a potent drug slipping past the bounds of close monitoring.

The crisis may subside as prescribing practices improve and supply stabilizes. Additionally, social pressure and medical advancements may cause demand to continue to outpace protections.

The phones continue to ring for the time being. Another patient is squinting at a syringe in Tennessee, hoping that their measurements were accurate.