A middle-aged American man with no previous medical history was found unconscious in his hotel room, with “unidentified crushed pills and a white residue” on a nearby table, according to a recent paper in BMJ Case Reports. White powder was visible around the man’s mouth.
This situation would be fairly unremarkable for a country that is in its tenth year of an illicit fentanyl epidemic. However, there was something remarkable about this case. It was the first reported instance of toxic leukoencephalopathy – damage to the brain’s white matter from a toxic substance – from smoking fentanyl.
