The Tennessee Poison Center is reporting a significant rise in calls related to exposure to tirzepatide and semaglutide—two FDA-approved medications widely used to treat Type 2 diabetes and support weight management—highlighting growing concerns about improper use as the drugs become more accessible.
Rebecca Bruccoleri, medical director of the Tennessee Poison Center, said the increase over the past five years reflects the rapid expansion in availability, new formulations, and pricing initiatives that have made the medications easier to obtain.
“These drugs are receiving new approvals, new formulations are coming to market, and discount programs are expanding,” Bruccoleri said. “There has also been a push to make them more affordable, which means more people are using them.”
Sharp Increase in Reported Cases
According to data compiled from incoming calls, the poison center handled:
- 28 cases in 2021
- 49 cases in 2022
- 87 cases in 2023
- 134 cases in 2024
- 239 cases in 2025
Bruccoleri emphasized that the center does not actively collect this data; the numbers represent individuals who reached out for help after experiencing potential overdoses or misuse.
Dosing Confusion a Major Factor
Many incidents stem from patients misunderstanding how to administer injectable versions of the drugs.
“Someone may be at home and not know how to use the injection pen correctly, resulting in a tenfold overdose,” Bruccoleri explained. “They then call us for guidance on how to manage it.”
Because these medications are often prescribed in very small doses, even minor miscalculations can lead to large errors. For example, a patient instructed to take 0.25 milligrams may mistakenly administer 2.5 milligrams.
“There can also be confusion about how often the medication should be taken,” she added. “It’s critical that patients clearly understand both the dosage and the method of injection.”
Some Cases Linked to Intentional Overuse
Brooke Nix, owner of Brooke Nix Medical Aesthetics, said some patients intentionally take higher doses in hopes of accelerating weight loss.
“These are not medical professionals,” Nix said. “Some people give themselves more because they’re not losing weight as quickly as they’d like.”
Such misuse can trigger severe gastrointestinal side effects, including nausea, vomiting, and diarrhea.
Nix noted that these medications are generally intended for individuals with a body mass index (BMI) over 30, yet many users fall outside that category.
“With most medications, people don’t try to overdose themselves,” she said. “But we’ve seen that happen with these drugs.”
In-Person Monitoring May Reduce Errors
Nix said her practice prefers to administer doses directly or provide pre-measured syringes to reduce the risk of mistakes.
“We draw it up for them so they receive the exact amount,” she said.
However, the rise of telehealth prescribing has made it possible for some patients to obtain medications without ever meeting a provider face-to-face, increasing the likelihood of misuse.
Concerns Likely to Continue
Both Bruccoleri and Nix expect the number of exposure calls to keep climbing. While an oral pill version under discussion could reduce injection-related errors, Bruccoleri warned it may introduce new risks tied to incorrect oral dosing.
“I am concerned that we may continue to see an increase in these calls,” she said.
Resource for the Public
The Tennessee Poison Center serves all 95 counties in the state and is staffed by trained nurses, pharmacists, and physicians who provide around-the-clock assistance. Anyone with questions about medication safety or potential exposure can contact the center at 1-800-222-1222.
