Addiction Toxicology Resources

This page has been created by the ACMT Addiction Toxicology Committee and contains pertinent resources with this focus. If you are an ACMT Member interested in joining this Committee please fill out this request form.

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Addiction Toxicology Reference
Articles from the
Journal of Medical Toxicology

View articles by year. Use ctrl + f to search keywords and authors

2020

Leadership Roles in Opioid Stewardship and the Treatment of Patients with Opioid Use Disorder Among Medical Toxicologists

One hundred and thirty-one out of 382 eligible individuals from at least 76 institutions responded to the survey. A majority (60%) had a DATA 2000 X-waiver, 21% were board-certified in addiction medicine (AM), an…

Joseph E. CarpenterBrian Patrick Murray… in Journal of Medical Toxicology (2020)

Mozeika, A.M., Ruck, B.E., Nelson, L.S. et al. Opioid-Associated Hearing Loss: A 20-Year Review from the New Jersey Poison Center. J. Med. Toxicol. 16, 416–422 (2020). https://doi.org/10.1007/s13181-020-00785-5

Naloxone Dosing After Opioid Overdose in the Era of Illicitly Manufactured Fentanyl

Illicitly manufactured fentanyl (IMF) is responsible for a growing number of deaths. Some case series have suggested that IMF overdoses require significantly higher naloxone doses than heroin overdoses. Our ob…

Joseph CarpenterBrian Patrick MurraySukhshant Atti… in Journal of Medical Toxicology (2020)

Buprenorphine Initiation in the Emergency Department: a Thematic Content Analysis of a #firesidetox Tweetchat

The height of the opioid epidemic in the USA has led to an increasing call for access to medication assisted treatment for opioid use disorder, including buprenorphine initiation from the emergency department …

Megan ChenworthJeanmarie PerroneJennifer S. Love… in Journal of Medical Toxicology (2020)

Rapid Assessment of Opioid Exposure and Treatment in Cities Through Robotic Collection and Chemical Analysis of Wastewater

Wastewater-based epidemiology with smart sewer selection and robotic wastewater collection is feasible to detect the presence of specific opioids, naloxone, methadone, and buprenorphine within a city. These resul…

Norkio EndoNewsha GhaeliClaire DuvalletKatelyn Foppe… in Journal of Medical Toxicology (2020)

Understanding Naloxone Uptake from an Emergency Department Distribution Program Using a Low-Energy Bluetooth Real-time Location System

Emergency department (ED)–based naloxone distribution programs are a widespread harm reduction strategy. However, data describing the community penetrance of naloxone distributed from these programs are lackin…

Jeffrey T. LaiBrittany P. ChapmanStephanie P. Carreiro… in Journal of Medical Toxicology (2020)

Assessment of the Utility of the Oral Fluid and Plasma Proteomes for Hydrocodone Exposure

Non-medical use and abuse of prescription opioids is a growing problem in both the civilian and military communities, with minimal technologies for detecting hydrocodone use. This study explored the proteomic …

Brooke L. Deatherage KaiserJon M. Jacobs… in Journal of Medical Toxicology (2020)

Severe Toxicity to the New Psychoactive Substances 3-Hydroxyphencyclidine and N-Ethylhexedrone: an Analytically Confirmed Case Report

3-Hydroxyphencyclidine (3-HO-PCP) is a new psychoactive substance (NPS) and a hydroxy derivative of phencyclidine (PCP), and N-ethylhexedrone (Hexen) is a synthetic cathinone. We describe an analytically confi…

Lisa Christine DunlopDavid WoodJohn Archer… in Journal of Medical Toxicology (2020)

Kratom Adulterated with Phenylethylamine and Associated Intracerebral Hemorrhage: Linking Toxicologists and Public Health Officials to Identify Dangerous Adulterants

Kratom is derived from the plant Mitragyna speciosa…which is indigenous to Southeast Asia. Active compounds, mitragynine and 7-hydroxymitragynine, cause mild stimulant and opioid agonist effects. Although repor…

Nicholas NaccaRachel F. SchultLingyun Li… in Journal of Medical Toxicology (2020)

Review of Health Consequences of Electronic Cigarettes and the Outbreak of Electronic Cigarette, or Vaping, Product Use-Associated Lung Injury

Electronic cigarettes (e-cigarettes) are battery-operated devices to insufflate nicotine or other psychoactive e-liquid aerosols. Despite initial claims of e-cigarettes as a nicotine-cessation device, aggressi…

Dazhe James CaoKim AldyStephanie HsuMolly McGetrick… in Journal of Medical Toxicology (2020)

2021

Impact of a Mandatory Prescription Drug Monitoring Program Check on Emergency Department Opioid Prescribing Rates

Prescription drug monitoring programs (PDMPs) exist in 49 states to guide opioid prescribing. In 40 states, clinicians must check the PDMP prior to prescribing an opioid. Data on mandated PDMP checks show mixe…

C. James WatsonMichael GanetskyRyan C. Burke… in Journal of Medical Toxicology (2021)

Opioid Overdose Deaths with Buprenorphine Detected in Postmortem Toxicology: a Retrospective Analysis

Buprenorphine is a unique μ-opioid receptor partial agonist with avid receptor binding, nominal euphoric reward, and a ceiling effect on sedation and respiratory depression. Despite a pharmacologic profile tha…

Rachel S. WightmanJeanmarie PerroneRachel Scagos… in Journal of Medical Toxicology (2021)

During the current global COVID-19 pandemic and opioid epidemic, wastewater-based epidemiology (WBE) has emerged as a powerful tool for monitoring public health trends by analysis of biomarkers including drugs…

Timothy B. EricksonNoriko EndoClaire Duvallet… in Journal of Medical Toxicology (2021)

Opioid Use and Driving Performance

The USA is in an opioid epidemic, with an increased number of individuals taking psychoactive drugs while executing the tasks of everyday life, including operating a motor vehicle. The pharmacology of opioids …

Keaton T. Cameron-BurrAlbert ConicellaMark J. Neavyn in Journal of Medical Toxicology (2021)

Pediatric Methamphetamine Toxicity: Clinical Manifestations and Therapeutic Use of Antipsychotics—One Institution’s Experience

Methamphetamine toxicity is common in the Southwest region of the United States and presents diagnostic and treatment challenges in the pediatric population. The aim of our study was to characterize signs and …

Hannah R. MalashockClaudia YeungAlexa R. Roberts… in Journal of Medical Toxicology (2021)

Implementation of a Medication for Addiction Treatment (MAT) and Linkage Program by Leveraging Community Partnerships and Medical Toxicology Expertise

Implementing a hospital medication for addiction treatment (MAT) and a linkage program…

Gillian A. BeauchampLexis T. Laubach… in Journal of Medical Toxicology (2021)

Descriptive Analysis of Inpatient and Outpatient Cohorts Seeking Treatment After Prescription Opioid Misuse and Medical Toxicology Evaluation

Medical toxicology expertise has expanded into the addiction medicine realm including outpatient medication for opioid use disorder (MOUD) and addiction treatment. Concomitantly, the emergency department (ED … …

Shawn M. VarneyTimothy J. WiegandPaul M. Wax… in Journal of Medical Toxicology (2021)

California Poison Control System Implementation of a Novel Hotline to Treat Patients with Opioid Use Disorder

In response to the opioid epidemic, California state officials sought to fund a variety of projects aimed at reducing opioid-related deaths. We describe the California Poison Control System’s (CPCS) successful ef…

Kathy T. LeSaintRaymond Y. HoStuart E. Heard… in Journal of Medical Toxicology (2021)

2022

Methadone vs. Buprenorphine for In-Hospital Initiation: Which Is Better for Outpatient Care Retention in Patients with Opioid Use Disorder?

Currently, few hospitals provide medications for opioid use disorder (MOUD) to admitted patients with opioid use disorder (OUD). Data are needed to inform whether the choice of medication during hospitalizatio…

Skyler H. KesslerEvan S. SchwarzDavid B. Liss in Journal of Medical Toxicology (2022)

Return Encounters in Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal

Phenobarbital has been successfully used in the emergency department (ED) to manage symptoms of alcohol withdrawal, but few studies have reported outcomes for ED patients who receive phenobarbital and are disc…

Jacob A. LebinAnita MudanCharles E. Murphy IV… in Journal of Medical Toxicology (2022)

The Potential Proconvulsant Effects of Cannabis: a Scoping Review

A total of 3104 unique articles were screened, of which 68 underwent full-text review, and 13 met inclusion/exclusion criteria. Ten of 11 studies evaluating acute cannabis exposures reported a higher seizure inci…

Eric E. KaczorKevin GreeneJennifer Zacharia… in Journal of Medical Toxicology (2022)

A Brief Educational Intervention to Increase ED Initiation of Buprenorphine for Opioid Use Disorder (OUD)

Despite the evidence in support of the use of buprenorphine in the treatment of OUD and increasing ability of emergency medicine (EM) clinicians to prescribe it, emergency department (ED)-initiated buprenorphi…

Utsha G. KhatriKathleen LeeTheodore Lin… in Journal of Medical Toxicology (2022)

Front-Loaded Versus Low-Intermittent Phenobarbital Dosing for Benzodiazepine-Resistant Severe Alcohol Withdrawal Syndrome

Phenobarbital is frequently used to manage severe alcohol withdrawal. The purpose of this study was to compare the incidence of mechanical ventilation in patients with benzodiazepine-resistant alcohol withdraw…

Poorvi ShahKati L. Stegner-SmithMohamad Rachid… in Journal of Medical Toxicology (2022)

Methadone vs. Buprenorphine for In-Hospital Initiation: Which Is Better for Outpatient Care Retention in Patients with Opioid Use Disorder?

Currently, few hospitals provide medications for opioid use disorder (MOUD) to admitted patients with opioid use disorder (OUD). Data are needed to inform…

Skyler H. KesslerEvan S. SchwarzDavid B. Liss in Journal of Medical Toxicology (2022)

Lebin, J.A., Mudan, A., Murphy, C.E. et al. Return Encounters in Emergency Department Patients Treated with Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal. J. Med. Toxicol. 18, 4–10 (2022). https://doi.org/10.1007/s13181-021-00863-2

2023

Correction to: The Potential Proconvulsant Effects of Cannabis: a Scoping Review

Eric E. KaczorKevin GreeneJennifer Zacharia… in Journal of Medical Toxicology (2023)

Delta-8-Tetrahydrocannabinol Exposure and Confirmation in Four Pediatric Patients

Delta-8-tetrahydrocannabinol (THC) is a known isomer of delta-9-THC, both found naturally in the Cannabis sativa plant and thought to have similar potency. Delta-8-THC products are widely accessible in retail …

Kerollos ShakerAndrea NillasRoss Ellison… in Journal of Medical Toxicology (2023)

Characterization of Nonfatal Opioid, Cocaine, Methamphetamine, and Polydrug Exposure and Clinical Presentations Reported to the Toxicology Investigators Consortium Core Registry, January 2010–December 2021

To characterize and compare opioid-only, cocaine-only, methamphetamine-only, opioid-and-cocaine exposure, and opioid-and-methamphetamine exposure and to examine clinical…

Emily GliddenKyle SuenDesiree Mustaquim… in Journal of Medical Toxicology (2023)

ACMT Digital Media with Addiction Toxicology Content

The ACMT Learning Center has hundreds of hours of digital content including webinars, live and on-demand courses, and podcasts containing content of interest to medical professionals in the field of addiction toxicology. To access this content, visit the Learning Center and select “Addiction Toxicology” under the the Site Search bar on the homepage. A good deal of content is member-only, but there is some open access webinar and podcast content for non-member viewing.

ACMT Webinars with Addiction Toxicology Content

* Denotes webinars accessible only to ACMT Members

Addiction Toxicology Case Conference

More information

The ACMT/ASAM Addiction Toxicology Case Conference is a monthly webinar series that discusses Addiction/Toxicology cases in an interactive fashion featuring experts from Addiction Medicine, Addiction Psychiatry, and Medical Toxicology. This activity is free and open to the public.

National Journal Club *

Links to webinars by year

2022

July 2021

This month’s topic is Pepper Spray and Tear Gas Agents. The articles will be reviewed by the University of Virginia Program in Medical Toxicology, led by Program Director Heather Borek.

March 2022

This month’s topic is Opioid Overdose and Naltrexone. The articles will be reviewed by the Washington University School of Medicine Program in Medical Toxicology, led by Dr. Evan Schwarz.

2021

May 2021

This month’s topic is Withdrawal and Recent Modalities. The articles will be reviewed by the Rutgers Medical Toxicology Program, led by Dr. Jeena Jaco.

National Grand Rounds *

Links to webinars by year

2022

October 2022        

Cannabis Regulation

February 2022

Gone to Pot? The Complex Relationship between Cannabis, Cannabinoids, and Psychosis

2021

October 2021

NPS Discovery – a five-phase approach to NPS identification, characterization, education, and harm reduction

ACMT Practice and Position Statement, and Public Policy Letters with Addiction Toxicology Focus

Practice Statements

Statements by year

2021

Sept. Interpretation of Urine Opiate and Opioid Tests. Read statement.

2020

May. Limiting Harms of Vaping and E-cigarette Use. Read statement.

2019

Nov. Interpretation of Urine for Tetrahydrocannabinol Metabolites. Read statement.

Sept. Buprenorphine Administration in the Emergency Department. Read statement.

Apr. Addressing Pediatric Cannabis Exposure. Read statement.

2016

Feb. Safety Issues Regarding Prescription Fentanyl Products. Read statement.

Public Policy Letters

Letters by year

2022

Oct 13, 2022. CSOO Requests DEA and SAMHSA Grant Continued Telehealth Flexibilities for Buprenorphine for OUD Declared in Response to the Opioid PHE. Read letter.

May 13, 2022. The Mainstreaming Addiction Treatment Act. Read letter.

Apr 12, 2022. CSOO Members on FY23 Appropriations Letter Aimed at Strengthening the Addiction Service Workforce. Read letter.

Mar 31, 2022. CSOO Members Support Legislation to Screen, Assess, and Treat Maternal Mental Health Conditions and SUDs. Read letter.

Feb 14, 2022. CSOO Members Advocate the Federal Parity Act be Fully Extended to Medicare, Medicaid, and TRICARE. Read letter.

2021

Jul 26, 2021. CSOO Urges Biden Administration to Fly Flags at Half-Staff on Overdose Awareness Day. Read letter.

May 27, 2021. Introduction of the Support, Treatment, and Overdose Prevention of (S.T.O.P) Fentanyl Act of 2021. Read letter.

May 3, 2021. Excellence in Recovery Housing Act. Read letter.

April 6, 2021. CSOO Urges Congress to Include Funding for Programs to Strengthen the Addiction Service Workforce in Fiscal Year 2022. Read letter.

2020

May 5, 2020. CSOO Urges Congress to Include Key Initiatives to Support the Mental Health and SUD Treatment Infrastructure in Next COVID-19 Package. Read letter.

ACMT/ AliEM Toxicology Visual Pearls

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I’ll Huff and I’ll Puff…

Jun 22, 2020 | ACMT Visual PearlsTox & Medications

By: Kathryn T. Kopec, DO and Blake Bauer, MD

“I have a nagging feeling about this”

Oct 5, 2020 | ACMT Visual PearlsEmergency MedicineTox & Medications

By: Brian Lewis, MDGilbert Nelson, DOThomas Vu, DO and Bryan Judge, MD, FACMT

Case of a Toxic Tea

Nov 9, 2020 | ACMT Visual PearlsEmergency MedicineTox & MedicationsBy: Nicholas Titelbaum, MDVir Singh, MD and Daniel Nogee, MD