ACMT Position Statements and Guidelines

Practice Statements

Statements on current clinical issues affecting the practice of medical toxicology and management of poisoned patients. Practice statements are developed, reviewed, and approved by a majority vote by the position statement committee. Final approval is made by the ACMT Board of Directors.

View all statements by year

Re: Practice Statements – These statements are intended to summarize a vast body of reviewed literature and expert opinion in a 1-2 page document with a small number (8-10) of references. The intended audience is both college members and others interested in the given topic. We see these as providing the basis for response to media, patients, and the starting point for further reading. They are not intended to be exhaustive treatises; however, they should recognize areas of controversy, providing a position backed by legitimate science. When applicable, each statement should include: * Introduction Introduce the topic or controversy and provide background regarding context (of exposure, contact, etc.) and purpose. * Data Where appropriate, this should be broken out into basic science, animal, human (epidemiologic, case-control, anecdotal) components. While raw numbers and summaries of studies are not required, any relative risk data should be referenced. * Conclusions Brief statement summarizing position of College. While not required, it is encouraged that authors use terms of the Bradford Hill criteria whenever imputing or refuting causation issues (strength of association, specificity, dose response, temporality, coherence, consistency, etc.). * References Major reviews and critiques. Any specific data cited in the statement should be referenced by the author in the body of the statement. * Date Include the date of submission (month/year) and any revisions noted.



  • Jun. Medication Administration and Safety During the Response to COVID-19 Pandemic. Read statement.
  • May. Limiting Harms of Vaping and E-cigarette Use. Read statement.


  • 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.


  • Nov. Alternative or Contingency Countermeasures for Acetylcholinesterase Inhibiting Agents. Read statement.
  • Aug. Sodium Bicarbonate Shortage Recommendations. Read statement.
  • Aug. The‚Äč ‚ÄčRole‚Äč ‚Äčof‚Äč ‚ÄčClinical‚Äč ‚ÄčPharmacists‚Äč ‚Äčin‚Äč ‚Äčthe‚Äč ‚ÄčEmergency‚Äč ‚ÄčDepartment. Read statement.
  • Jul. Preventing Occupational Fentanyl and Fentanyl Analog Exposure to Emergency Responders. Read statement.
  • Determining Brain Death in Adults After Drug Overdose. Read statement.


  • Mar. Duration of Intravenous Acetylcysteine Therapy Following Acetaminophen Overdose. Read statement.
  • Feb. Safety Issues Regarding Prescription Fentanyl Products. Read statement.
  • Jan. The Use of Methadone as an Analgesic. Read statement.
  • Jan. Safety Issues Regarding Prescription Opioids. Read statement.



  • Mar. Guidance Document: Management Priorities in Salicylate Toxicity. Read statement.

2012 and Pre-2012

Position Statements

Statements on public health and policy issues of interest to medical toxicologist professionals. Position statements are approved by the ACMT Board of Directors

View all statements by year

All position statements are edited by the committee and then referred to the board. Any comments are reviewed by the authors and the committee. Once endorsed by the board, they are posted on the ACMT website and published in an issue of JMT. All position statements are introduced by a disclaimer indicating that while individual practitioners may differ, this is the position of the college at the time written, after a review of the issue and pertinent literature. The original author(s) are asked to address any questions, indicating the date of any revisions on the statement. Each author must sign a disclosure form discussing any potential sources of bias and conflict of interest.


  • August. ACMT Statement on Expert Testimony. Read statement.
  • May. ACMT, AACT, AAEM Joint Statement Against Criminalization of Medical Errors. Read statement.


  • Sept. ACMT Cautions against Off-Label Prescribing of Ivermectin for the Prevention or Treatment of COVID-19. Read statement.
  • Sept. Allow Optimal Treatment for Healthcare Professionals With Opioid Use Disorder. Read statement.
  • Mar. ACMT & AAEM Joint Statement in Support of COVID-19 Vaccines. Read statement.
  • Mar. ACMT, AACT and AAPCC Joint Statement of Caution Regardingthe Use of Colchicine for Treatment of COVID-19. Read statement.



  • Jul. Recommending Removing The Waiver Requirement For Prescribing Buprenorphine For Opioid Use Disorder. Read statement.


  • Jan. Addressing the Rising Cost of Prescription Antidotes. Read statement.

Earlier Statements

Public Policy Letters

ACMT signs on to letters to public health policymakers and officials to promote our public policy goals.

View all letters

Coalition to Stop Opioid Overdose (CSOO) Letters

  • 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.
  • 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.
  • 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.
  • 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.
  • Nov 6, 2019. Comprehensive Addiction Resources Emergency (CARE) Act of 2019. Read letter.
  • Jun 27, 2019. Community Re-entry through Addiction Treatment to Enhance (CREATE) Opportunities Act. Read letter.
  • May 8, 2019. Comprehensive Addiction Resources Emergency (CARE) Act of 2019. Read letter.

Other Letters

  • May 13, 2022. The Mainstreaming Addiction Treatment Act. Read letter.
  • Feb 8, 2022. Letter to Nancy Pelosi & Chuck Schumer on USDOL CMP Authority for MHPAEA. Read letter.
  • Nov 18, 2021. Statement Supporting OSHA‚Äôs COVID Vaccine Requirement. Read letter.
  • Oct 13, 2021. The Improving Social Determinants of Health Act of 2021 (S. 104/H.R. 379). Read letter.
  • Sept 10, 2021. Letter to Chair Murray on USDOL CMP Authority for MHPAEA. Read letter.
  • Jul 13, 2021. Letter to DEA re: Removal of X-Waiver Restrictions on Prescribing Buprenorphine. Read letter.
  • Jul 1, 2021. Letter to Congress re: Hospital-based Violence Intervention Programs. Read letter.
  • Feb 12, 2021. Letter to Congress re: Including a Significant, Long-Term Investment in Public Health Infrastructure in COVID-19 Response Legislation. Read letter.