ACMT Position and Practice Statements, and Public Policy Letters
ACMT advocates for the practice of medical toxicology and patient care through the development of practice and other statements. ACMT often works in collaboration with partners and other key stakeholders to advance policies and programs that improve the quality of and access to health care for all patients.
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.
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.
2021
- Sept. Interpretation of Urine Opiate and Opioid Tests. Read statement.
2020
- 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.
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.
2017
- Nov. Alternative or Contingency Countermeasures for Acetylcholinesterase Inhibiting Agents. Read statement.
- Aug. Sodium Bicarbonate Shortage Recommendations. Read statement.
- Aug. The Role of Clinical Pharmacists in the Emergency Department. 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.
2016
- 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.
2015
- Nov. ACMT Ethics Statement. Read statement.
2013
- Mar. Guidance Document: Management Priorities in Salicylate Toxicity. Read statement.
2012 and Pre-2012
- Nov. Antidote Shortages: Impact and Response. Read statement.
- Oct. Medical Toxicologist Participation in Medication Management and Safety Systems. Read statement.
- Jun. Interpretation of Urine Analysis for Cocaine Metabolites. Read statement.
- Jun. Institutions Housing Venomous Animals. Read statement.
- Recognition of Medical Direction and Support of Poison Center Activities. Read statement.
- Interim Guidance for the Use of Lipid Resuscitation Therapy. Read statement.
- Post-Chelator Challenge Urinary Metal Testing. Read statement.
- Dietary Supplements. Read statement.
- Hospital Privileges for Physicians Practicing Medical Toxicology (Revised 2017). Read statement.
Position Statements
Statements on public health and policy issues of interest to medical toxicologists and other health professionals. Position statements are approved by the ACMT Board of Directors.
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.
2025
- Jan. ACMT Position Statement on Sterile Solution Shortage Read Statement.
2024
- Nov. ACMT Statement on Fentanyl “Exposure” Laws Read Statement.
- Oct. No Evidence that Tampons Cause Metal Poisoning. Read Statement.
- Sept. Mifepristone and Misoprostol are Not “Controlled Dangerous Substances” Read statement.
- May The American College of Medical Toxicology Commitment to Diversity, Equity, and Inclusion in Medical Toxicology Read statement.
- Mar. ACMT Comment on Recent Guidance on PFAS Laboratory Testing. Read Statement.
2023
- Sept. Expanding Treatment for Youth with Substance Use-related Illnesses. Read Statement.
- Jun. Role of Medical Toxicologist in the Management of Patients with Substance Use Disorder. Read statement.
- Jun. Position on the Recent Judicial Challenge of U.S. Food and Drug Administration Approval of Mifepristone. Read statement.
- Apr. End the Use of the Term “Excited Delirium” Read statement.
2022
- Aug. ACMT Statement on Expert Testimony. Read statement.
2021
- 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.
2020
- Sept. Ketamine Sedation and Law Enforcement. Read statement.
- Jun. Maintenance of Certification in Coronavirus Pandemic. Read statement.
- Jun. ACMT Statement on the Death of George Floyd. Read statement.
- May. Off-Label Prescribing during COVID-19 Pandemic. Read statement.
- Apr. Prescription Drug Shortages. Read statement.
- Apr. Medication Shortages During Coronavirus Disease Pandemic. Read statement.
2019
- Jul. Recommending Removing The Waiver Requirement For Prescribing Buprenorphine For Opioid Use Disorder. Read statement.
2018
- Jan. Addressing the Rising Cost of Prescription Antidotes. Read statement.
Earlier Statements
- Safety Data Sheets. Read statement.
- Institute of Medicine Report on Damp Indoor Spaces and Health. Read statement.
Joint Statements
Statements on public health and policy issues written and released jointly with other medical associations.
Statements on public health and policy issues written and released jointly with other medical associations.
2023
- Sept. ACMT & AACT Joint Statement on Nalmefene Should Not Replace Naloxone as the Primary Opioid Antidote at This Time. Read statement.
- Feb. ACMT, ACEP, NAEMSP Joint Statement on Naloxone Access and Utilization for Suspected Opioid Overdoses. Read statement.
2022
- May. ACMT, AACT, AAEM Joint Statement Against Criminalization of Medical Errors. Read statement.
2021
- Mar. ACMT & AAEM Joint Statement in Support of COVID-19 Vaccines. Read statement.
- Mar. ACMT, AACT and AAPCC Joint Statement of Caution Regarding the Use of Colchicine for Treatment of COVID-19. Read statement.
2020
- Aug. ACMT, AACT, AAPCC Joint Statement on the Dangers of Oleandrin Toxicity. Read statement.
2017
Nov. ACMT and AACT Position Statement on Preventing Occupational Fentanyl and Fentanyl Analog Exposure to Emergency Responders. Read statement.
Public Policy Letters
ACMT signs on to letters to public health policymakers and officials to promote our public policy goals.
Coalition to Stop Opioid Overdose (CSOO) Letters
- Dec 7, 2022. CSOO Support for the Due Process Continuity of Care Act. Read letter.
- 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 16, 2022. CSOO Letter of Support for the Parity Implementation Assistance 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.
- 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’s 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.
Endorsed Guidelines
2025
- Mar 2025 The Joint Clinical Practice Guideline on Benzodiazepine Tapering: Considerations when Benzodiazepine Risks Outweigh Benefits. Read guideline
Developed through a partnership of ten medical and professional societies, this guideline focuses on evidence-informed and consensus-based strategies to help clinicians determine whether tapering benzodiazepine medications may be appropriate for a given patient, and if so, how to taper them.
Benzodiazepines (BZDs) are commonly prescribed, and FDA approved to treat a wide range of conditions including anxiety and mood disorders, insomnia, and seizures. BZD use is associated with increased risk for adverse events including falls, motor vehicle accidents, cognitive impairment, and overdose (particularly when BZD are used in combination with opioids). Patients who have been taking BZD for longer than a month should not abruptly discontinue the medication, but rather should gradually taper the dosage over a period of time under clinical supervision. This guideline aims to assist clinicians in helping patients safely taper their BZD medication, while minimizing withdrawal symptoms and associated risks.
2023
- Nov 2023. ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder. Read guideline.