Evan S Schwarz, MD

Division Chief, Medical Toxicology; Associate Professor, Emergency Medicine

Education

  • BA: University of Texas at Austin 2001
  • MD: University of Texas Medical Branch at Galveston 2005

Training

  • Residency: Barnes-Jewish Hospital, St. Louis, MO 2009
  • Chief Resident: Barnes-Jewish Hospital, St. Louis, MO 2009
  • Fellowship: Toxicology, University of Texas Southwestern Medical Center, Dallas 2011

Licensure and Board Certification

  • Emergency Medicine
  • Medical Toxicology
  • Addiction Medicine

Honors and Awards

  • Resident board member of the Missouri College of Emergency Physicians, 2007-2008
  • Chief Resident Emergency Medicine Washington University, 2008-2009
  • Missouri State Medical Association Resident Fellow Division councilor, 2008
  • Fellow of the American College of Emergency Physicians, 2012
  • American College of Emergency Physicians Teaching Fellowship, 2014-2015
  • WUSM Academic Medical Leadership Development Program, 2015
  • Advisory Dean in the Office of Student Affairs, 2015- 2021
  • Vice president of the Missouri College of Emergency Physicians. 2016-2018
  • Board member of the American College of Medical Toxicology, 2016-present
  • Fellow of the American College of Medical Toxicology, 2017
  • President of the Missouri College of Emergency Physicians, 2018-2020
  • Board of Governors for ACEP’s Pain and Addiction Care in the Emergency Department
  • Elected Councilor for the Missouri College of Emergency Physicians 2017-Present
  • Annals of Emergency Medicine: Top New Reviewers 2020
  • Gateway Curriculum Coach in the Office of Student Affairs, 2021-Present

Recent Publications

Peer reviewed manuscripts

  1. Mullins M, Liss D, Schwarz E. Comment: severe anaphylactic reaction following Crotalidae Polyvalent Immune Fab (Ovine) administration for copperhead snakebite. Ann Pharmacother 2015;49(4):496.[PMID:25762655]
  2. Schwarz ES, Mullins ME.  Paracetamol: Is all the concern valid.  Ann Rheum Dis 2015;74(8):e48.[PMID:25858642]
  3. Kolinsky D, Schwarz ES.  Are New Oral Anticoagulants Safer Than Vitamin K Antagonists in the Treatment of Venous thromboembolism? Ann Emerg Med 2015;67(6):702-3.[PMID: 26707884]
  4. Kolinsky D, Keim SM, Cohn BG, Schwarz ES, Yealy DM. Is a Prehospital Treat and Release Protocol for Opioid Overdose Safe? Journal of Emergency Medicine 2016.52(1):52-58.[PMID: 27769615]
  5. Mullins ME, Schwarz ES. Commentary on “A new drug with a nasty bite: A case of krokodil-induced skin necrosis in an intravenous drug user.” J Am Acad Dermtaol 2016;2(5): 418. [PMID: 27872889]
  6. Connolly SJ, Milling TJ, Eikelboom JW, ANNEXA-4 Investigators. Andexanet Alfa for Acute Major Bleeding Associated with Factor Xa Inhibitors. N Engl J Med 2016;375(12):1131-41. [PMID: 27573206]
  7. Willman MW, Liss DB, Schwarz ES, Mullins ME. Do Heroin Overdose Patients Require Observation after Receiving Naloxone? Clin Tox 2017;55(2): 1-7. [PMID: 27849133]
  8. Willman MW, Liss DB, Schwarz ES, Mullins ME. The authors reply regarding “Do heroin overdose patients require observation after receiving naloxone?” Clin Tox 2017;55(4):2017.[PMID:28152639]
  9. Schwarz ES, Kopec TK, Wiegand TJ, Wax PM, Brent J. Should we be using the poisoning severity score? J Med Toxicol 2017;13(2):135-45.[PMID:28283941]
  10. Dezieck L, Hafez Z, Conicella A, Blohm E, O’Connor MJ, Schwarz ES, Mullins ME. Resolution of cannabis hyperemesis syndrome with topical capsaicin in the emergency department: a case series. Clin Toxicol (Phila) 2017;55(8):908-913.[PMID: 28494183]
  11. Schwarz ES, Mullins ME. When 2 is Not Better Than One. Br J Clin Pharmacol 2017. Accepted for publication.[PMID:28543530]
  12. Farrugia LARhyee SHCalello DPCampleman SLRiederer AMMalashock HRPizon AWiegand TWax PMBrent JToxicology Investigators Consortium Study Group.  The Toxicology Investigators Consortium Case Registry-the 2016 Experience.  J Med Toxicol. 2017. [PMID: 28766237]
  13. Hafez Z, Mullins ME, BLohm E, O’Connor MJ, Dezieck L, Schwarz ES, Conicella A. Cannabinoid hyperemesis syndrome and topical capsaicin: treating smoke with fire?-the authors reply. Clin Toxicol (Phila) 2017;55(8):908-913.[PMID: 287130852]
  14. Thoma B, Sebok-syer SS, Krishnan K, the METRIQ Study Collaborators, et al. Individual Gestalt Is Unreliable for the Evaluation of Quality in Medical Education Blogs: A METRIQ Study. Ann Emerg Med 2017;70(3):394-401.[PMID: 28262317]
  15. Liss DB, Schwarz ES, Mullins ME. Sodium Acetate Infusion for Serum and Urine Alkalinization. Ann Emerg Med 2017;70(4):601-602.[PMID: 28946986]
  16. Liss DB, Phillips TM, Pizon AF, Schwarz ES. Delayed Seizures in Bupropion Overdose with Concomitant Ingestion of Alpha-2 Agonist: A Case Report. Toxicology Communications 2017;1(1). https://doi.org/10.1080/24734306.2017.1364839
  17. Lewis L, Carpenter CR, Schwarz ES, Jotte RS, Waller C, Winograd R, Williams R, Stenger S, Rehder H, Governick S, Giuffra L. The Opioid Crisis in Missouri: A Call to Action for Physicians, Legislators, and Society. MO Medicine 2017;114(6):440-6. [PMID: 30228662]
  18. Mullins ME, Schwarz ES. Safety and Efficacy of Physostigmine: Seeing the Trees from the Forest Plot. Clin Toxicol(Phila) 2018;56(9):868-9. [PMID: 29490506]
  19. Carpenter CR, Lewis L, Jotte R, Schwarz ES. A Bridge to Nowhere? Challenging Outpatient Transitions of Care for Acute Pain Patients in the Opioid Epidemic Area. MO Medicine 2018.[PMID: 30228730]
  20. Karlow N, Schlaepfer CH, Stoll C RT, Doering M, Carpenter CR, Colditz GA, Motov S, Schwarz ES. A Systematic Review and Meta-Analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department. Academic Emergency Medicine 2018. In press. [PMID: 30019434]
  21. Kao L, Pizon A, ACMT Fellowship Directors Committee. Medical Toxicology Fellowship Training is Available to Applicants from Many Specialties. J Med Toxicol 2018;14(3):177-178. [PMID: 29785474]
  22. Farrugia LA, Rhysse SH, Campleman SL, Judge B, Kao L, Pizon A, Porter L, Riederer AM, Wiegand T, Calello D, Wax PM, Brent J, Toxicology Investigators Consortium (ToxIC) Study Group. The Toxicology Investigators Consortium Case Registry-the 2017 Annual Report. J Med Toxicol 2018;14(3):182-211. [PMID: 30094774]
  23. Marks LR, Munigala S, Warren DK, Liang SY, Schwarz ES, Durkin MJ. Addition medicine consultations reduce readmission rates for patients with serious infections from opioid use disorder. Clinical Infectious Diseases 2019;68(11):1935-1937.[PMID: 30357363]
  24. Lange J, Gaddis G, Varner E, Schmidt S, Cohen R, Schwarz E. Residents Access to the St. Louis County Prescription Drug Monitoring Program: Why PDMPs Matter and How to Gain Access. MO Medicine 2018; 115(6):487-493.[PMID: 30643325]
  25. Mullins ME, Liss DB, Fishburn SJ, Dribben WH, Schwarz ES. Comments on Chhabria et al. “Lipid emulsion for acute organophosphate insecticide poisoning.” Clin Toxicol (Phila) 2019;22:1. [PMID: 30666881]
  26. Connolly SJ, Crowther M, Eikelboom JW, Gibson M, Curnutte JT, Lawrence JH, Yue P, Bronson MD, Lu G, Conley PB, Verhamme P, Schmidt J, et al, ANNEXA-4 Investigators. Full Study Report of Andexanet Alfa for Bleeding Associated with Factor Xa Inhibitors. N Engl J Med 2019;380(14):1326-1335.[PMID:30730782]
  27. Mullins ME, Jones MS, Nerenz RD, Schwarz ES, Dietzen DJ. 5-Oxoproline concentrations in acute acetaminophen overdose. Clin Toxicol (Phila) 2020;58(1):62-64. [PMID:31050299]
  28. Wax PM, Stolbach AI, Schwarz ES, Warrick BJ, Wiegand TJ, Nelson LS. ACMT Position Statement: Buprenorphine Administration in the Emergency Department. J Med Toxicol 2019;15(3):215-216.[PMID: 31087272]
  29. Schwarz ES, Laes JR, Wiegand TJ. A New Way Forward in the Emergency Department. J Med Toxicol 2019;15(4):220-222. [PMID:31278586]
  30. Marino R, Perrone J, Nelson LS, Wiegand TJ, Schwarz ES, Wax PM, Stolbach AI. ACMT Position Statement; Remove the Waiver Requirement for Prescribing Buprenorphine for Opioid Use Disorder. J Med Toxicol 2019;15(4):307-309. [PMID 31414402]
  31. Reynolds WR, Schwarz ES. Dentists’ Current and Optimal Opioid Prescribing Practices: A Proactive Review. Mo Med 2019;116(5):347-350.[PMID: 31645771]
  32. Baumgartner K, Doering M, Schwarz ES. Vilazodone Poisoning: A Systematic Review. Clin Tox 2020;58(5):360-67. [PMID: 31777303]
  33. Carpenter J, Amirshahi M, Laes J, Nacca N, Nelson L, Perrone JM, Schwarz ES, Wiegand T, Wax P. Leadership roles in Opioid Stewardship and the Treatment of Patients with Opioid Use Disorder among Medical Toxicologists. J Med Toxicol 2020;16(2):204-11.[PMID: 31863312]
  34. Schwarz ES, Moy HP. In acute pain in prehospital settings, opioid and nonopioid analgesics do not differ for pain at 15 or 60 min. Ann Intern Med 2020;172(4):JC20 [PMID: 32066153]
  35. Marks LR, Munigala S, Warren DK, Liang SY, Schwarz ES, Durkin MJ. Evaluation of partial oral antibiotic treatment for persons who inject drugs and are hospitalized with invasive infections. Clinical Infectious Diseases 2020. [PMID:32239136]
  36. Friedman N, Shoshani-Levi M, Brent J, Wad P, Campleman SL, Finkelstein Y, on behalf of the Toxicology Investigators Consortium. Fatalities in Poisoned Patients Managed by Medical Toxicologists. Clin Toxicol (Phila) 2020;58(7):688-91. Accepted. 
  37. Beauchamp GA, Fishbein J, Makar GA, Pechulis RM, Cook MD, Cannon RD, Katz KD, Kincaid H, Carey JL, Greenberg MR, on behalf of the Toxicology Investigators Consortium. Sex Differences in Patients with Suicidal Intent that are Managed by Toxicologists: An Analysis of the Toxicology Investigators’ Consortium (ToxIC) Registry. Am J Emerg Med 2020;38(2):333-8. [PMID 31706659]
  38. Lewis LM, Schwarz E, Jotte R, West CP. The Need for an Integrated Approach to Well-Being in Healthcare. MO Medicine;117(2):95-8. [PMID: 32308222] 
  39. Stolbach A, Mazer-Amirshahi M, Schwarz ES, Juurlink D, Wiegand TJ, Nelson LS. ACMT Position Statement: Caring for Patients with Opioid Use Disorder during Coronavirus Disease Pandemic. J Med Toxicol 2020;16:484-6. [PMID: 32748068] 
  40. Baumgartner K, Filip A, Liss D, Devgun J, Schwarz E, Mullins M. N-acetylcystiene for acetaminophen toxicity: The one-bag regimen. Br J Cli Pharmacol 2021.87(5):2399-2400. [PMID: 33190332] 
  41. Upadhyaya A, Marks LR, Schwarz ES, Liang SY, Durkin MJ, Liss DB. Care Cascade for Patients with Opioid Used Disorder and Serious Injection Related Infections. Toxicology Commmunications 2020. Accepted for publication.  https://doi.org/10.1080/24734306.2020.1869899
  42. Lewis LM, Carpenter CR, Jotte R, Schwarz E. Healthcare Provider Wellness in the Time of COVID and Beyond. Mo Med 2021 Jan-Feb;118(1):13-17. 
  43. Hawk K, Hoppe J, Ketcham E, LaPietra A, Moulin A, Nelson L, Schwarz E, Shahid S, Stader D, Wilson MP, D’Onofrio G. Concensus Recommendations on the Treatment of Opioid Use Disorder in the Emergency Department. Ann Emerg Med 2021.[published on line] https://doiorg/10.1016/j.annemergemed.2021.04.023  

Invited Publications

  1. Critical Connections
    1. Need A Pressor but Don’t Really Want a Pressor…How ‘Bout Some Calcium? July 2013
    2. Snakes in the ED. Be Very Concerned…or Should You? June/July 2015
  2. Missouri College of Emergency Physicians EPIC
  3. Emergency Physicians Monthly Reviews
  4. Emergency Physicians Monthly Articles
  5. Editory for ACEP Now Opiod and Addiction Column
  6. Washington Manual Chapters in the 34th, 35Th, and 36th Editions
  7. Washington Manual of Emergency Medicine Chapter 79
  8. Tintinalli’s Emergency Medicine and Board Review 3rd Edition Question Book, Chapters 55-61
  9. Schwarz ES. Therapeutic Approach to the Critically Poisoned Patient, Including GI Decontamination. Critical Care Toxicology, 2nd ed. SpringerMeteo.

Texts

Schwarz ES, Kleinschmidt KC.  Chapter 187: Toxic Inhalants.  Vincent:  Textbook of Critical Care, 6th edition

PEPID 2012 update:  edited chapters on Toxicology General Principles: overview, charcoal hemoperfusion, dialysis in toxicology; isopropranol; Plants:  insoluble oxalates; industrial herbicides (paraquat, diquat); hydrofluoric acid (HF)

Halcomb SE, Mullins ME, Schwarz E.  Overdoses. Washington Manual of Medical Therapeutics, 34th Ed.  Washington University School of Medicine.  WoltersKluwer, Lippincott Williams and Wilkins.  St. Louis, 2012.

PEPID 2013 update:  edited chapters on multiple sclerosis, fever age 3-36 months, masotiditis, perforated tympanic membrane, and tinea corporis.

PEPID Pediatric Chapters:  Wrote chapters on Anticholinergic toxidrome, Cardiac Gylcosides, Carbon monoxide toxicity, Cholinergic toxidrome, Digoxin toxicity, Ethylene Glycol toxicity, Hydrocarbons, Cyanide, Cocaine toxicity, Carbamate toxicity

Schwarz ES, Arroyo AM.  Clinical Decision Support System on Clinical Toxicology. Antidepressants; serotonin syndrome.

Halcomb SE, Mullins ME, Schwarz ES.  Toxicology. Washington Manual of Medical Therapeutics, 35th Ed.  Washington University School of Medicine.  WoltersKluwer, Lippincott Williams and Wilkins.  St. Louis, 2015

Bavolek R, Sampson C, Schwarz ES, Wagner JC.  Chapter 24 Medical Emergencies. Washington Manual of Medical Therapeutics, 35th Ed. Washington University School of Medicine. WoltersKluwer, Lippincott Williams and Wilkins. St. Louis, 2015

Schwarz ES.  Therapeutic Approach to the Critically Poisoned Patient, including GI Decontamination.  Critical Care Toxicology, 2nd ed. SpringerMeteor. 2016.

Schwarz ES.  The Washington Manual of Emergency Medicine, 1st edition.  Chapter 79 Addiction. Washington University School of Medicine. Philadelphia; WoltersKluwer, Lippincott Williams and Wilkins. St. Louis, 2018.

Tintinalli’s Emergency Medicine & Board Review 3rd edition. Edited by Dr. Susan B. Promes. McGraw-Hill Global Holdings, LLC. To be published in 2018. I wrote questions for chapters 55-61.

Emergency Medicine Resident’s Association Toxicology Guidebook. Published in 2018. I edited the chapters on Anesthetics, Antihypertensives, Atypical Antipsychotics, Hydrocarbons, NOACs, Opioids, Tramadol, and Warfarin/Heparin.

Hilbert S, Levine MD, Schwarz ES.  Chapter 26 Medical Emergencies. Washington Manual of Medical Therapeutics, 36th Ed. Washington University School of Medicine. WoltersKluwer, Lippincott Williams and Wilkins. St. Louis, 2020

Dunn SE, Schwarz ES, Mullins ME.  Chapter 28. Toxicology. Washington Manual of Medical Therapeutics, 36th Ed.  Washington University School of Medicine.  WoltersKluwer, Lippincott Williams and Wilkins.  St. Louis, 2020

American College of Emergency Physicians Guide to Coronavirus Disease (COVID-19) Field Guide. Patients with Substance Use Disorders. https://www.acep.org/corona/covid-19-field-guide/special-populations/patients-with-substance-use-disorders/


Lectures & Presentations

October 18, 2021 Lifelong Learning and Self-Assessment for the 2021 Medical Toxicology Articles. North American Congress of Clinical Toxicology. Atlanta, GA. 

August 19, 2021 Total Tox Course. Heavy Metals in the Ed: Lead, Arsenic, and Mercury. Hosted by the American College of Medical Toxicology. Online course. 

July 2, 2021 Lifelong Learning and Self-Assessment for the 2021 Medical Toxicology Articles. Hosted by the American College of Medical Toxicology. Webinar. 

April 23, 2021 Excited Delirium: The Controversy in the Care of the Acutely Agitated Patient. American Society of Addiction Medicine Virtual Meeting. 

April 1, 2021 BHR event. Opioids. St. Louis, MO – rescheduled from March 2020 

March 25, 2021 Discussing MAT with Clients and Providers. Engaging Patients in Care Coordination Program. Webinar. 

March 2, 2021    Grand Rounds for Medical Toxicology at UT Southwestern. Fomepizole for Acetaminophen Toxicity. Leadership Lecture. Online. 

February 12, 2021 Missouri Telehealth Network. Opioid Use Disorder ECHO. Post Overdose Management. Online education. 

February 5, 2021 American College of Medical Toxicology Total Toxicology Course. Heavy Metals in the ED. Virtual-Rescheduled from August 2020 

February 1, 2021 Washington, DC ACEP Chapter MAT training. Online education. Rescheduled from June 2020. 

January 5, 2021 Iowa ACEP Chapter MAT training. Online education. Rescheduled from June 2020. 

December 15, 2020 2020 AACC Annual Scientific Meeting & Clinical Lab Expo. Drug Testing Under the Pressure of Drug Abuse Epidemics. Virtual – rescheduled from July 2020 

November 19, 2020 MAT waiver training session for ACEP. Online education. 

November 3, 2020 MAT waiver training session for ACEP. Online education. 

October 9, 2020 Missouri Telehealth Network. Opioid Use Disorder ECHO. Cannabis. Online education. 

September 11, 2020 North American Clinical College of Toxicology Pre-symposium. Sodium Channel Openers. Live online. 

August 28, 2020 American College of Medical Toxicology Board Review Course. Miscellaneous Toxins. Minneapolis, Minnesota 

August 26, 2020 American College of Medical Toxicology Total Toxicology Course. Heavy Metals in the ED. Minneapolis, Minnesota-Postponed due to COVID 

August 25-28, 2020 American College of Medical Toxicology Board Review Course. Dermatology and Pathology. Webinar. 

June 16, 2020 ACEP MAT Training.  Iowa Chapter of Emergency Physicians – Postponed due to COVID 

May 7, 2020 St. Louis Chapter of the Society of Hospital Medicine. Substance use disorders. St. Louis, MO – postponed due to COVID 

March 31, 2020 BHR event. Opioids. St. Louis, MO – postponed due to COVID 

March 13, 2020 Missouri Telehealth Network. Opioid Use Disorder ECHO. Post Overdose Management. Online education. 

March 5, 2020 Opioid Use Disorder in the Hospitalized Patient 2020. Handling Pain Responsibly. St. Louis, MO. Audience size: 50 people 

March 5, 2020 Opioid Use Disorder in the Hospitalized Patient 2020. Motivational Interviewing. St. Louis, MO. Audience size: 50 people 

January 23, 2020 Vizient. Closing the Treatment Gap with Inpatient and Emergency Department Initiated Medication Assisted Treatment (MAT) for Opioid-Use Disorder. Webinar. St. Louis, MO 

January 22, 2020 Grand Rounds at Mercy South. Opioids and the ED. St. Louis, MO. Audience size: 40 people 

January 8, 2020 VA John Cochran Grand Rounds. Emergency Toxicology. St. Louis, MO. Audience size: 40 people 

December 17, 2019 Centene Corporation. OUD in the ED. Webinar. St. Louis, MO 

November 19, 2019 BJC Grand Rounds at Christian Hospital. SUD in the ED and Hospital. St. Louis, MO. Audience size: 65 people 

November 5, 2019 14th Annual Pediatric Trauma Update Conference in Southern Illinois. Not Your Parent’s Pot. Carterville, Illinois. Audience size: 70 people 

October 9, 2019 Missouri Emergency Medicine Nursing. Opioids and Addiction in the Emergency Department. St. Louis, MO. Audience size: 35 people. 

October 1, 2019 Texas Club of Internists meeting. Opioids and Addiction. St. Louis, MO. Audience size: 50 people 

September 27, 2019 Lifelong Learning and Self-Assessment for the 2019 Medical Toxicology Articles. North American Congress of Clinical Toxicology. Nashville, TN. Audience size: 95 people 

July 10, 2019 Lifelong Learning and Self-Assessment for the 2019 Medical Toxicology Articles. Hosted by the American College of Medical Toxicology. Webinar.  

June 20, 2019 Barnes Jewish Hospital Nursing Grand Rounds. My Patient Did What? An Update on Drugs of Abuse. Audience size: 50 people 

April 26, 2019 Tom Steele Emergency Medicine Conference. Medication Assisted Therapy in the Emergency Department. Springfield, Illinois. Audience size: 75 people 

April 26, 2019 Tom Steele Emergency Medicine Conference. Alternatives to Opioids. Springfield, Illinois. Audience size: 75 people 

April 18, 2019  Behavioral Health Summit. Opioid 1-ED Meds, Medication First Therapy. Missouri Hospital Association. Lake of the Ozarks, Missouri. Audience size: 45 people 

April 5, 2019 American Society of Addiction Medicine 50th Annual Conference. Marijuana Today: Not Your Parent’s Pot. Orlando, Florida. Audience size: 350 people 

March 20, 2019 Ohio College of Emergency Medicine Annual Meeting. Medication Assisted Therapy in the Emergency Department. Audience size: 50 people 

March 8, 2019 Maine College of Emergency Medicine Annual Meeting. Medication Assisted Therapy in the Emergency Department. Audience size: 45 people