Overview of Toxicology Services

Toxicology is a rapidly growing part of the Division that is committed to providing the most up-to-date training in the management of poisoning, overdoses, and addiction medicine. We currently have five faculty members who participate in both education and research and provide a vital consulting service to the medical center. The toxicology attending’s also lecture throughout the year to multiple departments, to physician’s groups at other hospitals, and at regional and national meetings. 

The Division has its own fellowship and can accept up to two applicants each year. The fellows have their own large office with personal computers. Our physician assistant and rotators also share this space. Additionally, there is a large hall space with a dry erase wall and private conference room that are used for general as well as fellow-level didactics. Residents from emergency medicine, pediatrics, psychiatry, and internal medicine regularly rotate on the service. Additionally, medical students and pediatric emergency medicine fellows also rotate on the service.

The Toxicology service actively collaborates with the Missouri Poison Center, as well as with industry.  The fellows spend multiple afternoons a week there and work with the SPIs and managing and medical director. They participate in education and reviewing protocols among other activities. The attendings also frequently have teaching rounds at the poison center. We previously had developed a telehealth service for toxicology in 2012, one of the first in the country. We now are actively working to provide telehealth services to multiple BJC hospitals, some of which is part of two large SAMHSA grants. The Division also serves as the HAZMAT physicians for the Saint Louis Urban Search and Rescue Team, as well as assists with medical direction at the Cardinals and Blues games.  We work closely with the toxicologists at Bayer and the specialists at the St. Louis Zoo Herpetarium.  We also serve as toxicology specialists for industry. One of our former toxicology faculty, Dr. Eliza Halcomb, works as a toxicologist at Bayer. Dr. Goldstein, formerly of Bayer, is an adjunct faculty member.

The attending toxicologists and toxicology fellows staff the Medical Toxicology and Addiction Medicine Clinic.  The clinic is currently located in the Center for Outpatient Health.  Physicians board-certified in Medical Toxicology and/or Addiction medicine evaluate patients weekly; additionally, we have set up a telehealth service for the clinic  Patients that were exposed to a chemical or toxin at home or at work, were envenomated, or looking for an independent medical exam are evaluated in the clinic.  In addition, the physicians also treat patients with substance use disorders, which may include prescribing naltrexone or buprenorphine.  Social work and pharmacy resources are available at the clinic. 

For an appointment or if you are interested in the clinic, please call or email the clinic coordinator, Ms. Andrea Ramirez at (314) 362-4362 or ramireza@wustl.edu