Overview of Toxicology Services

Toxicology is a rapidly growing part of the Department 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 attendings also lecture throughout the year to multiple departments, to physician’s groups at other hospitals, and at regional and national meetings. 

The Division has a fellowship program and accepts up to two applicants each year. The fellows have their own large office with personal computers. Additionally, there is a large hall space with a dry erase wall and private conference room that are used for fellow-lead 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.  The fellows spend multiple afternoons a week there and work with the poison center medical director and specialists in poison information (SPIs). They participate in education and reviewing protocols among other activities. The attendings also frequently have teaching rounds at the poison center pre COVID.

We developed a telehealth service for toxicology in 2012, one of the first in the country. We are currently providing telehealth services in our outpatient clinic. We will soon be providing telehealth services to Missouri Baptist (one of our affiliate hospitals) with plans to expand to other BJC hospitals in the near future.

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 herpetologists at the St. Louis Zoo.  We also serve as toxicology specialists for industry. One of our former toxicology faculty members, Dr. Eliza Dunn, works as a toxicologist at Bayer. Dr. Daniel Goldstein, formerly of Bayer, is an adjunct faculty member of the toxicology fellowship.

The attending toxicologists and toxicology fellows staff the Medical Toxicology and Addiction Medicine Clinic.  The clinic is moving to the Center for Advanced Medicine.  Physicians board-certified in Medical Toxicology and/or Addiction medicine evaluate patients weekly; additionally, we have a telehealth services available. Patients 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