2023 ACMT Symposium | Self-Harm, Suicidality, and the Poisoned Patient: The Intersection of Toxicology and Mental Health

2023 ACMT Symposium | Self-Harm, Suicidality, and the Poisoned Patient: The Intersection of Toxicology and Mental Health

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2023 ACMT Symposium | Self-Harm, Suicidality, and the Poisoned Patient: The Intersection of Toxicology and Mental Health
Thursday, March 30, 2023
San Diego, Marriott La Jolla, San Diego, CA

Suicide is a major public health problem and leading cause of preventable death. The practice of medical toxicology often involves caring for patients who injure themselves (or attempt injury) by poisoning. Toxic exposures may affect the central nervous system, cause neuropsychiatric symptoms, and increase the likelihood of future suicidal behavior. 

"Toxicologists interact on a daily basis with patients who have myriad mental health problems, and in many cases those sufferings increase the risk of suicide,” says symposium organizer Mark Su, MD, MPH, FACMT. “As providers for patients with intentional xenobiotic exposures and suicide attempts, the toxicology community must be cognizant of these complex issues and understand substantive ways to address them in real time." 

This symposium will discuss the ethics, psychology, management, and global epidemiology of the suicidal patient through the toxicology lens. Clinicians will also learn about lethal means restriction, care of the “frequent attempter,” and strategies to prevent death by suicide. Ultimately, the course will hopefully help us better understand the suicidal toxicology patient and improve their care. 

This program brings together distinguished experts in Medical Toxicology, Psychiatry, Emergency Medicine, Medical Ethics, Military Medicine, Addiction Medicine, Public Health and related fields. 

Topics include: 

Ethical Issues in Treatment and Research 
Ethical Allocation of Resources: Transplant and the Suicidal Patient 
Psychology of Suicidal Behavior and Access to Means 
The Role of Medical Toxicology in Prevention of Suicidality 
The High Utilizer and Recurrent Suicidality 
Special Populations: Neuropsychiatric Consequences of Military and Occupational Exposures
The Intersection of Forensic Toxicology & Suicide: How To Determine Death by Suicidal Intent 
The event will conclude with “A Global Perspective on Suicide by Self-Poisoning” panel featuring international medical and public health experts representing the U.S., Scotland, Lebanon, Australia, and France. 

Continuing Education

This activity was planned by and for the healthcare team. Continuing Education is pending for this activity. It is expected to be approved for 6.25 Interprofessional Continuing Education (IPCE) credit for learning and change. 

Continuing Medical Education (CME), Continuing Pharmacy Education (CPE) and Continuing Nursing Education (CNE) credits will be available for this activity for an additional fee. To receive continuing education credits, learners must attend the sessions in-person. Learners should claim only the credit commensurate with the extent of their participation in the activity. 

Purchase CE Credits


All times listed in local, Pacific Time Zone.

7:45 - 8:00 AM - Opening Remarks

8:00 - 8:45 AM

Caring for the Suicidal Patient: Ethical Issues in Treatment and Research

Dominic Sisti, PhD, Associate Professor, Department of Medical Ethics & Health Policy, University of Pennsylvania, Pennsylvania, PA

8:45 - 9:15 AM

Ethical Allocation of Resources: Transplant and the Suicidal Patient

Filza Hussain, MD Clinical Associate Professor, Psychiatry and Behavioral Sciences - Medical Psychiatry, Stanford University, Stanford, CA

9:15 - 9:45 AM

Psychology of Suicidal Behavior

Elizabeth Ballard, PhD, Associate Scientist, NIMH, Silver Spring, MD

9:45 - 10:15 AM

Access to Means

J.J. Rasimas, MD, FAACT, FACLP, FACMT., FACPsych, Professor of Psychiatry and Emergency Medicine, University of Minnesota, Penn State College of Medicine, Health PEI, Charlottetown, PE  Canada

10:15 - 10:30 AM - Morning Break

10:30 - 11:00 AM

The Role of Med Tox in Prevention of Suicidality

Larissa K. Laskowski, DO, Assistant Professor, NYU Grossman School of Medicine, NYU Langone Health, Health + Hospitals Bellevue, New York, NY

11:00 - 11:30 AM

Recurrent Suicidality

Yaron Finkelstein, MD, FACMT, Professor of Pediatrics, Pharmacology and Toxicology at the University of Toronto, Clinician-Investigator faculty at The Hospital for Sick Children, Toronto, Ontario, Canada

11:30 - 12:00 PM

The High Utilizer Through the Lens of Suicidality

Gregory Carter, M.B.B.S. FRANZCP, PhD, Conjoint Professor in Psychiatry,School of Medicine and Public Health at the University of Newcastle, Waratah, NSW, AUS

12:00 - 1:30 PM - Lunch Break

1:30 - 2:00 PM

Neuropsychiatric Consequences of Occupational and Environmental Exposures

Mike Holland, MD, FEAPCCT, FAACT, FACOEM, FACMT, FACEP, Director of Occupational Medicine, Saratoga Hospital, Saratoga Springs, NY

2:00 - 2:30 PM

Neuropsychiatric Consequences of Military Exposures

LCDR T. Wolfgang Klotz, MD, Psychiatrist, United States Navy, San Diego, CA

2:30 - 3:00 PM

The Intersection of Forensic Toxicology & Suicide: How To Determine Death by Suicidal Intent

Steven Campman, MD, Chief Medical Examiner, San Diego County, San Diego, CA

3:00 - 4:00 PM

Panel | Global Perspective on Suicide by Self-Poisoning

Michael Eddleston, MD, Professor of Clinical Toxicology, University of Edinburgh, Edinburgh, Scotland, United Kingdom
Tharwat El Zahran, MD, Assistant Professor of Emergency Medicine and Medical Toxicology, Co-director, Toxicology Services, American University of Beirut, Beirut, Lebanon
Andrew Dawson, MD, Clinical Professor of Clinical Pharmacology and Toxicology & Central Clinical School, University of Sydney, Australia
Bruno Mégarbane, MD, Head of the Department of Medical and Toxicological Critical Care, Paris Cité University Lariboisière Hospital, Paris, France
CAPT (Dr.) Josh Schier, MD, MPH, USPHS, Chief Medical Officer, United States Public Health Service (USPHS) Commissioned Corps, Senior Medical Officer and Medical Toxicologist, Assistant Professor, Dept of Emergency Medicine, Section of Toxicology, CDC, Emory University of Medicine, Atlanta, GA

Elizabeth Ballard, PhD

Director of Psychology and Behavior Research, Predoctoral Training

Experimental Therapeutics and Pathophysiology Branch

Dr. Elizabeth Ballard is the Director of Psychology and Behavior Research and the Director of Predoctoral Training at the Experimental Therapeutics and Pathophysiology Branch in the National Institute of Mental Health.  She is trained as a clinical psychologist from the Catholic University of America and has extensive clinical experience working with suicidal patients.  She completed her predoctoral internship at the Department of Veterans Affairs Eastern Colorado Health Care System and a postdoctoral fellowship at Johns Hopkins School of Medicine. As an associate scientist, she is the Lead Associate Investigator on the Neurobiology of Suicide Protocol in the Intramural Program of the NIMH.  She has published over 95 articles and her research interests include short term risk factors for suicide and rapid acting treatments for suicidal thoughts.

Steven Campman, MD

Chief Medical Examiner

San Diego County

Dr. Campman is San Diego County’s Chief Medical Examiner.  He earned his B.S. in Biology from Loyola Marymount University in 1987; graduated from Creighton University School of Medicine in Omaha, in 1992, and then completed residency in Anatomic and Clinical Pathology at the University of California, Davis Medical Center, in 1997.  Following fellowship training in Forensic Pathology with the Northern California Forensic Pathology Group at the Sacramento County Coroner’s Office in 1998, he went to work for the US Air Force and was stationed at the Office of the Armed Forces Medical Examiner, the Armed Forces Institute of Pathology, in Washington DC, as Associate, then Deputy and Chief Deputy Medical Examiner for Medicolegal Operations and Investigations, until he went to work for the County in 2001 (later continuing to serve in the Air Force Reserve as a Regional Medical Examiner until he retired).  He is Board Certified in Anatomical/Clinical, and Forensic Pathology, and leads the Medical Examiner’s Department while continuing to regularly perform autopsies, and testify in CA Superior Court.

Gregory Carter, M.B.B.S. FRANZCP, PhD

Acting Director of Dept. Consultation Liaison Psychiatry & Conjoint Professor in Psychiatry

University of Newcastle School of Medicine and Public Health

Professor Carter is currently the Senior Staff Specialist and Acting Director of Dept. Consultation Liaison Psychiatry, Calvary Mater Newcastle Hospital, Waratah; and Conjoint Professor in Psychiatry in the College of Health, Medicine and Wellbeing, School of Medicine and Public Health, University of Newcastle. He is a Chief Investigator for the NHMRC Centre of Research Excellence in Suicide Prevention (CRESP 2.0). He is the Chair for the RANZCP for the Clinical Practice Guidelines for Deliberate Self-Harm, a member of the Presidents Suicide Advisory Committee and the RANZCP representative to the Prime Minister’s Suicide Advisory Group.

Current areas of clinical and research interest include; deliberate self-poisoning, suicide prevention, epidemiology of suicidal behaviours, delirium, screening for depression, somatisation, organ donation and psycho-oncology.


Director National Poisons Register & Clinical Toxicology

Royal Prince Alfred Hospital

Andrew Dawson is an Australian Clinical Pharmacologist and Toxicologist whose major interest is in translational clinical toxicology research to produce changes in policy and clinical practice.

He established the Australian Hunter Area Toxicology Service in Newcastle in 1987, research included interventions for deliberate self-harm, relative toxicity of drugs in overdose and prediction of toxicity.

In 2004 he moved to Sri Lanka to establish the South Asian Clinical Toxicology Research Collaboration. This group built sustainable research capacity addressing deliberate self-harm with pesticides and improved clinical practice in resource poor settings. This research contributed to policy that reduced Sri Lankan national suicide deaths by 50%

In 2010 he returned to Australia and became the Director of Clinical Toxicology Royal Prince Alfred Hospital, and the Director of the New South Wales Poison Information Centre (to 2021) at the Childrens Hospital Westmead. He is Clinical Professor Medicine, University of Sydney and Adjunct Professor School of Medicine University of NSW. Current interests include management of institutional responses to patients with challenging self-harm behaviours, substance use disorder and self-harm, evaluating the effects of regulatory changes on incidence of deliberate self-harm.

Michael Eddleston, ScD, FRCP(Edin), FBPhS, FEAPCCT, FRSE, RCPE, Cullen Gold Medalist

Professor of Clinical Toxicology

The University of Edinburgh

My work’s major aim is to reduce deaths from pesticide and plant self-poisoning in rural Asia, a cause of over 200,000 premature deaths each year and a key global means of suicide. To do this, I perform clinical trials in South Asian district hospitals to better understand the pharmacology and effectiveness of antidotes and community-based controlled trials to identify effective public health interventions. This work is complemented by translational studies of antidotes in minipig models of poisoning in a large animal critical care laboratory that I established in Edinburgh, work with sociologists and anthropologists to better under-stand the meaning of self-harm, and work with the WHO and FAO to aid implementation. I work with pesticide regulators through the Centre for Pesticide Suicide Prevention. I also perform clinical and animal research in Edinburgh to improve treatment of other forms of poisoning (such as from cyanide, alcohol, and contrast media) by developing and/or testing novel antidotes.

Tharwat El Zahran, MD

Medical Director, Assistant Professor of Emergency Medicine

American University of Beirut Medical Center

Dr. Tharwat El Zahran is an Assistant Professor of Emergency Medicine and the Medical director for the emergency department at the American University of Beirut Medical Center (AUBMC)

She completed a fellowship training in medical toxicology at Emory University and CDC, and currently co-directs the medical toxicology service at AUBMC.

Yaron Finkelstein, MD, FACMT

Professor of Pediatrics, Pharmacology and Toxicology

The Hospital for Sick Children, University of Toronto

Dr. Finkelstein is a Professor of Pediatrics, Pharmacology and Toxicology, University of Toronto and a Senior Clinician-Scientist at The Hospital for Sick Children. 

He holds the Canada Research Chair in Pediatric Drug Safety and Efficacy (Tier I). Dr. Finkelstein is triple-trained in medical toxicology, clinical pharmacology and pediatric emergency medicine. Since 2016, he has served as a “Thought Leader” for NIH’s Pediatric Trials Network, an alliance of >200 hospitals, working for drug label modifications for children at FDA. He also established and leads the ACMT Pediatric Marijuana & Opioids (PEDMOP) Toxicology Investigators Consortium (ToxIC) sub-registries.

The overarching goal of his research program focuses on optimizing therapeutics and outcomes of sick and injured children in acute care settings and prevention of accidental and intentional drug overdose and subsequent suicide, employing epidemiological, randomized clinical trials and precision tools.


Director of Occupational Medicine

Saratoga Hospital

Michael Holland is the  Director of Occupational Medicine for the Saratoga Hospital Medical Group, Saratoga Hospital Employee Health Medical Director,  Clinical Professor of Emergency Medicine at SUNY Upstate Medical University in Syracuse, NY,  Consulting Medical Toxicologist at the Upstate New York Poison Center and at the Onondaga County Medical Examiner’s Office-both in Syracuse, NY, and Principal Medical Toxicologist at the Center for Toxicology and Environmental Health (CTEH) in Little Rock, AR.  Dr. Holland has ABMS Board Certifications in Occupational Medicine, Medical Toxicology, Emergency Medicine, and Addiction Medicine.

Filza Hussain, MD

Clinical Associate Professor

Stanford University

Filza Hussain, MD, is a Clinical Associate Professor of Psychiatry at Stanford University School of Medicine. She attended medical school in Pakistan and completed her residency training at the Mayo Clinic, Minnesota and a Consultation Liaison Psychiatry fellowship at Columbia University in New York. Her clinical focus is transplant psychiatry and she serves as the liaison to the Liver and Kidney transplant programs at Stanford. Other areas of clinical/research interests include Personality disorders, Suicidology, Cultural Psychiatry, and medical pedagogy.

T. Wolfgang Klotz, MD


United States Navy

Dr. Klotz received his undergraduate degree from the University of Southern California in International Relations, his medical degree from the Uniformed Services University of the Health Sciences, and completed his residency in Psychiatry at Naval Medical Center San Diego. He is a member of the Gold Humanism and Alpha Omega Alpha honor societies. He is currently the embedded psychiatric provider for the 5th Marine Regiment in San Clemente California.

Larissa Laskowski, DO

Assistant Professor

NYU Grossman School of Medicine, NYU Langone Health, Health + Hospitals Bellevue

Larissa Laskowski is a clinical assistant professor and medical toxicologist at NYU Grossman School of Medicine, and serves as a consultant for the New York City Poison Control Center. She is also cofounder and director of The Prevention Education Partnership (PEP), an initiative dedicated to decreasing the incidence of preventable illness and injury commonly seen in the emergency department. Through PEP Talks, a harm-reduction drug education curriculum, she deploys doctors into local schools to educate middle and high school students, teachers, and parents, in an effort to keep NYC youth safe, healthy, and out of the ER. Due to the rapidly evolving threat of teen fentanyl overdose, she is currently laser-focused on ensuring that every student, teacher, and parent knows how to recognize an opioid overdose and save a life by administering naloxone. 

She currently resides in Manhattan with her husband Mike and two small children Frida and Miles.

Bruno Megarbane, MD, PhD

Head of the Department of Medical and Toxicological Critical Care

Paris Cité University Lariboisière Hospital

Bruno Mégarbane is Professor of critical care medicine at Paris University and directs a research team at INSERM UMRS-1144. He is the Head of the Department of Medical and Toxicological Critical Care at Lariboisière Hospital, Paris, France. He conducted several clinical and experimental studies in clinical toxicology.

J.J. Rasimas, MD, PhD, FAACT, FACLP, FACMT, FACPsych

Professor of Psychiatry & Emergency Medicine

University of Minnesota & Penn State College of Medicine

Dr. Rasimas attended the University of Scranton and graduated summa cum laude with degrees in biochemistry, mathematics, and philosophy. He completed the Medical Scientist Training Program at Penn State University, earning a Ph.D. in chemical biology (2002) and M.D. (2003). Upon graduation from the Penn State College of Medicine, Dr. Rasimas matriculated to psychiatry residency training at the Mayo Clinic in Rochester, Minnesota. He was a clinical fellow at the NIMH, training in consultation-liaison psychiatry, bioethics, and clinical research. Dr. Rasimas has studied psychoanalytic psychotherapy at the Minnesota Psychoanalytic Society and Institute and the Washington School of Psychiatry. He served as a C-L psychiatrist for Milton S. Hershey Medical Center and remains an Associate Professor of Psychiatry and Emergency Medicine for the Penn State College of Medicine, there. He completed the critical care based medical toxicology fellowship at Penn State, obtained board certification in addiction medicine, and then returned to NIMH to join the Undiagnosed Diseases Program and the Intramural Research Program to oversee clinical trials in mood and anxiety disorders. He is also a Fellow of the Academy of Psychosomatic Medicine and a Laughlin Fellow with membership in the American College of Psychiatrists. Dr. Rasimas is a Professor at the University of Minnesota, pursuing an academic medical career at the interface of psychosomatic medicine, medical toxicology, and psychodynamic psychotherapy with a primary clinical interest in the phenomenology of suicide. His current clinical position is the director of Consultation-Liaison Psychiatry services for the Queen Elizabeth Hospital in Charlottetown, Prince Edward Island.

Joshua Schier, MD, MPH

Chief Medical Officer

USPHS Commissioned Corps, CDC

CAPT Joshua G Schier, MD MPH was appointed the 9th Chief Professional Officer of the Medical Category of the Commissioned Corps of the U.S. Public Health Service (Corps) in November 2021. As the Chief Medical Officer, CAPT Schier provides leadership and direction for Corps medical officers and advises the Office of the Surgeon General and the Department of Health and Human Services (HHS) on recruitment, assignment, deployment, retention, and career development of Corps physicians. CAPT Schier is currently assigned to the CDC's National Center for Injury Prevention and Control (NCIPC), Division of Overdose Prevention (DOP) as a Senior Medical Officer. At CDC, he serves as a Strategy Lead for CDC’s Overdose Data to Action Program overseeing activities related to linking overdose patients to care and supporting providers and health systems across 66 states, counties, and metropolitan areas. He is the CDC/ATSDR Site Director for the joint Emory/CDC Medical Toxicology Fellowship and serves as a subject matter expert for CDC in Medical Toxicology for informing various activities related to stimulants and other drugs of abuse. CAPT Schier spent 15 years at CDC’s National Center for Environmental Health, where he oversaw national real-time surveillance activities for poisoning events via PCC data, radiation disaster preparedness activities, and provided expert clinical consultation for suspected and known domestic and international mass poisoning incidents. He served two terms on ABEM’s Medical Toxicology Sub-Board and has published more than 75 articles in peer-reviewed journals and CDC’s Morbidity and Mortality Weekly Report.

Dominic Sisti, PhD

Associate Professor, Department of Medical Ethics & Health Policy

University of Pennsylvania

Dominic Sisti, PhD, is an associate professor in the Department of Medical Ethics & Health Policy at the University of Pennsylvania. He directs the Scattergood Program for the Applied Ethics of Behavioral Health Care and holds secondary appointments in the Department of Psychiatry, where he directs the ethics curriculum in the residency program, and the Department of Philosophy. Dr. Sisti examines ethical and policy challenges in mental health care, including long-term psychiatric care for individuals with serious mental illness and clinical ethics issues in correctional settings. Sisti's research also explores ethical issues in psychedelic research and clinical application.

Registration Rates

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Early-Bird Rate*

Early-bird rates expire at midnight on FEBRUARY 16, 2023. Fees increase to the Regular Rate after this date, no exceptions.

Cancellation Policy

Cancellation Policy: Cancellations received in writing on or prior to February 16, 2023 will be refunded subject to a $150 processing fee. No refunds will be given after February 16, 2023. Please send cancellation request to ACMT at events@acmt.net.

Continuing Education

In support of improving patient care, this activity has been planned and implemented by Amedco LLC and American College of Medial Toxicology. Amedco LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Amedco Joint Accreditation #4008163.

Physicians (ACCME) Credit Designation
Amedco LLC designates this live activity for a maximum of 6.25 AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses (ANCC) Credit Designation
Amedco LLC designates this activity for a maximum of 6.25 ANCC contact hours.

Pharmacists and Pharmacy Technicians (ACPE) Credit Designation
Amedco LLC designates this activity for a maximum of 6.25 knowledge-based CPE contact hours.

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Live In-Person Event
03/30/2023 at 8:00 AM (PDT)   |  9 hours  |  Attendance Required
03/30/2023 at 8:00 AM (PDT)   |  9 hours  |  Attendance Required