Addiction Toxicology Case Conference - March 2026

Addiction Toxicology Case Conference - March 2026

Recorded On: 03/13/2026

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DIY Microdosing: An Update on Low Dose Initiation in Different Situations where Resources May be Limited

Friday, March 13, 2026

1:00-2:00pm ET

Case 1: A prisoner with cocaine washout and mild fentanyl dependence

Case 2: Do we have any options here?  Missed methadone induction, lost inpatient bed, (& detox full), homeless and desperate –fentanyl use few hours prior, approx. 80 mg  methadone about 12-16 hours before… Sent to ED from referral center. 

Case 3: 

Leveraging reduced bioavailability (‘the Wiegand approach’) or when you don’t have the doses you would normally use and can’t cut the films…


Learning Objectives

1. Describe the difference between a ‘rapid’ low dose initiation and a standard low dose initiation (which often has full agonist concomitantly administered) and what clinical scenario each would be best in.


2. Describe what “leveraging reduced bioavailability” means in terms of low dose initiation of buprenorphine.


About The Series: The ACMT/ASAM Addiction Toxicology Case Conference webinar series discusses Addiction/Toxicology cases in an interactive fashion featuring experts from Addiction Medicine, Addiction Psychiatry, and Medical Toxicology.

This webinar is free and open to the public.

Timothy J. Wiegand, MD, FACMT, DFASAM (Moderator)

Director and CEO, Toxicology Consulting

Medicine, Addiction Toxicology Consulting PLLC, ASAM President Elect (2025-2027)

Dr. Tim Wiegand is the Director of Toxicology Consults and President of CMO Medicine and Toxicology & Addiction Consulting. Board-certified in both Medical Toxicology and Addiction Medicine, Dr. Wiegand specializes in Addiction Toxicology, combining clinical practice with research, teaching, and leadership roles. He has served two terms on the Board of Directors for the American College of Medical Toxicology (ACMT) and is currently on the Board of Directors for the American Society of Addiction Medicine (ASAM). From 2023-2025, he served as Treasurer of ASAM, having previously served as Vice President on the Executive Council. From 2025-2027, Dr. Wiegand will serve as ASAM President Elect and then ASAM President (2027-2029). Dr. Wiegand founded and led the Toxicology Service at URMC until 2022, when he transitioned to Director of Addiction Medicine and Director of Addiction Medicine Consults in the Department of Emergency Medicine. He also serves as Fellowship Director for the URMC Combined Addiction Medicine Fellowship and is leading efforts to launch the URMC Medical Toxicology Fellowship, which is expected to be formally accredited by July 2023.

Gloria Baciewicz, MD (Moderator)

Addiction Psychiatrist

Strong Recovery

Since 1986, Dr. Gloria Baciewicz has specialized in the treatment of addiction. Professor of clinical psychiatry at the University of Rochester Medical Center, she serves as an addiction psychiatrist at Strong Recovery. Dr. Baciewicz is certified in addiction medicine by the American Board of Preventive Medicine and board certified in psychiatry, with added qualifications in addiction psychiatry. Dr. Baciewicz is a co-principal investigator for the University of Rochester’s Recovery Center of Excellence.

Robert "Cole" Pueringer, MD

Medical Toxicologist, Addiction Medicine Specialist, Hospitalist

Essentia Health in Duluth

Dr. Robert “Cole” Pueringer is a Medical Toxicologist, Addiction Medicine Specialist, and Hospitalist. He joined Essentia Health in September of 2022. He completed his medical training in the Twin Cities, including Medical School at the University of Minnesota, Internal Medicine Residency and Chief Resident year at Hennepin County Medical Center (HCMC). He received his CTropMed certification for Tropical Medicine & Travelers’ Health at the University of Minnesota. He then completed a Medical Toxicology fellowship at the Health Partners Institute/HCMC in 2021 and an Addiction Medicine fellowship at the University of Minnesota in 2022. His academic interests include medical education, Global Health, and the overlap of Medical Toxicology and Addiction Medicine. He is particularly passionate about substance use disorder - a disease that has affected many aspects of his own life – and hopes to contribute significantly to substance use treatment, education, de-stigmatization, and harm reduction in northern Minnesota.

Mayank Gupta, MD

Emergency Medicine and Assistant Professor, University of Rochester Medical Center

Dr. Mayank Gupta is based in University of Rochester Medical Center in Rochester, NY, specializing in Emergency Medicine with a subspecialty in Medical Toxicology. He completed his medical degree at Michigan State University College of Human Medicine in 2020, followed by a residency in Emergency Medicine at Corewell Health William Beaumont University Hospital from 2020 to 2023. He completed his Medical Toxicology fellowship at Emory University School of Medicine from 2023 to 2025.

Bryan Ross

MD

University Hospitals Cleveland Medical Center.

Dr. Bryan Ross is an Emergency Medicine specialist and a Psychiatrist in Cleveland, Ohio at University Hospitals Cleveland Medical Center. He received his Medical Degree from University of Toledo College of Medicine, completed his Emergency Medicine Residency at the Hospital of the University of Rochester Medical Center and completed his Fellowship in Medical Toxicology at Indiana University Hospital. 

Andrew King, MD

Associate Professor in the Department of Emergency Medicine & Medical Director

Wayne State University School of Medicine & Michigan Poison and Drug Information Center

Dr. King is an Emergency medicine physician, Medical Toxicologist and Addiction Medicine specialist at the Detroit Medical Center and Wayne State University. He works as an emergency physician at Sinai Grace and Detroit Receiving Hospitals. He additionally works at the Tolan Park Research Center where he sees patients with substance use disorders. He is the interim director of the Michigan Poison and Drug Information Center and the Fellowship Director of the Medical Toxicology Fellowship. He is excited to be an organizer and presenter at the Total Tox Course!

David K Carroll, MD

Medical Toxicologist

Michigan Poison and Drug Information Center

Dr. David Carroll is a Medical Toxicologist at Michigan Poison and Drug Information Center and Assistant Professor of Emergency Medicine, Wayne State University SOM. 

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