Day 2: In the Laboratory | Complexities in Testing and Interpretation - 2026 ACMT Seminar in Forensic Toxicology

Day 2: In the Laboratory | Complexities in Testing and Interpretation - 2026 ACMT Seminar in Forensic Toxicology

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Overview

Created in partnership with The Center for Forensic Science Research & Education (CFSRE), Day 2 of the 2026 ACMT Seminar in Forensic Toxicology shifts the focus to the laboratory, addressing the latest challenges in toxicology testing, interpretation, and application in forensic contexts.

Highlights include:

  • Timely Principles of Analytical and Forensic Toxicology – Review the foundations of toxicology testing, its limitations, and critical preanalytical factors.
  • Illicit Opioids & Stimulants – Understand current drug trends, specialized testing protocols, and the role of toxicology in determining cause of death.
  • Quantitative Blood Concentrations in Polydrug Overdoses – Explore interpretation challenges in today’s complex clinical and forensic cases.
  • Supratherapeutic Dosing of Therapeutic Drugs – Examine forensic cases involving substances such as benzonatate, tianeptine, and loperamide.
  • Western Use of Kratom & Associated Challenges – Gain insights into detection, analysis, and interpretation pitfalls.
  • Interpretative Value of Alpha-2 Agonists – Learn about the forensic significance of xylazine, medetomidine, and related substances.
  • Alternative Matrices – Discover the potential and pitfalls of testing non-traditional samples, from breast milk to beyond.
  • Case Panels on Unexpected Tests – Apply your knowledge to unique and challenging real-world scenarios.

With faculty expertise, case-driven discussions, and updates on emerging substances, this session will enhance your ability to interpret complex toxicology results and provide clear, defensible conclusions in forensic contexts.


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Continuing Education

Live and Enduring continuing education credits for Physicians and Pharmacists is provided by AKH Inc., Advancing Knowledge in Healthcare. It is expected that learners will receive up to 6.50 credits for learning and change.


Target Audience

This seminar is designed for forensic toxicologists, clinical toxicologists, physicians, pharmacists, laboratorians, medical examiners, coroners, attorneys, and trainees who want to enhance their skills in toxicology testimony and evidence interpretation.


Learner Objectives

By the end of Day 2, participants will be able to:

  1. Identify strengths and limitations of toxicology testing and interpretation methods.
  2. Discuss challenges in interpreting results for complex and emerging substances.

Agenda | January 21, 2026


9:45 - 10:00 AM ET | Opening Remarks


10:00 - 10:30 AM ET
Timely Principles of Analytical and Forensic Toxicology
Luke N. Rodda, PhD, Chief Forensic Toxicologist and Director, Forensic Laboratory Division, Office of the Chief Medical Examiner, City and County of San Francisco


10:30 - 11:00 AM ET
Timely Principles of Medicolegal Death Investigations
James Caruso, MD, Retired Chief Medical Examiner and Forensic Pathologist, Retired Medical Officer, US Navy, Castle Rock, CO


11:00 - 11:45 AM ET

Using Quantitative Blood Concentrations to Determine cause of non-fatal overdoses in polydrug world

Paul Wax, MD, FACMT, Executive Director, American College of Medical Toxicology, Phoenix, AZ
Alex Krotulski, PhD, Director of Toxicology & Chemistry, The Center for Forensic Science Research and Education, Willow Grove, PA
Rachel Wightman, MD, FACMT, Associate Professor of Emergency Medicine and Epidemiology, The Warren Alpert Medical School of Brown University


11:45 - 12:15 PM ET | Break - 30 min


12:15 - 1:00 PM ET
Case Panel on Opioids and Stimulants

Panel
Lewis S Nelson, MD, MBA, Dean and Chief of Health Affairs, Professor of Emergency Medicine / Medical Toxicology, Schmidt College of Medicine at Florida Atlantic University
Donna Papsun, MS, D-ABFT-FT, Forensic Toxicologist & Business Scientist, NMS Labs, Horsham, PA
Luke Rodda, PhD, Chief Forensic Toxicologist and Director, Forensic Laboratory Division, Asst. Adj. Professor, Laboratory Medicine, University of California, San Francisco

Moderator 
Rachel Wightman, MD, FACMT, Associate Professor of Emergency Medicine and Epidemiology, The Warren Alpert Medical School of Brown University


1:00 - 1:45 PM ET
Current state of Illicit Opioids & Stimulants
Alex Krotulski, PhD, Associate Director of Toxicology & Chemistry, The Center for Forensic Science Research and Education, Willow Grove, PA


1:45 - 2:15 PM ET
Supratherapeutic Dosing of Therapeutic Drugs and Adverse Effects
Karen S. Scott, PhD, F-ABFT, Director, Forensic Toxicology Laboratory; Medical Director, Hospital Toxicology Laboratory; Associate Professor, Laboratory Medicine


2:15 - 2:45 PM ET
Western Use of Kratom Products and Associated Challenges
Donna Papsun, MS, D-ABFT-FT, Forensic Toxicologist & Business Scientist, NMS Labs, Horsham, PA


2:45 - 3:15 PM ET | Break - 30 min


3:15 - 3:45 PM ET
Interpretative Value of Alpha-2 Agonists in Forensic Toxicology: Xylazine and Medetomidine
Kari Midthun, PhD, F-ABFT, Forensic Toxicologist, NMS Labs


3:45 - 4:30 PM ET
Alternative Matrices: Applications and Pitfalls
Gwendolyn A. McMillin, PhD, DABCC-CC, DABCC-TC, FADLM, Vice President of Clinical Scientific Engagement, NMS Labs, Horsham, PA
Jessica Kent, MD, Medical Toxicologist, Ontario Poison Centre, Investigating Coroner - Office of the Chief Coroner (Central West Region) Adjunct Assistant Professor - Clinician-Investigator, University of Toronto


4:30 - 5:30 PM ET
Case Panels on Unexpected Tests

Panel
Gwendolyn A. McMillin, PhD, DABCC-CC, DABCC-TC, FADLM, Vice President of Clinical Scientific Engagement, NMS Labs, Horsham, PA
Luke Rodda, PhD, Chief Forensic Toxicologist and Director, Forensic Laboratory Division, Asst. Adj. Professor, Laboratory Medicine, University of California, San Francisco

Moderator
Donna Papsun, MS, D-ABFT-FT, Forensic Toxicologist & Business Scientist, NMS Labs, Horsham, PA

Registration Rates

Registration includes:

  • Access to the live virtual event on January 21, 2026
  • Access to the on-demand recording for 90 days after event
  • Access to the Speaker slides
  • 6.50 Continuing Education Certificate. Available credits: Continuing Medical Education (CME) & Continuing Pharmacy Education (CPE).

Member Rates


     Member Tier I: Full, Affiliate, International, Emeritus


     $300


     Member Tier II: Fellows


     $175


     Member Tier III: Residents, International - Developing Country


     $150


     Member IV: Medical Students


     $125

Non-Member Rates


     Non-member Tier I: Physicians, Pharmacists, Lawyers, "Other"


     $375


     Non-member Tier II: Fellows, SPIs, Nurses, etc.


     $250


     Non-member Tier III: Educators & Emergency Responders


     $225


     Non-member IV: Residents & Students


     $200

Interested in becoming an ACMT Member? Contact our Membership Team at membership@acmt.net. Learn more at: www.acmt.net/membership


Package Rates

Sign up for the both days of the 2026 ACMT Seminar in Forensic Toxicology and save $50!

Purchase the package here!


Refunds and Cancellations

  • Cancellations made 16 days or more in advance of the event date will receive a full refund less a 8% processing fee.
  • Cancellations made within 15 days of the event date will not receive a refund.

All cancellation requests must be made in writing and emailed to: events@acmt.net. No telephone cancellations will be accepted. A refund that results from a cancellation or change to your registration will be returned to the original payer and in the original method of payment. 

Pending review, limited exceptions will be made based on need and circumstance (family emergency, for example) and must be submitted in writing to events@acmt.net. For these instances, the full registration fee, minus a 6% processing fee, will be refunded. Because each exception must undergo a review and approval process, we ask in advance for your patience.


Questions?

For any questions, please email us at events@acmt.net.

James Caruso, MD

Retired Chief Medical Examiner and Forensic Pathologist

Retired Medical Officer, US Navy

James Caruso, MD is the recently retired Chief Medical Examiner and Forensic Pathologist for the City and County of Denver. He is also a retired United States Navy Medical Officer and former Armed Forces Medical Examiner. Captain Caruso served nearly 30 years in roles spanning shipboard medicine, diving and submarine medicine, aviation medicine, pathology, and forensic pathology. During his Navy career, he was a Diving Medical Officer with the Explosive Ordnance Disposal Unit, completed a residency in Anatomic and Clinical Pathology and a fellowship in Diving and Hyperbaric Medicine at Duke University Medical Center, and trained in forensic pathology at the Office of the Maryland Chief Medical Examiner.

Dr. Caruso has personally performed more than 5,000 autopsies and supervised countless others, working in environments ranging from military hospitals to combat zones. His notable cases include the investigation of the Space Shuttle Columbia disaster and the autopsy of Pat Tillman. Widely published in forensic pathology and diving medicine, Dr. Caruso has contributed numerous scientific papers and book chapters throughout his career. He now resides in Castle Rock, Colorado, and works as a Forensic Pathologist in Colorado and California.

Rachel Culbreth, PhD, MPH

ToxIC Research Director

American College of Medical Toxicology

Dr. Culbreth joined the Toxicology Investigators Consortium/ACMT in May 2022. She received her PhD and MPH in epidemiology and biostatistics from Georgia State University. Her dissertation focused on the development of novel statistical methods to measure current and amount of substance use in a hybrid structural equation mixture model framework. She was an Assistant Professor in the College of Nursing and Health Professions at Georgia State University from 2019-2022, where she taught undergraduate and graduate-level research methods, healthcare leadership, and advanced statistical topics for pre-doctoral students. As ToxIC's Research Director, she leads new grant development and scientific dissemination through manuscripts and presentations, and enjoys working closely with clinical colleagues to advance medical toxicology research and practice.

Jessica Kent, MD, MClSc

Medical Toxicologist; Emergency Medicine Physician; Investigating Coroner

Unity Health - St. Michael's Hospital, Ontario Poison Centre, Office of the Chief Coroner (North Peel), University of Toronto

Dr. Jessica Kent-Rice is an Emergency Physician and Medical Toxicologist at St. Michael’s Hospital and the Ontario Poison Centre in Toronto, an Investigating Coroner for North Peel and an Adjunct Assistant Professor – Clinician Investigator in the Department of Medicine at the University of Toronto. She completed her Emergency Medicine residency and Clinical Pharmacology & Toxicology fellowship at the University of Toronto.

Dr. Kent-Rice’s work lies at the intersection of acute care, toxicology, and forensic medicine. Her academic and clinical interests include preventable drug-related deaths, the forensic applications of clinical pharmacology, and the use of toxicovigilance to inform public health and policy.

Alex Krotulski, PhD (Moderator)

Associate Director of Toxicology & Chemistry

The Center for Forensic Science Research and Education

Dr. Alex J. Krotulski serves as a Director at the Center for Forensic Science Research and Education (CFSRE) working in the areas of forensic toxicology and forensic chemistry and is the Program Manager for NPS Discovery, the CFSRE’s drug early warning system and flagship program for the identification and characterization of new and emerging synthetic drugs. Dr. Krotulski is a chemist by training and practices as a forensic toxicologist. Dr. Krotulski holds faculty appointment and serves as the Program Director for the Thomas Jefferson University Master of Science in Forensic Toxicology (MSFT) program and is an Senior Associate Editor for the Journal of Analytical Toxicology.

Gwendolyn A. McMillin, PhD, DABCC-CC, DABCC-TC, FADLM

Vice President of Clinical Scientific Engagement

NMS Labs

Dr. Gwendolyn A. McMillin is the Vice President of Clinical Scientific Engagement at NMS Labs in Horsham, Pennsylvania. She is board-certified by the American Board of Clinical Chemistry in both Clinical Chemistry and Toxicological Chemistry. Before joining NMS Labs, Dr. McMillin spent over two decades at ARUP Laboratories and the University of Utah School of Medicine, where she served as Medical Director of Clinical Toxicology and Pharmacogenomics, Scientific Director of Mass Spectrometry, and Professor (Clinical) of Pathology.

Dr. McMillin’s research focuses on pharmacogenomics, newborn drug exposure, and analytical method development. She has received multiple awards for her contributions to laboratory medicine, including the Ellis Benson Young Investigator Award from the Academy of Clinical Laboratory Physicians and Scientists and the Past Chair Award from the TDM and Toxicology Division of the American Association for Clinical Chemistry (now ADLM).

Kari Midthun, PhD, F-ABFT

Forensic Toxicologist

NMS Labs

Kari Midthun, PhD is a Forensic Toxicologist at NMS Labs with experience spanning academia, government, and industry at the intersection of biology and chemistry. She previously served as Assistant Laboratory Director at United States Drug Testing Laboratories and as a Forensic Scientist with the New York State Police. Dr. Midthun earned her PhD and MS in Chemistry and Chemical Biology from Cornell University, where she was a National Science Foundation IGERT Fellow. Her professional background includes forensic science, chemistry, nanotechnology, chemical safety, and education, and she brings expertise in laboratory leadership, analytical methods, and applied forensic toxicology.

Lewis S. Nelson, MD, MBA

Dean and Chief of Health Affairs | Professor of Emergency Medicine / Medical Toxicology

Schmidt College of Medicine at Florida Atlantic University

Lewis S. Nelson, MD, MBA, is Dean and Chief of Health Affairs at Florida Atlantic University’s Charles E. Schmidt College of Medicine. A nationally recognized leader in emergency medicine, medical toxicology, and addiction medicine, Dr. Nelson brings over three decades of experience in clinical care, education, and academic leadership. Prior to joining FAU in 2025, he served as Professor and founding Chair of Emergency Medicine at Rutgers New Jersey Medical School, where he also led the Division of Medical Toxicology and Addiction Medicine and served as Chief of Service for the Emergency Department at University Hospital of Newark.

Dr. Nelson has held numerous national leadership positions, including President of the American College of Medical Toxicology and the Association of Academic Chairs in Emergency Medicine, and board roles with the American Board of Emergency Medicine, the Accreditation Council for Continuing Medical Education, and the Society for Academic Emergency Medicine. A prolific scholar, he has authored more than 300 peer-reviewed publications and serves as lead editor of Goldfrank’s Toxicologic Emergencies, the definitive reference in medical toxicology. His work focuses on emergency medicine, toxicology, addiction medicine, and health policy, with an emphasis on improving patient safety and advancing evidence-based care.

Donna Papsun, MS, D-ABFT-FT

Forensic Toxicologist & Business Scientist

NMS Labs

Donna Papsun is a forensic toxicologist and business scientist with NMS Labs in Horsham, PA. She has dual Bachelor of Science degrees in Chemistry and Forensic & Investigative Science and a Master of Science degree in Pharmacology. She is also certified as a Diplomate in Forensic Toxicology through the American Board of Forensic Toxicology and is a member of both the Society of Forensic Toxicologists (SOFT) and the American Academy of Forensic Sciences (AAFS). 

Ms. Papsun has been with NMS Labs since 2008, first as a bench analyst before promotion to toxicologist in 2012. Ms. Papsun’s main area of interest is novel psychoactive substances or NPS. As one of the two leaders of NMS’s NPS strategy team, she continuously works to help maintain NMS’s leadership in identifying the newest trends in the changing landscape of the designer drug market and developing tests for their detection in forensic toxicology casework. Ms. Papsun also serves in a secondary role as a business scientist, working to align the technical and scientific expertise of NMS Labs with commercial efforts.

Luke Rodda, PhD

Chief Forensic Toxicologist and Director

Office of the Chief Medical Examiner, City and County of San Francisco

Dr. Rodda is the Chief Forensic Toxicologist and Director of the Forensic Laboratory Division at the San Francisco Office of the Chief Medical Examiner with 20 years of experience in drug detection and interpretation. He also holds the position of Assistant Adjunct Professor position at the University of California, San Francisco. Dr. Rodda is an ANSI National Accreditation Board certified Forensic Technical Assessor and ABFT Accreditation Assessor. He is a member of, and holds positions, in numerous state, national and international professional societies, including President of the California Association of Crime Laboratory Directors, and Past-President of the California Association of Toxicologist, TIAFT Bulletin Co-Editor and SOFT Postmortem committee Vice Chair. As an invited California state Drug-Impaired Driving Taskforce member, member of Sexual Assault Response and Preventions groups, and national and regional drug death expert groups, he actively promotes drug harm reduction in impaired driver, sexual assault, and decedent casework within the community. Dr. Rodda has authored over 50 published articles and book chapters, over 100 scientific abstracts, whilst also having reviewer and editorial board commitments. He is also the host for the upcoming 2026 SOFT-TIAFT joint annual meeting.

Karen S. Scott, PhD, F-ABFT

Director; Medical Director

Forensic Toxicology Laboratory; Hospital Toxicology Laboratory; University of Alabama at Birmingham

Karen S. Scott, PhD is Associate Professor and Director of the Clinical and Forensic Toxicology Laboratories at the University of Alabama at Birmingham, with more than 30 years of experience in forensic toxicology. She earned her PhD from the University of Glasgow, where she trained in postmortem toxicology alongside forensic pathologists, and later completed a postdoctoral fellowship at Japan’s National Institute of Health Sciences focusing on drug detection in hair. Dr. Scott has held leadership roles in both academia and forensic laboratories, including directing the MSFS program at Arcadia University and the Master’s in Forensic Toxicology program at Glasgow. She currently serves on the executive board of the National Safety Council’s Alcohol, Drugs, and Impairment Division, the editorial board of Clarke’s Analysis of Drugs and Poisons, and the OSAC Forensic Toxicology Subcommittee. In 2025, she received the Outstanding Service to Council of Forensic Scientists (COFSE) Award in recognition of her contributions to the field.

Paul M. Wax, MD, DFACMT

Executive Director

American College of Medical Toxicology (ACMT)

Dr. Wax is the Executive Director of the American College of Medical Toxicology. He received his B.A from Dartmouth College, his M.D. from the Mount Sinai School of Medicine, his Emergency Medicine training at the UCLA Hospitals, and his Medical Toxicology training at Bellevue Medicine Center / New York University. He is Board-certified in both Medical Toxicology and Emergency Medicine, and is a Fellow of the American College of Medical Toxicology.

Rachel Wightman, MD, FACMT

Associate Professor of Emergency Medicine and Epidemiology

The Warren Alpert Medical School of Brown University

Dr. Rachel Wightman is an Associate Professor of Emergency Medicine and Epidemiology at Alpert Medical School of Brown University. Trained in Emergency Medicine and Medical Toxicology at Bellevue Hospital, New York University, New York City Poison Control Center Dr. Wightman currently serves as the Director of Toxicology and Addiction Medicine for Brown Emergency Medicine and is a Consultant Medical Director at the Rhode Island Department of Health. She is a NIH-funded Principal Investigator focused on cannabis and opioid use.

Continuing Education

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2026 ACMT Seminar in Forensic Toxicology | Day 2: In the Laboratory | Complexities in Testing and Interpretation
Please claim your continuing education credits within 30 days of the live event: January 21, 2026

CE credit provided by AKH Inc., Advancing Knowledge in Healthcare. 

Activity Overview

A live-in-person format fosters interactive learning, expert-led discussions, and hands-on application of toxicological principles,
enhancing comprehension, engagement, and practical skills to achieve desired outcomes.


Target Audience
This activity is designed for an audience of: physicians and pharmacists


Learning Objectives
Upon completion of the educational activity, participants should be able to:


● Examine core principles of toxicology to both courtroom and laboratory settings.
● Communicate toxicology findings clearly and effectively in medical-legal contexts.
● Develop effective strategies for expert testimony and consultation by integrating scientific principles, case analysis, and best practices in forensic toxicology.


Criteria for Success
Certificates of completion will be awarded based on the participant's attendance. A certificate of completion will be available
upon completion of an online evaluation/claim credit form available at:

Please claim your credit by February 21, 2026

If you have questions about this CE activity, please contact AKH Inc at bethany@akhcme.com


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In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare 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.

This activity was planned by and for the healthcare team, and learners will receive 6.50 Interprofessional Continuing Education (IPCE) credit for learning and change. 


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Physicians: AKH Inc., Advancing Knowledge in Healthcare designates this live activity for a maximum of 6.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Pharmacists: AKH Inc., Advancing Knowledge in Healthcare designates this continuing education activity for 6.50 contact hours.



h3>Instructions

Once you have completed your registration:

  1. Click on the Contents tab on the day of live event. This is where you will be able view the Zoom link for the course as well as all required components.
  2. Watch live event. You can use the Zoom link in the Learning Center to leave and enter the webinar during event.
  3. Complete the Event CE Survey. If you are completing CE, this survey is required.
  4. Claim your CE certificate. Once you have claimed your CE credit, you will not be able to change your CE certificate.

Full credit can only be claimed after completion of all required components.


Hardware/Software Requirements

Computer or Other Internet-Enabled Device; Internet Connection; Browser. 

Materials

None. 

Prerequisites

None. 

Format

This event is a live Webinar.


Need Assistance or Have Questions?

For assistance logging in, accessing content, purchasing or completing Continuing Education credits, or for other questions, please contact us at events@acmt.net or visit our FAQ page.

If you are in need of accessible learning accommodations, please contact events@acmt.net for additional assistance.

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2026 Seminar in Forensic Toxicology - Zoom Link Day 2
01/21/2026 at 9:40 AM (EST)  |  470 minutes
01/21/2026 at 9:40 AM (EST)  |  470 minutes
CE and Event Survey
35 Questions
35 Questions Please complete this survey to access your CE certificate.
Continuing Education & Attendance Certificate
Up to 6.50 medical credits available  |  Certificate available
Up to 6.50 medical credits available  |  Certificate available
On-Demand Recordings
Recordings will be available after the Event!
Recordings of the sessions will be available 5-6 days after the event.
Timely Principles of Analytical and Forensic Toxicology
Recorded 01/21/2026  |  31 minutes
Recorded 01/21/2026  |  31 minutes
Timely Principles of Medicolegal Death Investigations
Recorded 01/21/2026  |  24 minutes
Recorded 01/21/2026  |  24 minutes
Using Quantitative Blood Concentrations to Determine Cause of Non-fatal Overdoses in a Polydrug World
Recorded 01/21/2026  |  45 minutes
Recorded 01/21/2026  |  45 minutes
Case Panel on Opioids and Stimulants
Recorded 01/21/2026  |  43 minutes
Recorded 01/21/2026  |  43 minutes
Current state of Illicit Opioids & Stimulants
Recorded 01/21/2026  |  49 minutes
Recorded 01/21/2026  |  49 minutes
Supratherapeutic Dosing of Therapeutic Drugs and Adverse Effects
Recorded 01/21/2026  |  27 minutes
Recorded 01/21/2026  |  27 minutes
Western Use of Kratom Products and Associated Challenges
Recorded 01/21/2026  |  28 minutes
Recorded 01/21/2026  |  28 minutes
Interpretative Value of Alpha-2 Agonists in Forensic Toxicology: Xylazine and Medetomidine
Recorded 01/21/2026  |  33 minutes
Recorded 01/21/2026  |  33 minutes
Alternative Matrices: Applications and Pitfalls
Recorded 01/21/2026  |  44 minutes
Recorded 01/21/2026  |  44 minutes
Case Panels on Unexpected Tests
Recorded 01/21/2026  |  55 minutes
Recorded 01/21/2026  |  55 minutes