Ameritox Investments in Testing Capabilities Gives Doctors New Insights into Flakka and Kratom

Today AmeritoxSM, a national leader in medication monitoring solutions, announced it is offering tests for two dangerous street drugs, flakka and kratom. The additions are in response to reports from clinicians and state and federal law enforcement about the potential for abuse of these two substances among those who misuse or abuse prescription drugs.

“We determine the need for a new test by regularly speaking with the physicians we serve – finding out what they’re hearing and seeing in their communities,” said Ameritox Chief Medical Officer, Dr. Tom Smith. “We also monitor DEA notices and law enforcement alerts about dangerous new drugs. We added flakka and kratom to our testing options because they’re a growing concern for the patients our clinicians care for.”

Flakka, made from a chemical compound called alpha-PVP, is a cousin of the amphetamine-like drug found in bath salts. It is classified as an “upper,” and can induce hallucinations and even death. Kratom is derived from a tree found in parts of Southeast Asia. Its primary chemical compounds, mitragynine and 7-hydroxymitragynine, have been shown to reduce pain by activating opioid receptors in the brain.1

“Candidly, flakka and kratom are still relatively new street drugs, the effects of which aren’t completely understood,” Smith said. “The benefit of knowing whether patients are using these drugs will help protect them from potential tragedy.”

When alerted that ‘new’ drugs are being abused, Ameritox obtains a “reference standard,” or a laboratory-made, pure sample of the drug, to use as a baseline for measurement in patients participating in urine drug monitoring. From there, the Ameritox laboratory equipment is calibrated to be able to test for the new drug.

“Research and development at Ameritox is deeply important,” said CEO Scott Walton, “because what we learn helps to keep doctors informed, and potentially save the lives of the patients we serve.”

Ameritox: Ingenuity Health Releases Updated Data Revealing Persistent Problem of Medication Non-adherence Among Those with Serious Mental Illness

AmeritoxSM, a national leader in medication monitoring solutions, today announced updated research reaffirming the problem of medication non-adherence among patients prescribed antipsychotic drugs to treat diagnosed Serious Mental Illness (SMI). The study reveals that nearly 25 percent of patient samples tested negative for the prescribed medication.

“Medication non-adherence among those with SMI can create significant hardship. These patients have increased risk for substance use disorders and negative clinical outcomes such as an increased number of hospital visits and longer stays,” said Ameritox Chief Executive Officer Scott Walton.

“While our latest research unfortunately confirms a continuing trend, it also reveals a new worry for clinicians – misuse and abuse of benzodiazepines and non-prescribed antipsychotic drugs among those with SMI,” said Ameritox Chief Medical Officer Thomas Smith, MD.

The study showed that 7.3 percent of samples that tested negative for the prescribed antipsychotic and 5.3 percent of samples that tested positive for the prescribed antipsychotic also contained the presence of a benzodiazepine, such as brand names Xanax®, Valium®, or Ativan®. A non-prescribed antipsychotic medication was found in 6.7 percent of samples.

“Given the documented harmful effects of drug interactions among benzodiazepines and antipsychotics, misusing or abusing these drugs at the same time can be life-threatening,” Smith said.

Ameritox conducted its first behavioral health population study in the fall of 2014, with 7,700 patient samples comprising its universe of data. The updated research is based on more than 62,000 samples.

The Ameritox Medical Affairs team this week presented this research in the form of a medical poster titled “Urine Drug Monitoring in Patients on Prescribed Antipsychotic Medications” to the U.S. Psychiatric and Mental Health Congress, held in San Antonio, Texas. For more information on this conference, please visit:

Ameritox’s Ingenuity Health Announces Research Study from UCLA Center for Health Services and Society

Ingenuity Health, a leading provider of medication monitoring solutions to behavioral health clinicians and a service of AmeritoxSM, today announced it has commissioned a research study by the UCLA Center for Health Services and Society that will help establish the first clinical guidelines for the use of urine drug monitoring among behavioral health patients who have been diagnosed with a serious mental illness. The research for the study has been completed, and the analysis is forthcoming.

“Using urine drug monitoring is still a very new concept in behavioral health, and this study will give us a solid understanding of how clinicians are utilizing it now, and how it’s helping those same clinicians in treating their patients,” said Ameritox Chief Medical Officer Thomas Smith, MD.

The UCLA Center for Health Services and Society was selected for their expertise in enhancing the health of communities; access to and quality of care; and qualitative research. All Center publications undergo a rigorous peer review process to verify the accuracy of findings and to gauge their relevance and utility to intended audiences.

The research findings will be announced by both Ameritox and the UCLA Center for Health Policy Research. Please visit for more information about this research institution.

About Ingenuity Health
As part of AmeritoxSM, a national leader in medication monitoring solutions, Ingenuity Health utilizes urine drug monitoring to provide highly reliable data and analysis that helps doctors and behavioral health specialists better treat patients diagnosed with serious mental illness.

Visit the Ingenuity Health website at:  
Follow Ingenuity Health on Twitter:

Ameritox: National Public Health Emergency Declaration for Opioid Epidemic Important Step to Halting Crisis

Ameritox, a national leader in medication monitoring solutions for patients prescribed opioids and other medications for chronic pain and severe mental illness, today applauded the declaration of the opioid crisis as a national public health emergency by President Donald J. Trump. Ameritox has long advocated for dedication of additional attention and resources toward the opioid epidemic – the largest man-made epidemic in history.

“The patients Ameritox serves are not often connected to the opioid epidemic, in part because their clinicians utilize medication monitoring to help identify if a patient is headed down a dangerous path,” said Todd Gardner, Chief Executive Officer of Ameritox. “This declaration will help equip all who are fighting the opioid epidemic with the additional tools they need to claim control – medication monitoring can and should be one of those tools,” Gardner said. “Appropriate prescribing with monitoring and intervention can help stop the epidemic, and will improve clinical outcomes and lower costs.”

Ameritox and Gardner recently sent a letter to the Chairman and Vice-Chairman of the United States House of Representatives Committee on Energy and Commerce in support of Jessie’s Law, legislation aimed at spurring important conversations about opioid addiction among clinicians and patients, which was passed by the U.S. Senate and awaits action in the House. A copy of that letter can be viewed here:

Ameritox Study on ADHD Medication Behavior in Adolescents Reveals Which Drug is More Likely to be Misused or Diverted

Ingenuity Health, a leading provider of medication monitoring solutions to behavioral health clinicians and a service of AmeritoxSM, today released research showing that patients between the ages of 6 and 25 who are prescribed medication to treat Attention Deficit Hyperactivity Disorder (ADHD) were more likely to test negative for a prescribed amphetamine medication than a prescribed methylphenidate.

More than 35 percent of patients tested negative for a prescribed amphetamine, compared with just over 26 percent of those who tested negative for prescribed methylphenidate. The research outcomes are based on urine samples collected from patients over a 16-month period.  

“Our research confirmed the ongoing problem of adolescents not taking their prescribed ADHD medication properly with almost 33 percent of the patients testing negative for the prescribed medication,” said Ameritox Chief Medical Officer Thomas Smith, MD.  “Interestingly, the study also suggests that the amphetamine drugs are more likely to be misused or diverted than methylphenidate.”

“One hypothesis in the treating community is that amphetamine– a drug which is highly effective for ADHD – is also more likely to be diverted to the street or shared with friends,” Smith continued. “While our study does not provide proof that this is the case, it does support the hypothesis.”

“When we begin a study, we seek to either confirm or deny a broad trend within medical research, but we also want to dive down into sub-trends that will help the doctors we serve to better understand their patients, and protect them from dangerous behavior,” said Scott Walton, Ameritox CEO. “This research shows our commitment to isolating the troubling behavior that can lead to poor patient outcomes and potential human tragedy, and to providing clinicians the added knowledge to help prevent it.”

The Ameritox Medical Affairs team this week presented this research in the form of a medical poster titled “Medication Adherence in Pediatric and Young Adult Patients Prescribed ADHD Stimulant Medications” to the American Academy of Child and Adolescent Psychiatry conference, held in New York. For more information on this conference, please visit:

18-year-old son died of overdose, Grieving mother pushing Oxy ban

A Story By A Grieving Mother Who Lost Her Son to Prescription Pain Medication Abuse

Until it hits home in your own family, headlines like these will not affect you. It will be somebody else’s child, not your own; it doesn’t affect you. You can put down people like that, thinking they may be the scum of the earth, not even realizing that some of those children started off like your own kids. Just living their life, going to school, thinking about college and their careers. Then the tragedy of addiction hits the family.

 It may have been a legitimate pain issue, they may have had surgeries young and pain issues that seemed beyond control. You as a parent may have questioned the expensive upscale doctor, voicing aloud to him your concerns. “Why such high pain killers so soon? Aren’t morphine patches something given to hospice patients? Will my child still need these medications if they have surgery?”

He immediately tried to pacify you, “It isn’t addictive, and it is something they can take their whole life through if necessary.”

You weren’t convinced, yet who were you? Did you have as many degrees as this doctor? Isn’t he noted in the community for his work? Didn’t he say he’d do the same treatment for his own daughter or son if in your shoes? It wasn’t long before the teen that was in pain was of legal age to continue with the doctor without your consent. And sooner than later the things you were concerned with came about. That is why we have painkiller abuse in our society. I don’t have to name names; there are legions in our State and country that were writing prescriptions at that time, with no concern for the long-term outcome, which in most cases was addiction.  

Prescription medicine addiction is a real dilemma in our society and it isn’t getting any easier to decide who is right and who is wrong. Of course, I can understand when someone is in dire need of medications that they shouldn’t be denied. I am not against doctors who truly must help those who suffer with chronic pain; I am all for good medical care. Yet the utmost scrutiny should be given to doctors that write painkiller prescriptions, too many, too soon. Look at the recent celebrity deaths and the doctors that were a part of each one! We have become such a drugged-up nation; sometimes I wonder if anyone knows real people anymore or are they just someone either doped up or a facade of that person you used to know and love?

Addiction itself has been described as cunning, baffling, and powerful by AA and Al-Anon groupsThat means to me that the person becomes so cunning in taking care of their addiction that it is second nature to them to use any form of manipulation to get their source of relief. It baffles the ordinary person to find this such a powerful influence in our loved one. The person you once knew and loved seems to be gone from you forever and you can only hand the problem over to a loving God who alone can bring help for the true pain; the pain that painkillers will never cover.

Try not to judge harshly; statistics say addiction hits all families and social-economic groups before long.  You wouldn’t want to walk a mile in the shoes or the grieving mother or father, rehash in your mind what you could’ve or should’ve done, or be in the body of the addict who became addicted following doctor’s orders. And then we have the issues of people being released from the hospital or mental health wards, who have been on high doses of medications that they are unable to continue on without several appointments at the  psychiatrist’s office; their body may be jerking with tremors, but they can’t get in right away for medications. It’s all a sad dilemma. 

Urine Drug Testing for Synthetic Marijuana Cannabinoids

What are synthetic cannabinoids?
Synthetic Cannabinoids, a class of designer drugs, are available in head shops, tobacco stores, and over the Internet under a variety of names, such as, “K2”, “Spice”, “Tucatan Fire”, “Skunk”, “Moon Rocks”, “Black Mamba”, and “Bombay Blue”. They are often labeled “not for human consumption” and common routes of administration include inhalation and oral ingestion.1

Regular users of Synthetic Cannabinoids may experience withdrawal and addiction symptoms.2 Tolerance to these agents may develop rapidly, which might be associated with dependence.3 The compounds are stored in the body for a long period of time and long-term effects on humans are not known.1

In 2010, the American Association of Poison Control Centers received 2,906 calls related to synthetic cannabinoids. In 2011, the number of calls received increased to 6,959.4 On July 9, 2012, President Obama signed into law the Synthetic Drug Abuse Prevention Act banning synthetic compounds commonly found in synthetic marijuana, by placing them under Schedule I of the Controlled Substance Act.   5

Synthetic Marijuana and Drug Testing – Why Monitor?
Ameritox provides quantitative K2/Spice urine drug testing results for 15 of the most common synthetic cannabinoid compounds:

  • AKB48 5-Hydroxypentyl
  • AKB48 Pentanoic acid
  • AM2201 4-Hydroxypentyl
  • BB-22 3-Carboxyindole
  • JWH 018 Pentanoic acid
  • JWH 073 Butanoic acid
  • JWH 122 5-Hydroxypentyl
  • MAM 2201 4-Hydroxypentyl
  • PB-22 3-Carboxyindole
  • PB-22 Pentanoic acid
  • UR-144 5-Hydroxypentyl
  • UR-144 Pentanoic acid
  • XLR11 4-Hydroxypentyl

As of July 2012, these synthetic cannabinoids have been placed into Schedule 1 by the DEA, as “necessary to avoid imminent hazard to the public safety” due to high abuse potential and lack of medical use.1

Reported psychological effects of synthetic marijuana use2,6:

  • Paranoia
  • Panic attacks
  • Giddiness
  • Psychotic episodes
  • Hallucinations
  • Elevated mood
  • Relaxation
  • Altered perception

Reported physiologic of synthetic marijuana use2,6:

  • Tremor
  • Seizures
  • Nausea
  • Vomiting
  • Increased heart rate
  • Increased blood pressure
  • Mycardial ischemia
  • Heart attack

US Department of Justice, Drug Enforcement Administration 2011 Drugs of Abuse Resource Guide.
2 National Institute of Health, National Institute of Drug Abuse (2012, May). DrugFacts: Spice (Synthetic Marijuana).
Vardakou, I., Pistos, C., & Spiliopoulou, C. (2010). Spice drug as a new trend mode of action, identification and legislation. Toxicology Letter, 197, 157-162.
American Association of Poison Control Centers, Synthetic Drugs Data and Fact Sheets, Bath Salts and Synthetic Marijuana (September 2012).
United States Department of Health and Human Services, Food and Drug Administration. Food and Drug Administration Safety and Innovation Act (FDASIA).
Spiller, HA, et. Al (2011). Clinical experience with and analytical confirmation of “bath salts” and “legal highs” (synthetic cathinones) in the United States. Clinical Toxicology. 49(6) 499-505.

New Research Reveals Link between Marijuana and Inappropriate Use of Pain Medications, other Prescription Drugs

BALTIMORE – April 12, 2013 – Ameritox, one of the nation’s leaders in pain medication monitoring, announced new research today showing a correlation between positive marijuana tests and higher rates of potential prescription drug non-adherence among chronic pain medication users. The research was presented at the American Academy of Pain Medicine annual meeting in Fort Lauderdale, Florida.

Over the course of one year, Ameritox studied more than a 100,000 urine samples from patients nationwide who were prescribed hydrocodone, the most frequently prescribed medication in the United States, marketed under the names Vicodin, Lorcet, Lortab and others. The results show that of the samples that tested positive for marijuana, 36.5% did not have the prescribed hydrocodone present.  For patients who had no illicit drug detected, 29.7% had a negative test for hydrocodone use. This finding was statistically significant. The research also found that 29.1% of the samples that were positive for marijuana and 29.9% of samples that were positive for cocaine contained an additional non-prescribed medication, such as a tranquilizer.  In patients without evidence of illicit drug use only 22% of samples indicated an unexpected or non-prescribed medication was being used.

“A clinician considering whether to test for marijuana should know that the data strongly suggests that marijuana use is associated with an increased risk of potential prescription drug non-adherence,” Ameritox Chief Medical Officer Dr. Harry Leider said. “Evidence of marijuana use on a urine drug test can be as much of a red flag as a positive cocaine test that a patient’s use of prescription narcotics requires close monitoring.”

Additional information on the methods, design and results of the research are available at

About Ameritox Ameritox is the nation’s leader in Pain Medication Monitoring  SolutionsSM, offering specialized laboratory testing and reporting services. Ameritox’s expertise and innovative science provide physicians with the information and support they need to enhance and optimize the care of chronic pain patients. Monitoring through prescription drug testing can help physicians make more informed clinical decisions while also helping to reduce the possible risk of misuse, abuse or diversion of powerful medications. Ameritox is headquartered in Baltimore, Md. with laboratory facilities in Midland, Texas and Greensboro, N.C. Ameritox can be found online at, on Twitter @Ameritox, on Facebook at, and on YouTube at

Ameritox Offers Unique Monitoring Service To Support Physicians On Front Lines Of Oxymorphone Misuse And Abuse

The Nation’s Leader in Pain Medication Monitoring Solutions Offers a Tool to Help Physicians Make Informed Patient-Care Decisions Amid Escalating Oxymorphone Abuse

AmeritoxSM, the nation’s leader in Pain Medication Monitoring Solutions®, today announced enhancements to its test offerings, as public health concerns about the rapid increase in oxymorphone abuse continue to escalate. Law enforcement agencies report misuse and abuse of the powerful prescription pain reliever (oxymorphone is also known by the trade name Opana®) has surged in recent years. 

The patented Ameritox Rx GuardianSM with Rx Guardian CDSM medication monitoring now includes oxymorphone, providing physicians with a tool to compare normalized drug levels in their patients’ urine to a database of patients who were prescribed oxymorphone for chronic pain and were clinically assessed as adherent. No other urine drug monitoring (UDM) service includes this kind of information that can help physicians in their assessment of patients. 

“Oxymorphone has an important role in the treatment of chronic pain – but like other opioids, it has potential for misuse and abuse, which must be balanced with the need to protect patient access to pain relief and quality care,” said Dr. Harry Leider, chief medical officer of Ameritox. “These data can support physician decision-making, by providing additional information that can inform clinical decisions to improve patient care and safety.  When we first introduced Rx Guardian CD, we pledged to continually refine and enhance our dynamic database supporting it – and this new offering demonstrates our commitment to doing just that.”

Total prescriptions for oxymorphone increased from 268,000 in 2007 to more than one million in 2010, according to IMS Health.

Manufacturers of oxymorphone and other powerful prescription pain medicines have taken steps to develop abuse-resistant formulations, including a new formulation of Opana that is designed to be crush-resistant. However, the risk of overdose remains, as those who misuse and abuse these drugs continue to adapt in order to satisfy their dangerous addiction. Since the old and new formulations of Opana are “bio-equivalent,” Ameritox Rx Guardian with Rx Guardian CD provides monitoring results for both versions.

“Our objective is to assist physicians in identifying potential misuse, abuse, or diversion of opioid pain medications like oxymorphone – so that patients have continued access to needed drugs. We believe Rx Guardian CD helps fulfill that need,” said Leider.

Rx GuardianSM with Rx Guardian CDSM is also available for other potent pain medicines prone to misuse, abuse and diversion, including methadone, morphine, hydrocodone and oxycodone.

About Ameritox

Ameritox is the nation’s leader in Pain Medication Monitoring Solutions®, offering specialized laboratory testing and reporting services. Ameritox’s expertise and innovative science provide physicians with insights and support to enhance and optimize the care of chronic pain patients. Ameritox offers the most thorough pain medication monitoring lab process – Rx GuardianSM – with Rx Guardian CDSM, the only pain medication monitoring process with a proprietary normalization algorithm and a reference database of pain patients clinically assessed for adherence. Patient results are compared against this database, helping physicians assess whether patients are taking their pain medications correctly. Monitoring through prescription drug testing helps physicians make more informed clinical decisions and manage the risks and complexities associated with prescribing pain medications. Ameritox is headquartered in Baltimore, Md. with laboratory facilities in Midland, Texas and Greensboro, N.C.Ameritox can be found online at, on Twitter @Ameritox,on Facebook at, and on YouTube at

© 2012 Ameritox Ltd. All rights reserved. Ameritox, Ameritox-Medication Monitoring Solutions, Rx Guardian, Rx Guardian INSIGHT and Rx Guardian CD are trademarks of Ameritox. Other trademarks are the property of their owners.

Ameritox Webinars to Help Educate Physicians on New Indiana Prescription Drug Mandates

Ameritox announced today that it is sponsoring a series of webinars aimed at educating Indiana physicians about a new set of laws intended to curb prescription drug misuse and abuse.

In 2010, 711 people in Indiana died from accidental drug overdoses, and nationally the Centers for Disease Control have deemed prescription painkiller abuse an “epidemic.” Modeled after Kentucky legislation aimed at stemming prescription drug abuse, Indiana is addressing the problem with an Emergency Prescribing Rule that will go into effect December 15 for physicians who prescribe opioids for chronic pain.

The Medical Licensing Board’s Emergency Rule requires specific actions of physicians, aimed at the safe and responsible prescribing of opioids. These new requirements involve heightened patient assessment and management, including calculating the morphine equivalent dosage of a patient’s prescription and taking action when such dosing exceeds certain levels. In addition, patients are required to sign treatment agreements consenting to periodic drug screens and random pill counts, among other things.

“We’ve long recognized that this national epidemic of prescription drug abuse is putting clinicians under intense pressure to both improve the clinical care of their patients and keep communities safe,” said Ameritox CEO Scott Walton. “It’s our job to make available to doctors the best tools to improve patient care, along with information to help them combat the epidemic and support them in understanding how to comply with these new laws.”

Roz Cordini, an attorney with Louisville-based law firm Wyatt, Tarrant and Combs LLP, will conduct the compliance education webinars on behalf of Ameritox. Cordini, a registered nurse and healthcare attorney, has extensive experience in matters involving hospital administration, regulatory oversight, health care fraud and abuse, and was extensively involved in Kentucky’s revisions to House Bill 1, that state’s laws aimed at curbing prescription drug abuse.

“The Attorney General of Indiana is personally involved in combatting prescription drug abuse and in shaping these regulations,” Cordini said, “so prescribers need to not only understand these regulations, but also establish a thorough system in their practices to document that they are following the rules.”

The webinars are scheduled for Dec. 17, Dec. 19, Jan. 14 and Jan. 23. They are free.

“These laws are not just for so-called pain doctors,” Cordini said. “Whether you are a gynecologist, general practitioner or an oncologist, if you are prescribing opioid painkillers long-term, you fall under the scope of these regulations.”

For more information on national prescription drug abuse: