Pain Medication Monitoring for Physicians & Staff

Ameritox provides accurate and thorough lab reports, as well as comprehensive tools and resources, to help you in the day-to-day monitoring of your patients’ pain medication use.

Ameritox’s Rx GuardianSM process goes beyond standard urine drug testing and features Rx Guardian CDSM, which consists of a proprietary normalization algorithm and is derived from the most comprehensive reference database of pain patients who are clinically assessed as adherent. Patients’ standard scores are compared to results in the reference database, providing you with added confidence in making informed assessments about whether patients are taking their medication correctly.

With the accurate and detailed information from the Rx GuardianSM process, you may:

  • Reduce the risk of a patient’s misuse or abuse of a prescribed medication.
  • Gain insight into the likelihood that a patient is taking his or her medication as prescribed.
  • Learn about controlled substances a patient is taking.
  • Learn about potentially harmful drug-to-drug interactions.

Our medication monitoring solutions help advance the treatment of chronic pain by providing detailed information and insight on patients’ pain medication use. The comprehensive and easy-to-interpret Rx GuardianSM results report indicates where test results are inconsistent with the treatment plan—along with explanations of findings. In addition, experienced Ameritox Toxicology SpecialistsSM are available for consultation on results. Our process helps you assess whether a patient is:

  • Taking illicit drugs.
  • Taking an additional medication prescribed by another provider that could cause dangerous drug-to-drug interactions.
  • Likely taking his or her medications correctly.
  • Not taking enough medication.
  • Taking too much medication.
  • Potentially abusing, misusing or diverting medication.

Bath Salts: With Dangerous Drug Use on the Rise, Ameritox Launches Critical New Test to Help Detect Designer Drug

BALTIMORE, July 11, 2012 /PRNewswire/ — Ameritox(SM), the nation’s leader in pain medication monitoring, today announced that it has developed a test to detect “bath salts,” a class of drugs being created in chemistry labs with the purpose of bypassing laws and providing a “legal high.”

Though the Drug Enforcement Administration currently includes three synthetic cathinones – known on the street as “bath salts” or “plant food” – on its list of banned Schedule 1 drugs, Ameritox scientists have formulated tests that screen for five additional chemical compositions. This level of screening for bath salts puts Ameritox at the forefront of other pain medication monitoring labs.

Structurally and pharmacologically similar to amphetamine, methamphetamine, and MDMA (“Ecstasy”), synthetic cathinones, or bath salts, are laboratory-created versions of a controlled substance. These substances, however, have no legitimate bathing use, in contrast to Epsom salts. In what some have called a “chemical cat and mouse game,” new versions of bath salts are continuously produced with a slightly altered molecular structure to avoid being classified as illicit drugs.

“Physicians know the dangers of combining dangerous substances with powerful prescription painkillers,” said Harry Leider, MD, Chief Medical Officer of Ameritox. “Assuring patient safety has taken on new, high-stakes challenges with the proliferation of these designer drugs. Many of these laboratory concoctions are so new they are not yet illegal – but are still extremely dangerous.”

Bath salts are said to affect users similarly to methamphetamine, with side effects that can include agitation, combative behavior, hallucinations, paranoia, anxiety, seizures and palpitations.

Deaths related to the use of bath salts have occurred in numerous states in recent weeks and poisonings have jumped. In 2011, the National Poison Control Centers received over 6,000 calls about synthetic cathinones, compared to only 300 in 2010.

Bath salts are widely available for $25 to $60 a packet at convenience stores and smoke shops, and the U.S. government has mobilized to combat their rising abuse. In June 2011, the DEA placed three specific synthetic cathinones into its Schedule 1 category of controlled substances, citing the move as “necessary to avoid imminent hazard to the public safety” due to high abuse potential and lack of medical use.

According to DEA, synthetic cathinones are falsely marketed as “research chemicals,” “plant food,” or “bath salts.” Packages usually have the warning “not for human consumption,” most likely in an effort to circumvent statutory restrictions for these substances. Common brand names for these are Purple Rain, Cloud 9, White Rush and Scarface.

Ameritox has developed tests for bath salts that not only detect three common synthetic cathinones that the DEA categorized as controlled substances, but also tests for five other chemical components commonly used in bath salts products.

“These basement chemists will almost certainly alter their formulas to stay one step ahead of the law and urine drug testing, but Ameritox is just as focused on leveraging our state-of-the-art laboratory capabilities to meet the growing dangers posed by the emergence of designer drugs,” said Leider. “We know that to best support the efforts of physicians to reduce drug misuse and abuse, our scientific research has to remain leading edge.”

For additional information, visit

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 Guardian(SM) – with Rx Guardian CD(SM), 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.

For more information, contact:

Lon Wagner
[email protected]

Bath Salts: Drug Testing for Synthetic Cathinones for Patients on Chronic Opioid Therapy

What are Bath Salts (Synthetic Cathinones)?

Not to be confused with Epsom salts or other bathing additives, bath salts are synthetic stimulants that are structurally and pharmacologically similar to amphetamine, methamphetamine, and MDMA (“Ecstasy”).  Bath Salts are often available in drug paraphernalia stores and on the Internet under a variety of names, such as “Ivory Wave,” and “Vanilla Sky,” “Purple Wave,” “Bliss,” “Cloud Nine,” “Ocean Snow,” and “White Lighting.”  These designer drugs are sold in plastic or foil packages, in the form of powder, crystals, capsules or pills. They are often labeled “not for human consumption” in an effort to circumvent federal narcotics laws.

Commonly taken by inhalation, injection, or oral ingestion, bath salts produce reported effects that can include severe agitation, psychosis, paranoia, anxiety, and other stimulant-like effects.  Some deaths have also been reported related to bath salt use.

Bath Salts and Drug Testing – Why Monitor?

Ameritox provides quantitative bath salt testing results for eight of the most common synthetic cathinone compounds:

  • MDPV* a psychoactive drug with stimulant properties
  • Mephedrone* is a synthetic stimulant drug of the amphetamine and cathinone class
  • Methylone* is a stimulant of the phenethylamine, amphetamine, and cathinone classes
  • Naphyrone is a drug derived from pyrovalerone that acts as a triple reuptake inhibitor, producing stimulant effects
  • Methedrone a stimulant and entactogen drug of the phenethylamine, amphetamine, and cathinone chemical classes
  • Butylone stimulant of the phenethylamine chemical class
  • Methcathinone is a psychoactive stimulant
  • Ethylone is an entactogen, stimulant, and psychedelic of the phenethylamine, amphetamine, and cathinone chemical classes

* The Drug Enforcement Administration (DEA) placed these three synthetic cathinones into Schedule 1 in October 2011, as “necessary to avoid imminent hazard to the public safety” due to high abuse potential and lack of medical use.

Learn More About Bath Salts & Testing With Ameritox

As the leader in pain medication monitoring, Ameritox urine drug monitoring provides testing for a broader set of synthetic cathinones than the three compounds placed on the DEA list of illicit drugs.  Ameritox will continue to evaluate customer needs as new synthetic cathinone compounds emerge.Fill out the form to the right to learn more information about these dangerous designer drugs and how urine drug testing can help detect these substances in your pain patients.

Reported Effects of Bath Salts Use1:

  • Agitation
  • Combative behavior
  • Hallucinations
  • Paranoia
  • Confusion
  • Anxiety
  • Involuntary muscle movements

Other Reported Clinical Effects:

  • Stimulant-life effects
  • Palpitations
  • Tachycardia
  • Seizures
  • Vomiting
  • Tremors
  • Headaches
  • Sweating
  • Chest pain
  • Hypertension
  • Dilated pupils

Reference: 1 Spiller, HA, et Al (2011). Clinical experience with and analytical confirmation of “bath salts” and “legal highs” (synthetic cathinones) in the Unites States. Clinical Toxicology. 49(6) 499-505.

AAPM Annual Meeting

The AAPM Annual Meeting provides education for the entire pain care team. It’s an opportunity to network with fellow pain colleagues, learn from leading experts in the field, and hear about the latest clinical and scientific advancements in the field.

Now in its 36th year, the AAPM Annual Meeting takes place each spring. A multidisciplinary, multimodal committee of experts works with the Academy education team to generate an educational program featuring the latest advancements in research, clinical best practices, patient management, practice management, and the diagnosis and treatment of patients in pain.

Unlike any other meeting, the AAPM Annual Meeting offers an educational program that educates and informs the multidisciplinary practice of pain medicine rather than one subspecialty area of pain management. At the AAPM Annual Meeting you can expect to hear about the latest in a wide variety of pain treatment disciplines and modalities.

Past meetings

For prior meeting locations and information, see the past meeting archive.

Future meetings

AAPM 2020 will take place February 26-March 1, 2020 in National Harbor, MD. The call for sessions and scientific poster abstracts will open in summer 2019. Check back for updates and join our mailing list in order to receive the latest information about the meeting.

National Prescription Drug Report

More Americans die each year from poisonings, including drug overdoses, than from car accidents. In three out of four cases, the drug is a prescription painkiller, and the number of deaths involving opioids – a common class of painkiller – now outnumbers those from cocaine and heroin combined. Medication monitoring results can help a clinician assess whether a patient is taking the prescribed medication or if a patient is taking other drugs that the clinician is not aware of. The results presented in this report came from samples collected by Ameritox in 2012 from about 527,000 individual patients.

CBD Oil Highlighted by Opiate Patients

The most shocking discovery of the National Prescription Drug Report in 2019 was that there is an increasing number of those weening off of prescription painkillers who were using CBD oil for pain relief. One individual reported that rather than take a daily dose of his pain medication, he would take three drops of a 1000mg CBD oil tincture. This would manage the pain without reliance on opiates.