Journal of Medical Toxicology

, Volume 13, Issue 3, pp 271–273 | Cite as

ACMT Position Statement: Determining Brain Death in Adults After Drug Overdose

  • Mark J. Neavyn
  • Andrew Stolbach
  • David M. Greer
  • Lewis S. Nelson
  • Silas W. Smith
  • Jeffrey Brent
  • Laura M. Tormoehlen
  • On behalf of the American College of Medical Toxicology
Position Statement

The position of the American College of Medical Toxicology, endorsed by the American Academy of Clinical Toxicology and the Society of Critical Care Medicine, is as follows:

We agree with the American Academy of Neurology (AAN) recommendation that the clinical determination of brain death should only be made in the absence of drug intoxication or poisoning. However, a drug screen and clearance calculation using five drug half-lives (T1/2) are not sufficient to exclude intoxication in all cases. Drug screens are not sufficiently comprehensive to detect all drugs that may cause mental status depression. Even when the specific drugs are quantitatively identified, the use of kinetic data to determine clinical effects is limited because drugs often have prolonged half-lives in overdose. For certain drugs and toxins, the duration of effect may extend beyond their detected presence in the vascular space. We recommend identification of drugs or toxins by careful history and targeted testing....


Brain death Toxicology Poisoning Overdose 


Compliance with Ethical Standards

Source of Funding for the Project


Conflicts of Interest



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Copyright information

© American College of Medical Toxicology 2017

Authors and Affiliations

  • Mark J. Neavyn
    • 1
  • Andrew Stolbach
    • 2
  • David M. Greer
    • 3
  • Lewis S. Nelson
    • 4
  • Silas W. Smith
    • 5
  • Jeffrey Brent
    • 6
  • Laura M. Tormoehlen
    • 7
  • On behalf of the American College of Medical Toxicology
  1. 1.University of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Johns Hopkins UniversityBaltimoreUSA
  3. 3.Department of NeurologyYale University School of MedicineNew HavenUSA
  4. 4.Department of Emergency Medicine, Division of Medical ToxicologyRutgers New Jersey Medical SchoolNewarkUSA
  5. 5.Department of Emergency MedicineNew York University School of MedicineNew YorkUSA
  6. 6.University of Colorado School of MedicineAuroraUSA
  7. 7.Departments of Neurology and Emergency MedicineIndiana University School of MedicineIndianapolisUSA

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