Independent medical-legal analysis of substance use disorders, withdrawal, treatment, and drug-related causation.
Shaun D. Carstairs, MD, DFACMT, FACEP, is board-certified in Addiction Medicine, Emergency Medicine, and Medical Toxicology. He provides independent consultation for plaintiff and defense counsel in matters involving addiction medicine, overdose, withdrawal, medication-assisted treatment, and the interaction between substance use and emergency care.
Discuss an Addiction Medicine Case
Questions an addiction medicine review can address
- Substance use disorder assessment: clinical evidence supporting or not supporting a diagnosis and the significance of the available history and records.
- Opioid-related care: opioid use disorder, fentanyl and other opioid exposure, withdrawal, overdose, naloxone response, and treatment considerations.
- Medication treatment: buprenorphine, methadone, naltrexone, and other medications used in the treatment of substance use disorders, within the scope of the assignment.
- Alcohol-related matters: alcohol use disorder, intoxication, withdrawal, and the medical consequences of chronic or acute alcohol use.
- Stimulants and other substances: methamphetamine, cocaine, cannabis, and other drugs when the clinical effects or treatment are relevant to the legal question.
- Standard of care and causation: whether the care provided was medically appropriate and whether a substance use disorder, exposure, treatment decision, or withdrawal syndrome contributed to the claimed outcome.
Where addiction medicine overlaps with toxicology and emergency medicine
Many cases do not fit neatly into a single specialty. A matter involving fentanyl, for example, may require analysis of toxicologic effects, opioid use disorder, emergency treatment, withdrawal, and causation. Dr. Carstairs’ training across Addiction Medicine, Medical Toxicology, and Emergency Medicine allows those questions to be evaluated within one clinical framework.
Examples of matters considered
- Opioid and fentanyl overdose
- Opioid use disorder and withdrawal
- Buprenorphine and methadone treatment
- Alcohol intoxication and withdrawal
- Stimulant-related illness
- Drug testing and interpretation of toxicology results
- Medication interactions and adverse effects
- Emergency department management of patients with substance use disorders
Expert services
Services may include case screening, medical-record and literature review, standard-of-care and causation analysis, attorney consultation, written opinions and reports, and deposition or trial testimony. Suitability is determined after reviewing the requested assignment, jurisdiction, conflicts, records, and deadlines.
Related services: Medical Toxicology Expert Witnesses and Emergency Medicine Expert Witnesses.