Gas Station Highs
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- Non-Member - $39
- Regular Member - $29
- Retired - $29
- Early Career Physician - $29
- Resident - $19
- Student - $19
- Associate - $19
- ASAM Staff - Free!
- International Member - $29
- Emeritus Member - $29
- Provisional Member - $29
- Fellow Member - $29
- Honorary Member - $29
- CRT Member - $29
Gas Station Highs
Recorded: Thursday, April 23, 2026 to Sunday, April 26, 2026
On-Demand Session
Overview
This 60-minute on-demand session from the ASAM 57th Annual Conference addresses gas station accessible substances including tianeptine, phenibut, and alkyl nitrites, covering toxidromes, complications, and harm reduction strategies.
Gas station" and internet drugs such as tianeptine, phenibut, kratom, and alkyl nitrites exist in a lax regulatory environment that permits easy access, leading to increased emergency presentations for intoxication, withdrawal, and unique harms. In this session, toxicology, emergency medicine, and addiction experts use case vignettes to teach rapid toxidrome recognition, practical management, and effective discharge counseling grounded in current FDA and CDC alerts and recalls. Attendees will gain practical tools, algorithms, and up-to-date references for bedside management. "Gas station heroin?" and "legal morphine?" Think again! In this session we myth-bust and dismantle the pejorative language used to describe kratom-derived products consumed by millions of adults. This session synthesizes epidemiological findings, real-world case reports, preclinical literature, and emerging data to inform attendees about kratom-derived products relevant to their practice. These include products containing 7-hydroxymitragynine ("7-OH"), mitragynine pseudoindoxyl ("pseudo"), kratom-kava products, and emerging MGM analogues. Recommendations are given for how substance use disorder assessment, diagnosis, and treatment can improve. This workshop is an interactive session that challenges participants to examine the real-world barriers in PSUD care in their own community and leave with strategies to build systems change. Participants will participate as small groups to learn more about the North Carolina PSUD Network and use the evolution of the NC PSUD Network as their blueprint to identify strategies to improve PSUD access and collaboration in their own state.
The target audience for this Advanced level session includes physicians, nurse practitioners, physician assistants, other clinicians, researchers, residents, fellows, and students.
This session addresses the following ACGME Competencies: Medical Knowledge, Practice-based Learning and Improvement.
This session addresses the following IPEC Competencies:Teams and Teamwork.
Learning Objectives
Upon completion, learners will be able to:
- Identify common gas station or internet-accessible agents (e.g., tianeptine, alkyl nitrites/poppers, phenibut, kratom) and describe core pharmacology and toxidromes.
- Recognize intoxication, withdrawal, and unique complications including poppers maculopathy, severe tianeptine toxicity, phenibut withdrawal, and kratom-associated adverse events.
- Apply evidence-informed outpatient and acute care strategies, including supportive care, targeted antidotes and adjuncts, and discharge harm-reduction counseling specific to unregulated products.
Registration Rates
| Rate Description | Rate |
| ASAM Member | $29 |
| Non-Member | $39 |
| Associate Member | $19 |
| Resident Member* | $19 |
| Student Member* | $19 |
*Residents, Fellows-in-training, Interns, and Students must join ASAM to receive a discounted registration rate. Click here to become an ASAM member. National and Chapter membership dues apply. There is no charge for Students to become a Member, but verification of student status is required.
Membership Question? Call ASAM at 1.301.656.3920, email us, or view the ASAM website for more information.
Refunds & Cancellations
All ASAM eLearning Center refund requests must be made in writing to education@asam.org within 90 days of purchase. Those requesting refunds for courses that are in progress will receive partial refunds or e-Learning Center credit. Automatic full refunds will be made for any course with a live-course component that has been cancelled.
Registration Open: 05/25/2026 - 04/25/2029
User Access Closed: 05/25/2029
Course Instructions
- Click on the Contents tab to watch the on-demand recording.
- Click Complete Post Test to answer multiple choice questions. You will have 10 attempts to pass and must answer 4 out of 5 questions correctly.
- Click Complete Evaluation to provide valuable activity feedback. Scroll down on all questions as there may be answer options that expand past the size of the window.
- Click the button Claim Medical Credits in the box titled Claim Credits & Certificate. Choose the type of credit and click submit. Click the button View/Print Certificate to save or print your certificate. You can view/print your certificate at any time by visiting the ASAM eLearning Center, clicking Dashboard, and clicking Transcript/Achievements.
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Alaina R. Steck
MD
Alaina R. Steck, MD is an Assistant Professor of Emergency Medicine at Grady Memorial Hospital, in the Emory Department of Emergency Medicine. She completed her residency training in Emergency Medicine at Boston Medical Center in Boston, MA and her fellowship in Medical Toxicology at the Emory / Centers for Disease Control and Prevention Combined Fellowship in Medical Toxicology, followed by board certification in Addiction Medicine. She currently serves as the Medical Director of the Grady Medication-Assisted Opioid Treatment clinic, clerkship director for Medical Toxicology, Assistant Director at the Georgia Poison Center, and co-chair of the Drug Safety Task Force of the Injury Prevention Research Center at Emory.
No relevant financial relationships
Steven Quam, MD
Addiction Medicine Fellow
University of Minnesota
JoAn Laes
MD
JoAn Laes, MD is an addiction medicine physician and consulting medical toxicologist. Her focus is inpatient addiction medicine and toxicology consultation, and outpatient treatment of opioid and other substance use disorders. She is an owner at Twin Cities Toxicology, providing consultation, medical directorship, and expert opinion in the fields of addiction medicine and medical toxicology. She is board-certified in Internal Medicine, Addiction Medicine, and Medical Toxicology. She completed an internal medicine residency at Hennepin County Medical Center and medical toxicology fellowship at Regions Hospital in St. Paul, Minnesota. She has spoken nationally on the subjects of addiction medicine and toxicology.
No relevant financial relationships
Jeremiah D. Fairbanks
DO
Jeremiah Fairbanks, DO is a current addiction medicine fellow at the University of Minnesota. He completed his medical training at Des Moines University followed by a family medicine residency through the University of Minnesota. He has helped develop programs treating office based opioid use disorder through primary care in southern Minnesota and has his family medicine board certification.
Robert Pueringer
MD
Robert "Cole" Pueringer, MD, CTropMed: I am an Internist/Hospitalist, Medical Toxicologist, and currently an Addiction Medicine Fellow at the University of Minnesota. Originally from Montana but all my medical training has been in the Minnesota. I completed Medical School at the University of Minnesota Twin Cities (2015), Internal Medicine Residency at Hennepin County Medical Center (Hennepin Healthcare) (2018), and a Medical Toxicology Fellowship at HealthPartners Institute/HCMC (2021). Interists include the overlap of Toxicology Addiction, Global Health, and SUD in healthcare professionals. I enjoy ourdoor recreation, soccer, and engagement in the recovery community.
Evan Schwarz
MD
Dr. Evan Schwarz is an Assistant Professor of Emergency Medicine at the Washington University School of Medicine in Saint Louis. He is the Medical Toxicology section chief and directs their inpatient and outpatient clinical services. This includes managing inpatients with substance use disorders as well as following them in the outpatient toxicology and addiciton medicine clinic. In addiction to his clinical activities, he is a core faculty member of the emergency medicine residency, the Vice President for the Missouri College of Emergency Physicians, and a member of the Board of Directors for the American College of Medical Toxicology.
Lewis Nelson
MD, FACEP, FACMT, DFASAM
Lewis Nelson, MD, FACEP, FACMT, DFASAM is Professor and Chair of the Department of Emergency Medicine and Chief of the Division of Medical Toxicology at Rutgers New Jersey Medical School in Newark, NJ. He is a member of the Board of Directors of the American Board of Emergency Medicine and a Past-President of the American College of Medical Toxicology. He remains actively involved with the CDC, FDA, DHS, and several professional medical organizations, including ASAM. Dr. Nelson is an editor of the textbook Goldfrank’s Toxicologic Emergencies and on the editorial boards of several journal.
No Relevant Financial Disclosures
Accreditation & Credit Designation Statements
Joint Accreditation Statement
In support of improving patient care, the American Society of Addiction Medicine 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.
Physicians
The American Society of Addiction Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurses
This activity awards 1 Nursing contact hours.
Pharmacology Hours
This activity has 1 hour that satisfy the requirements for NP and PA Pharmacology Hours.
PAs
ASAM has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1 AAPA Category 1 CME credits. Approval is valid until 05/25/2029. PAs should only claim credit commensurate with the extent of their participation.
Social Workers
As a Jointly Accredited Organization, ASAM is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 1 general continuing education credits.
IPCE Credit
This activity was planned by and for the healthcare team, and learners will receive 1 Interprofessional Continuing Education (IPCE) credits for learning and change.
California Association for Drug/Alcohol Educators (CAADE)
This educational program is approved by CAADE: #CP40 999 1225.
California Association of DUI Treatment Centers (CADTP)
This educational program is approved by CADTP: #205.
California Consortium of Addiction Programs and Professionals (CCAPP)
This educational program is approved by CCAPP: # OS-20-330-0227.
Other Professions - Continuing Education Credits (CEUs)
Upon completion of the activity and online evaluation, all other participants may request a certificate of participation. Participants may submit this certificate of participation to their professional organization/institute as documentation for completing this accredited continuing activity.
Maintenance of Certification (MOC) or Continuing Certification Programs (CCP)
This activity is designed to meet the requirements for MOC/CCP for several primary physician boards and for state licensing CME requirements. MOC Credit is only reported and designated for ABA, ABIM, ABP and ABS. By completing the online credit claim and evaluation, the learner permits ASAM to report credits to the appropriate Board. Learn more.
American Board of Anesthesiology (ABA)
This activity offers up to 1 CME credits, of which 1 credits contribute the patient safety CME component of the American Board of Anesthesiology’s redesigned Maintenance of Certification in AnesthesiologyTM (MOCA®) program, known as MOCA 2.0®. Please consult the ABA website, www.theABA.org, for a list of all MOCA 2.0 requirements.
Maintenance of Certification in Anesthesiology® and MOCA® are registered certification marks of the American Board of Anesthesiology®
American Board of Internal Medicine (ABIM)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1 Medical Knowledge MOC points and patient safety MOC credit in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
American Board of Pediatrics (ABP)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn up to 1 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit learner completion information to ACCME for the purpose of granting ABP MOC credit.
American Board of Preventive Medicine (ABPM)
This activity has been designed to satisfy the Lifelong Professional Development requirements of The American Board of Preventive Medicine’s Continuing Certification (CCP) requirements. These credits are not reported directly to ABPM. Please save your certificate for your records.
American Board of Psychiatry and Neurology (ABPN)
This activity has been designed to satisfy the CME requirements of the American Board of Psychiatry and Neurology’s Continuing Certification (CC) requirements. These credits are not reported directly to ABPN. Please save your certificate for your records.
American Board of Surgery (ABS)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
Royal College of Physicians and Surgeons of Canada (RCPSC)
The Royal College of Physicians and Surgeons of Canada will recognize activities registered for CME for MOC as meeting the requirements for Royal College MOC Program Section 3 (Self-Assessment Programs) credits. Visit CME that Counts for Royal College MOC for more information.
Disclosure Information
In accordance with the disclosure policies of ASAM and Joint Accreditation, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all accredited continuing education activities. These policies include identifying and mitigating all relevant financial relationships with ineligible companies for those involved in the creation and dissemination of accredited continuing education. Click here to view the full disclosure listing.
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