While he is no stranger to treating patients with co-occurring mental health and substance use disorder diagnoses, Dr. Tony had only part of the story prior to ordering definitive testing for the patient.

Leveraging High-Complexity Toxicology Testing to Inform Clinical Decisions in Addiction Medicine and Psychiatry

Treating patients like family in an environment that builds trust and encourages honesty is the cornerstone of Dr. Anthony Hale’s treatment approach. “Dr. Tony” as he is known by his patients, is a nurse practitioner specializing in psychiatry at M.A.B. Health Services in Milwaukee, WI. He knows the story that each of his patients bring to his practice, and definitive testing has played a significant role in piecing those stories together and deepening trust with his patients.

“I didn’t even know this patient was on methadone,” Dr. Tony shared in a recent conversation about one of his patient’s results. While he is no stranger to treating patients with co-occurring mental health and substance use disorder diagnoses, Dr. Tony had only part of the story prior to ordering definitive testing for the patient. “She struggled with oxycodone misuse in the past and entered a [Medication Assisted Treatment] program. The methadone was not on the state prescription drug database.” The patient had also experienced a family emergency causing her to travel unexpectedly and leave her prescriptions behind. “I have been prescribing venlafaxine for menopausal symptoms and diazepam for anxiety,” Dr. Tony explained. Those medications were not detected in her urine. Upon discussing the results with the patient, Dr. Tony learned of her unexpected travel and forgotten medications. Definitive testing was also able to differentiate alprazolam from the benzodiazepine metabolites that would be expected with diazepam ingestion, so this afforded Dr. Tony the opportunity to ask the patient about this result and learned, “The patient admitted to taking a family member’s medication while traveling.”

Definitive testing allowed for an open, honest conversation about medication adherence issues and the dangers of taking non-prescribed medication. Ingesting medication that is not prescribed – even in good faith from well-intending family members – can result in ingestion of unknown and unplanned compounds such as designer and synthetic drugs. Counterfeit pills can also contain lethal amounts of fentanyl.

Dr. Tony’s brother passed away in late 2023 from a drug overdose, and this is part of what fuels his passion for the direct and focused dialogue he shares with his patients. He uses the information his patients tell him plus the results of definitive testing to help him with safer prescribing decisions that will keep patients on track with their recovery and not increase their risk of adverse outcomes.

Dr. Anthony Hale, Doctor of Nursing Practice
Dr. Hale specializes in psychiatry and is the owner of M.A.B. Health Services.

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