The mission of NOAP is to promote public safety through participation of healthcare professionals in monitored rehabilitation and recovery as an alternative to license discipline; emphasizing fitness to practice and retention of competent professionals.


MRO Toxicology Webinar

Thursday, May 7, 2020, 2pm eastern

Files (pdf)

  1. MRO Toxicology Webinar Slides
  2. Urinary Auto Brewery Syndrome Article
  3. Auto Brewery Syndrome Undiagnosed Medical Condition Article
  4. Barry Lubin Handout
  5. James Ferguson Handouts:
    1. Dilution Concerns for Recovery Monitoring
    2. Tips to Avoid Dilute Urine Specimens
    3. Dilution Concerns in Recovery Monitoring
    4. Dilute Urine Specimens - Follow up
    5. MRO Review in RMS



  1. Discuss the pros and cons of PEth vs blood spot.

  2. Describe the limitations of hair testing and understand how that impacts the interpretation of their program results.

  3. Describe the anatomy of a fingernail and how drug is incorporated into fingernail.

  4. Relate case study reports from the literature and our laboratory experience to better interpret their cases at their program.


  • Moderator: Kathie Simpson, RN, BSN, CACPN
  • Anthony Costantino, PhD, F-ABFT; DrugScan, Inc.; Horsham, Pennsylvania
  • James Ferguson, DO, DFASAM, C-MRO; FSSolutions; Chalfont, Pennsylvania
  • Joe Jones, PhD, USDTL; Des Plaines, Illinois
  • Barry Lubin, MD, FASAM, MRO; Affinity Online Solutions; Vienna, Virginia 


  • This course has been approved by the California Board of Registered Nursing through The American Association of Nurse Attorneys (TAANA), provider #CEP16785, for a maximum of 1.75 Nursing Contact Hours. The licensee must retain this document for a period of four (4) years after the course concludes.

  • This activity has been approved through NAADAC, The Association for Addiction Professionals.

Anthony Costantino, PhD, F-ABFT; DrugScan, Inc.; Horsham, Pennsylvania

Anthony Costantino is the President and CEO of Drugscan Inc., a SAMHSA certified laboratory that specializes in Toxicology Monitoring. He previously served as Vice President of Operations for National Medical Services in Willow Grove, PA, and as Senior Vice President and Director of Toxicology for American Medical Laboratories in Chantilly, VA. Dr. Costantino has a degree in Pharmacy as well as a M.S. in Pharmacology/Toxicology from Duquesne University, Pittsburgh, PA. He earned his Ph.D. in Forensic Toxicology at the University of Maryland, School of Medicine in Baltimore, Maryland. He is a former President of the Society of Forensic Toxicology (SOFT) and is a member of SAMHSA’s Drug Testing Advisory Board (DTAB). He is also the author of over 30 scientific publications in the field of forensic toxicology.

James Ferguson, DO, DFASAM, C-MRO; FSSolutions; Chalfont, Pennsylvania

Dr. Ferguson is the Medical Director of FSSolutions (formerly FirstLab) Recovery Management Services and has held this position since March 2011. He serves as Chairman of the Medical Review Officer Certification Council Advisory Committee in collaboration with Research Triangle Institute (RTI) and is a former member of the SAMHSA Drug Testing Advisory Board (DTAB). Dr. Ferguson was Course Director for the American Society of Addiction Medicine Comprehensive MRO training program from 2003-2013 and continues to direct MRO Training through the American Osteopathic College of Occupational and Preventive Medicine (AOCOPM). He is also a member of the American College of Occupational and Environmental Medicine (ACOEM) MRO Training faculty. Dr. Ferguson is the author of "The MRO Team Manual," co-author of the "MRO chapters of the Principles of Addiction Medicine" and the "Handbook of Workplace Drug Testing." He is a consultant to the Substance Abuse and Mental Health Services Administration (SAMHSA) Division of Workplace Programs (DWP).

Joe Jones, PhD, USDTL; Des Plaines, Illinois

Joseph Jones has worked in the clinical forensic toxicology field for over 30 years for large workplace drug testing laboratories and boutique forensic laboratories that specialize in testing alternative specimen types. Jones holds a BS in Chemistry from the University of North Carolina at Chapel Hill, a MS in Chemistry from North Carolina Central University in Durham, North Carolina and has earned a PhD in Public Health-Epidemiology at Walden University. Jones has worked in every area of the clinical forensic laboratory. Jones serves as the Chief Operating Officer and Executive Vice President for United States Drug Testing Laboratories (USDTL). While at USDTL, Jones has developed over 50 bioanalytical assays that are part of the unique offerings of the laboratory. Jones has provided drug testing expert testimony on behalf of LabCorp and USDTL for over 15 years in a number of venues including union arbitration, unemployment hearings, family court child custody, child abuse/neglect and capital murder cases. Jones has contributed to over 25 peer-reviewed scientific journal articles and conducted over 20 workshops or presentations in the field of urine adulteration, newborn toxicology, long-term alcohol biomarkers and drugs of abuse testing in hair. In addition, Jones has served as the project manager for over 7 National Institutes of Health (NIH) funded grants. Jones is a member of 9 scientific professional societies and has been certified by the National Registry of Certified Chemists at a Toxicological Chemist.

Barry Lubin, MD, FASAM, MRO; Affinity Online Solutions; Vienna, Virginia

Barry H. Lubin, MD, graduated Phi Beta Kappa from Rutgers University in 19670 with a Bachelor's Degree with highest honors in biological sciences. He then received his MD degree from Hahnemann University in Philadelphia in 1974. He completed a 3 year residency in Internal Medicine in 1977 at Jackson Memorial/University of Miami Hospitals and engaged in a successful practice of Internal Medicine in Broward County, Florida until 1989. Dr. Lubin became certified by the American Society of Addiction Medicine and a Diplomat of the American Board of Addiction Medicine. He is a certified Medical Review Officer. He was employed for 7 years at Talbott Recovery Center. He has also worked at Sante Center for Healing. He has been the Medical Director and Medical Review Officer at Affinity eHealth for the last 11 years.

Kathie Simpson, RN, BSN, CACPN; NOAP President; Irwin, Pennsylvania

Kathie Simpson, RN, BSN Certified in Addictions Counseling
Developed and served as the Executive Director for SARPH from 2004 to 2019; 35 years of experience working with impaired healthcare professionals; adjunct professor at various schools of nursing and pharmacy teaching impairment related to substance use disorders, psychiatric disorders and physical disorders, ie – early dementia; certified as expert witness in court and administrative hearings. Past critical care, OR/PAR, management, and psychiatric nursing experience with certifications. She is now a private consultant to ATD programs, Healthcare Boards and attorneys.


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