Please don’t take advice on the risks of COVID19 from the guy who only 6 weeks ago recommended people not get tested and asked:

“Have the vaccines not transformed SARSCOV2 into just another regular respiratory virus?”
March 10, 2021: “The pandemic is essentially done.”
How many times do you have to incorrectly try to make the same point before you admit your bias and stop?

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More from @RyanMarino

13 Sep
Rates of substance use in healthcare professionals are similar to general population. So why do we force HCPs into dangerous & non-evidence based therapies that increase risks of relapse, OD & death, & prohibit them from treatment that reduces those risks?…
Proud to be able to share our evidence-based position and continue to advocate for better care of all people who use drugs, and especially thankful for @acmtmedtox @twtoxmd @kavitababu @mbspyres @toxicologist12
I could scream this from the rooftops every day but it’s my favorite section:

“Abstinence-based and detoxification programs have been associated with increased relapse risk and increased risk of overdose death”
Read 4 tweets
12 Aug
How it started How it's going
“The most viral story (21M Facebook views) involved an East Liverpool, OH officer who claimed to have “[felt] his body shutting down” from brushing white powder off of his uniform after a traffic stop. Neither the powder nor his overdose were confirmed.”…
“East Liverpool-An embattled police officer is no longer with the dept…As a result of a public records request, officials provided documentation of over two dozen violations, including dishonesty, discourteous treatment of the public & gross misconduct.”…
Read 4 tweets
22 Jul
“Don’t shove the vaccine down my throat,” said the man willing to accept endotracheal intubation
This is *not* an issue of personal choice or individual liberties.

You are either a science denier who doesn’t care about anyone else, or you get the vaccine the first chance you can so that you take care of yourself and everyone you know.
There are legitimate questions about the vaccines (and many legitimate issues to accessing them). This man - and the many exactly like him - is not an example of either of those things.
Read 4 tweets
21 Jul
One major source of confusion is so-called experts who keep giving totally incorrect messaging, like Dr. Gandhi, who predicted that COVID was over in India in February due to herd immunity she said was achieved through asymptomatic infections. 2.5 million Indians have died since.
It should be noted that herd immunity has never been achieved through infection alone, so regardless of the fact that there was no data to support it, it has never been known to be possible in human history.
Things an infectious disease doctor should know…
Read 4 tweets
20 Mar
Recently had a patient who was really suffering from very miserable opioid withdrawal after stopping heroin (on top of some other unpleasant things) tell me their family had convinced them not to start buprenorphine (suboxone) therapy because “it’s just legal heroin”

A thread...
Withdrawal from opioids is classically taught as “not life threatening” bc the direct effects are rarely fatal (unlike alcohol for example).

1) This is a dumb take like “but did you die?” because suffering is still suffering & we can very easily treat this misery

2) Withdrawal is associated with some of the highest rates of overdose & death, most likely *because* it is so painful & miserable. Not that it should matter, but there is great evidence that people who use heroin, etc. every day are treating withdrawal & not “just getting high.”
Read 8 tweets
15 Mar
Medical toxicologist here to correct the anti-drug zealot with no science background:

There are none of the same ingredients in the COVID vaccines as there are in antifreeze.

Polyethylene glycol is not in antifreeze but it is in ice cream!
Ice cream: surprising also just proprietary ingredients mixed into lipids, sugars, and polyethylene glycol, and requiring subzero temperatures for storage
Yes, I meant polyethylene glycol and not propylene glycol (structurally, physically and chemically very similar though). Propylene glycol is probably more common in commercial ice cream ingredients if I were to guess but polyethylene glycol is also in frozen desserts. And MiraLax
Read 4 tweets

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