Addiction medicine can be hard not because of the work— that part is always rewarding because treatment works, harm reduction saves lives & people we partner with are spectacular, gritty, resilient humans— but because of the moral injury of discriminatory policies & systems 1/7 It is our broken, racist, stigma-laden policies and approaches that cause harm, are painful to bear witness to, and deadly for those they impact. Today I’m thinking about the many people I’ve known and cared for injured or killed by stigma 2/7

I read @drcarlhart #DrugUseForGrownUps this weekend. I am even more inspired by his work & courage. I so appreciated his reflections on his own academic journey, importance of cognitive flexibility, and evidenced reminder that most ppl who use drugs do not develop addiction. 1/ He shines a light on how deeply broken our approach to drug use is. Racism drives drug policy and the drug war and its many foot soldiers have created a giant smokescreen which allows for massive funding for surveillance, imprisonment, and even murder of Black and brown bodies 2/

Excited to share study ⁦@LarochelleMarc⁩ ⁦@darshaksanghavi⁩, others & I did comparing effectiveness of different #opioid use disorder treatments. Bottom line- only methadone or buprenoprhine associated w/ reduced #overdose at 3 and 12 months jamanetwork.com/journals/jaman… We looked at claims data for nearly 41,000 individuals w/ OUD and compared outpatient counseling, IOP, detox/residential, naltrexone, or methadone/buprenorphine to no treatment on outcomes of overdose or opioid-related ED or hospitalization at 3 months.