Out today: New analysis on teen overdoses in @NEJM

Overdoses hit an all-time high in 2022, killing the equivalent of a high school classroom of teens each week across the US

Overdoses now the 3rd leading cause of death in kids

I care for these teens. Here's what's needed 🧵 1/ We found hotspots all over the US:

- LA County CA with the most deaths
- Maricopa County AZ
- Clark County NV
- Many many more all over urban & rural areas in Illinois, Washington, Tennessee, New Mexico, Colorado...

Full study here:
2/tinyurl.com/ytdk3pay

As a pediatrician & dad, I want to respond to 2 news stories out of Texas:

(1) Legislature voted yesterday to ban gender-affirming care for teens & (2) Adolescent medicine docs were pushed out of @dellchildrens in Austin for providing care. #LGBTQ 🧵 1/ Gender-affirming care is not merely hormones & surgeries despite how lawmakers frame it.

It is broader support: a safe space to ask questions, be welcomed & be affirmed, be cared for holistically.🌈

Banning gender-affirming care has a chilling effect, shutting down ALL care. 2/

It's National Fentanyl Awareness Day. I want to share critical info as a pediatrician & dad.

Drug overdoses now kill the equivalent to a high school classroom of teens every week across the US. About 9 in 10 are caused by fentanyl. 🧵 1/ A rising % of overdoses in teens involve counterfeit pills. Pills made to look like, for example, oxycodone or Xanax, but instead contain fentanyl. More than half of all pills contain a lethal amount of fentanyl. These pills are commonly sold to teens on social media. 2/

Pediatrician here. An unprecedented # of kids—daughters, sons, sisters, brothers—are dying of drug overdoses.

Driven by fentanyl. Often in fake pills that look like oxycodone or Xanax, or contaminating other drugs (eg, cocaine).

Here’s what you (esp parents) should know.🧵1/ Just published moments ago is a piece I wrote for @CNNOpinion to help spread awareness & education. After watching too many young people die, I want to get this info out as widely as possible. Link here:
2/ cnn.com/2022/12/27/opi…

Horrifying but not surprising new data from US children's hospitals.

Amid a youth mental health crisis, ER visits in kids are climbing. Most visits are for depression, anxiety, suicide.

Matches what we're seeing on the front lines of pediatric care. 1/ 1 in 8 kids 'bounces back' to the ER within 6 months, suggesting that they may not be getting the care they need.

Absent high-quality, readily available mental health care covered by insurance and without waitlists, families turn to ERs to keep their kids safe. 2/

This 5.2 lb, 450-page stack of documents is my 2011 green card application. My husband & I applied for it on the basis of our same-sex marriage.

My green card was denied.

I want to share what codifying same-sex marriage means for families like ours. 🧵 1/ We were married in 2010 in front of 127 friends & family.

I'm Canadian. My husband, American. We were living & working in Boston, me as a pediatrician, him as a primary doctor for veterans.

My status here wasn't secure. Other married couples get green cards. We applied. 2/

Drug overdoses are a top cause of death in teens in the US. Fatalities doubled from 2019 to 2021. Three-quarters involve fentanyl. Short 🧵 1/ We're in a national overdose crisis affecting ppl of all ages, but today's @NPR piece by @mbebinger sheds light on some key youth-specific concerns.

Counterfeit pills made to look like oxycodone, Xanax, Adderall are commonly laced with fentanyl. 2/ npr.org/2022/11/14/113…

Alarming new study out today in @JAMA_current: Teen deaths from fentanyl overdose TRIPLED from 2019 to 2021. 😲

What's causing this? My thoughts as a teen addiction specialist working on the front lines 🧵 1/ Argh, Twitter dropped the rest of my thread. Which I'll try to furiously add now.

First, here's the study:
2/ jamanetwork.com/journals/jama/…

Here's how many teens may attempt suicide in Florida each year because of its new #DontSayGay law:

Nearly 4,000.

I did some math. Please retweet & share widely the terrible potential impact of this anti-LGBTQ policy. 🧵 1/ Some background: FL signed into law a bill last week keeping teachers from talking to K-3 kids about developmentally-appropriate LGBTQ-related issues entirely, and restricting discussions in older kids, forcing families like mine to live in the shadows. 2/ washingtonpost.com/politics/2022/…

Let me take on some of the arguments folks are making in favor of Florida's #DontSayGay bill.

Here's why child health & policy experts across the US are worried. 🧵 1/ "You haven't read the bill."

Getting this common rebuke out of the way. Yes, I have, many times, and you can too. Here's where: 2/ myfloridahouse.gov/Sections/Bills…

Putting my foot down as a pediatrician, expert on teen health, gay man, and a dad.

I won’t mince words.

Florida lawmakers: Teens will die if you pass the so-called “Don’t Say Gay” bill and the latest proposed amendment. 🧵 1/ theweek.com/education/1010… I repeat, teens will die.

I care for LGBTQ+ patients and cannot understate the mental health toll teens experience when adults create harmful school environments for them.

Depression, anxiety, suicide, eating disorders, substance use. I see it all. Routinely. 2/

Vaccines for kids under 5 — lots of news coverage this AM. Might be available here in the US within a month.

Here’s a 🧵 diving a little deeper from my perspective as a pediatrician. 1/ We pediatricians are hearing from many, many families that they’re desperate for a vaccine for kids under 5.

This resonates for me & my family. We have two kids in this age group. /2

Pediatrician here. The acquittal of #KyleRittenhouse exemplifies all the ways America is messing up teen boys & perpetuating gun culture, while meanwhile terrorizing youth of color. 🧵1/ I’m a doc for plenty of 17-year-olds and, like everyone else, can’t help but notice that Rittenhouse got a pass for murder while #TamirRice & #TrayvonMartin & countless other teen boys of color (often much younger) are killed (often by police) in the absence of a crime. 2/

In light of new data showing that 100,000+ Americans died of drug overdose in a 1-year period, and quotes in the piece about teens being prescribed opioids for wisdom teeth, let me share some thoughts... The vast majority of teens prescribed an opioid *will not* develop addiction. Our work has shown it's fewer than 1 in 300 who will have a problem. pubmed.ncbi.nlm.nih.gov/33739476/