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Aaron Fox, MD Profile picture
Aaron Fox, MD
@adfoxMD
Social Medicine | primary care | addiction medicine | clinical research | Director, Bronx Transitions Clinic
May 9, 2021 • 5 tweets • 3 min read
Ok, since we're talking about ppl injecting on the subway

We just surveyed 101 persons in NYC who inject opioids

Reality is that public injection is common

However, there are things we could do as a society to make this situation better for everyone...🧵 Nearly half were injecting in public regularly

Injecting at home also common, but nearly 80% reported unstable housing

Injecting alone at home also risk factor for overdose -

Most overdose deaths in NYC occur in at home (not in a public place)
www1.nyc.gov/site/doh/healt…
Sep 29, 2019 • 7 tweets • 3 min read
This includes my neighborhood where I live & work treating opioid use disorder.

NY has good Medicaid program. We have methadone & buprenorphine. There are inpatient & outpatient programs. There is overdose education & naloxone distribution.

Yet overdoses continue to ⬆️
1/7 This is an abandoned building where ppl hang out. There is evidence of public injection. No one wants this.

Ppl inject opioids & other drugs in alleys, parks, bathrooms & other secluded places b/c there is no place safe to go.
2/7
Jan 27, 2019 • 17 tweets • 7 min read
Invited as discussant for inpatient medicine case conference.

40yo M w/ persistent asthma & >10 exacerbations past yr

Smoker? No
Environmental exposures? No pests/2nd hand smoke at home
Med adherence? High co-pays, yes

But also resumed intranasal heroin use last yr

[1/17] Can intranasal heroin use lead to asthma exacerbations?

Yes.

Mechanism may be histamine release w/i respiratory tract & bronchospasm

ncbi.nlm.nih.gov/m/pubmed/12576…
Oct 7, 2018 • 14 tweets • 3 min read
Buprenorphine prevents illicit opioid use & overdose death by tightly binding brain opioid receptors & blocking the effects of other opioids. A primary goal for addressing the opioid overdose crisis needs to be improving access to bupe tx AND also retaining ppl in treatment. 1/14 A huge problem is that ppl drop out of bupe treatment too soon: ~50% at 12 mos. Buprenorphine doesn’t work for everyone & most ppl don’t want to take medication forever, but too often ppl are forced from treatment early against their will. 2/14