Sarah Wakeman @DrSarahWakeman Twitter profile

Last Seen Profiles

@neo_erlandsson

@Somzizhan

@himekoi_info

@cukienaknikmati

@P_pro2

@afc

@Vanvisatr1505

@octocinn

@TheRealKofiB

@wasabi02038

@1kprojectorg

@yusufalmajed

@edhenry

@_MetaLens

@Norsk_Radiograf

@yorazzy

@Hijabbacol2883

@KM__950424

@kkpapua1

@LaibShawn

@NicholeMaddox87

@MLN_Tupamaros

@rdkise_45

@UgurUgurculha2

@Loreto_Beaufort

@AgnessMack

@Vyjalanas_Art

@WigtownBookFest

@sambest_1

@xl856358831997

@SasinJacek

@seanb2b

@ifilmstblurry

@Strykewitch

@marian_may11

@mcrelayrace

Sarah Wakeman

@DrSarahWakeman

3 years

Watching streams of people wear KN95s to walk into a restaurant and then take them off to eat in an indoor, crowded space in Boston where cases are ridiculously high is a reminder of how confusing and ineffective guidance and practices are right now.

364

2K

22K

Sarah Wakeman

@DrSarahWakeman

4 years

I am over addiction treatment systems & providers blaming the patient for not engaging in care in the year 2020. No one has time for that weak, blame-the-victim-sh*t. What is wrong w/ model & approach that no one wants what you’re offering? People don’t fail tx, tx fails people📣

40

192

1K

Sarah Wakeman

@DrSarahWakeman

2 years

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

18

231

950

Sarah Wakeman

@DrSarahWakeman

4 years

Promoted to associate professor @harvardmed ! Honored to join 34% who are #WomenInMedicine . Thanks to mentors including @markeisenberg16 @katrinarmstrong @valstonemd @jtetrault17 @TomSequist @UnhealthyAlcDrg @drjodyrich Hope to see % women & #BIPOC faculty only continue to grow!

107

30

942

Sarah Wakeman

@DrSarahWakeman

4 years

Patient to me “it takes a big heart to be a nurse, thank you!” Very true & my nursing colleagues are the absolute best. But I introduced myself as Dr. & I’m wearing a giant badge that says “attending doctor.” Here’s to a future where we don’t make gendered assumptions about roles

12

32

679

Sarah Wakeman

@DrSarahWakeman

4 years

Friend went to dentist & proudly shared she started flossing 5-6x/week. In response, hygienist told her she should be flossing 2x/daily. Friend stopped flossing. This is perfect metaphor for problem w/ “abstinence” only SUD models & why embracing any positive change is so key.

24

67

684

Sarah Wakeman

@DrSarahWakeman

4 years

If docs who haven’t done inpatient medicine in years can be quickly trained to be hospitalists on COVID surge teams & impressive fleet of healthcare workers can learn to manage a brand new disease, surely we can start providing SUD tx, MOUD, harm reduction as part of routine care

12

163

654

Sarah Wakeman

@DrSarahWakeman

4 years

Reading a letter of rec for a woman physician (written by a man) and it describes her as “personable, well-dressed, and even-tempered.” I can’t even.... 🤬🤯 #WomenInMedicine #MedTwitter

49

59

648

Sarah Wakeman

@DrSarahWakeman

2 years

With @ScottWeinerMD et al. looked at use of stigmatizing terms that @NIDAnews #WordsMatter recommends against (like “abuse” “addict” “clean/dirty”) among 30k patient charts w/ SUD, found 61% had stigma terms by NLP, disproportionately ⬆️ % for Black pts & those w/ Medicaid. 1/2

18

206

575

Sarah Wakeman

@DrSarahWakeman

2 years

In recognition of #Treatmentweek I hold multiple truths to be true. 1) Addiction is a good prognosis, treatable health condition & #AddictionMedicine is the most rewarding field in medicine. 2) Most people who use drugs never develop addiction & most people use drugs (☕️🍷). 1/3

12

147

561

Sarah Wakeman

@DrSarahWakeman

4 years

NYPD arrest Black & Latinx people for supposed social distancing violations & cannabis charges (hello #WaronDrugs ) while white people crowd parks & have cannabis parties. Also golf courses are now re-opened. #whiteprivilege 👴🏻🏌🏼

29

239

521

Sarah Wakeman

@DrSarahWakeman

4 years

Lost a dear patient. So many tragic layers; family member saying “This was bound to happen if he started using again” was among saddest. People die b/c of bad drug policy, lack of sterile equipment, safe supply, safe spaces, & person-centered methadone. Prohibition & stigma kill.

17

68

532

Sarah Wakeman

@DrSarahWakeman

3 years

Great piece⁩ “addiction is defined as compulsive drug use despite negative consequences. We spent 100+ years trying to use negative consequences to fix something that's defined by its resistance to them. It's time for something else” ⁦ @maiasz ⁩

First, do no harm: An argument for a radical new paradigm for treating addiction

Ars chats with author Maia Szalavitz about her book, Undoing Drugs.

arstechnica.com

15

183

519

Sarah Wakeman

@DrSarahWakeman

5 years

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

Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder

This comparative effectiveness research study examines associations between opioid use disorder treatment pathways and overdose and opioid-related acute care use as proxies for opioid use disorder...

jamanetwork.com

19

278

513

Sarah Wakeman

@DrSarahWakeman

6 years

Saw patient in early remission after yrs of severe addiction, incarceration, homelessness. Over years we have given naloxone, talked about injection practices, done low threshold bupe. He wept w/ me & nurse & kept saying: “you guys never gave up on me.” #HarmReductionSavesLives

8

87

499

Sarah Wakeman

@DrSarahWakeman

3 years

Longtime patient who has made many positive changes over years- no heroin/fentanyl use, no IDU, cut back significantly on cocaine, getting HCV treated. Reflecting on encounters w/ different hospitals pt said “it feels like they hate me, like I’m on some sort of shit list” 🧵 1/3

18

77

501

Sarah Wakeman

@DrSarahWakeman

3 years

The hysteria & pushback against safer smoking as integral component of harm reduction is ridiculous, unscientific, & echoes racist differential responses to crack use seen throughout drug war. Safer smoking kits reduce sharing, injection use, Hep C, & other infectious disease 1/2

6

141

482

Sarah Wakeman

@DrSarahWakeman

3 years

Signs you’re married to a street medicine doctor would be a sharps container on your mantle 😂

14

4

459

Sarah Wakeman

@DrSarahWakeman

3 years

Patient I’ve known more than a decade shared photo of them surrounded by family attending their child’s graduation & remarked if it weren’t for OUD treatment it could’ve been all those family at their funeral instead. Buprenorphine saves lives & I have such a joyful job!💫🌈

6

40

457

Sarah Wakeman

@DrSarahWakeman

3 years

I agreed to project & male physician asked if I could meet duties since he heard I was having kid soon. Why would I say yes unless I could? Also I’m on inpatient consults & oncall for 4 clinical services heading into 38w 🤰🏻doesn’t he realize doctor moms are bad a** b*****s? 🤨

26

8

452

Sarah Wakeman

@DrSarahWakeman

4 years

Just spoke to doctor at outside hospital caring for vulnerable patient of mine w/ SUD, trauma, homelessness who attempted suicide after release from prison. Team’s plan is to discharge him to street w/ list of programs. Makes my head explode and my heart hurt 🤯🤬 #DoBetter

40

60

435

Sarah Wakeman

@DrSarahWakeman

3 years

Person ends saying, “I know you won’t hurt me.” 😢 Not being hurt by health systems & providers should be given but it’s not. Lots of work to make care welcoming to our most vulnerable. Flexible models so crucial. Also nothing better than #primarycare & #addictionmedicine 💕3/3

8

24

427

Sarah Wakeman

@DrSarahWakeman

4 years

Today was reminded of how important offering kindness, dignity and withdrawal relief in the hospital is. Solid methadone dose, warm shower, new pair of underwear and clothes goes long way for someone who has been traumatized and humiliated by prohibition and stigmatizing “care.”

8

58

414

Sarah Wakeman

@DrSarahWakeman

3 years

Threat to Roe, mass school shooting, rising COVID cases & Omicron, 100,000 OD deaths, reminder of need for solidarity in collective struggles for reproductive justice, racial justice, harm reduction, health. To quote Audre Lorde “There is no such thing as a single-issue struggle”

5

78

418

Sarah Wakeman

@DrSarahWakeman

4 years

“People say, ‘I don’t understand how people could have tolerated slavery... How could people have gone to a lynching? If I was living at that time I would never have tolerated anything like that.’ The truth is we are living in this time, and we are tolerating it.” Bryan Stevenson

5

117

414

Sarah Wakeman

@DrSarahWakeman

3 years

Drug dependence is not addiction & it matters. Accurate terminology critical to reduce stigma, avoid confusion & conflation of long term med use w/ addiction (compulsive use despite harm), & for accurate research. Great to collab w/ @maiasz @krigg01

Drug dependence is not addiction—and it matters

Accurately identifying persons with addiction is critically important for effectively targeting treatment and harm reduction interventions. Misdiagnosis of addictive disorders can lead to a cascade...

www.tandfonline.com

26

142

411

Sarah Wakeman

@DrSarahWakeman

1 year

Calls for involuntary treatment for addiction sometimes come from family and clinicians who care deeply and desperately want to help. Yet these models are not the solution. My latest in @statnews @MassGenBrigham @MassGeneralNews

Why involuntary treatment for addiction is a dangerous idea

Involuntary treatment might be worth it if it worked — but evidence strongly suggests that it doesn’t.

www.statnews.com

31

170

400

Sarah Wakeman

@DrSarahWakeman

3 years

Why is cannabis use even relevant? Continued reminder that our approach, mindset, and punitive approaches towards certain types of substance use makes no sense.

18

53

404

Sarah Wakeman

@DrSarahWakeman

2 years

Maternity leave drug related thoughts: 1. The oxytocin rush from baby snuggles 🤱🏻 is the best. 2. I had a fantastic fentanyl epidural and oddly no hazmat suits were required #WTFentanyl 😉 💗💉

13

28

399

Sarah Wakeman

@DrSarahWakeman

4 years

As I tried to wrangle two kids, three bags, masks, winter coats and a stroller out of the house this morning our neighbor walked by and our four year-old said to him solemnly, “mom is having a hard time this morning.” 🤣🙃

6

5

397

Sarah Wakeman

@DrSarahWakeman

4 years

@DrBryanLeyva @AyannaPressley described the situation aptly as “vaccine redlining.” 🎯

5

55

382

Sarah Wakeman

@DrSarahWakeman

3 years

Excited to share that the labor of love that is our textbook "Treating opioid use disorder in general medical settings" is officially published. Thanks to the incredible scholarship of the all-star 🌟 author line-up, it was a joy to edit their work 🧵

Treating Opioid Use Disorder in General Medical Settings

link.springer.com

21

69

373

Sarah Wakeman

@DrSarahWakeman

4 years

My daughter asked me if I can still put her to bed every night when she is 80. I think that sounds just about perfect and I thank her future husband/wife/life partner/roommate in advance for understanding.

7

1

374

Sarah Wakeman

@DrSarahWakeman

3 years

This is so heartbreaking, tragic, and preventable if only we fully supported #harmreduction , drug checking, safer supply, supervised consumption sites, and low threshold, effective treatment with MOUD. My heart goes out to his loved ones. #MichaelKWilliams

12

79

357

Sarah Wakeman

@DrSarahWakeman

4 years

10,514 injections & ZERO overdose deaths in @NEJM evaluation of unsanctioned safe consumption site. How many more people need to die in unsupervised settings before we see full implementation of all lifesaving interventions? @alexhkral

8

182

353

Sarah Wakeman

@DrSarahWakeman

7 years

“Throughout our nation’s history, the narrative has been clear. If a drug crisis is perceived to affect white Americans, it’s a public health crisis. If a drug crisis is perceived to impact African Americans, it’s a criminal justice problem.”

Opioid crisis ‘whitewashed’ to ignore rising black death rate - The Chicago Reporter

African Americans in Illinois and other states are disproportionately dying from opioid overdoses. That contradicts the prevailing racial narratives on handling the drug epidemic punitively.

www.chicagoreporter.com

8

148

340

Sarah Wakeman

@DrSarahWakeman

4 years

My 4 yo daughter just watched @SenKamalaHarris speech and asked “Mommy when I grow up, can I have as many jobs as I want? Can I be President, work in a vet clinic, make sweaters for puppies, be a mommy, be a real person doctor, and be a pilot?” Why yes my love YOU CAN!! 😭💜

13

7

353

Sarah Wakeman

@DrSarahWakeman

3 years

100,000 people died from overdose in 1 yr- 2x more than peak HIV deaths in 1995. How many more deaths until we broadly implement effective harm reduction & care? Drop barriers to OAT, low threshold tx, decriminalize, SCS, safer supply, housing needed now

9

162

348

Sarah Wakeman

@DrSarahWakeman

4 years

Keeping my shirt & scrub consult game strong 💪 #nohumanisillegal especially not on #stolenland

13

19

332

Sarah Wakeman

@DrSarahWakeman

4 years

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/

13

71

317

Sarah Wakeman

@DrSarahWakeman

6 years

What if there were a peer support group for people living with diabetes that shunned the use of insulin and only embraced people who utilized “spiritual principles” to manage their illness? Mutual help can be so helpful but very problematic that NA openly espouses this dogma.

33

118

315

Sarah Wakeman

@DrSarahWakeman

1 year

Harm reduction is love and compassion. It is granola bars and water and naloxone and kindness and noncoercive offers of a menu of services. It is lifesaving. This article is a powerful firsthand perspective of that.

I was addicted to fentanyl. Here's what we should be doing about it.

“The life I lived in active addiction was not pretty; it wasn’t a dignified...

www.sfgate.com

11

98

312

Sarah Wakeman

@DrSarahWakeman

3 years

I trained before sacubitril-valsartan for CHF or GLP-1 receptor agonists for diabetes were around. Imagine if as an internist I opted to never learn or adopt new treatments. So why is it ok to opt out of prescribing meds for OUD or AUD regardless of whether part of training?

8

37

318

Sarah Wakeman

@DrSarahWakeman

4 years

Now seems like a good time for a reminder that the #ElectoralCollege has been and always will be about #WhiteSupremacy . It’s conceptulaization was rooted in ensuring the power of white, male, slave holders.

The Electoral College’s Racist Origins

More than two centuries after it was designed to empower southern white voters, the system continues to do just that.

www.theatlantic.com

15

70

310

Sarah Wakeman

@DrSarahWakeman

7 years

Important article about disgusting profiteering by supposed healthcare professionals preaching cruel “tough love” coupled w/ dangerous & unscientific interventions (detox in pregnancy) Worst of all they blame the victim w/ stigmatizing “addict” rhetoric

11

129

284

Sarah Wakeman

@DrSarahWakeman

6 years

“A classic example [of harm reduction] is seat-belts. Another is the holes in the tops of pen caps that allows a child to breathe if they accidentally swallow one. No one wants children swallowing pen caps. But they do. So why not prevent them from dying when it happens?”

Filter | harm reduction journalism

@Filtermag_org

6 years

As “harm reduction” enters the mainstream lexicon, people hearing it for the first time may associate it with things like safer consumption spaces, or prescribed heroin. In reality, harm reduction is everywhere—even though it’s not always described as such.

1

23

59

5

113

299

Sarah Wakeman

@DrSarahWakeman

5 years

Physicians are privileged. I have added privilege of being white & part of institutions of power. To me that means responsibility to speak up, call out discrimination & demand excellence- especially in areas of medicine which have been allowed to underperform like addiction care.

6

57

300

Sarah Wakeman

@DrSarahWakeman

2 years

4) the way we talk about, regulate, & punish certain types of substance use is unscientific, discriminatory, & racist. 5) much of what passes for addiction treatment would be malpractice for any other condition. We need the best & brightest in this field & fighting for change 3/3

6

48

295

Sarah Wakeman

@DrSarahWakeman

3 years

Devastating loss of an incredible clinician, researcher, addiction medicine expert, mentor, friend & human. The world is dimmer without Rich’s brilliance, wit, kindness & humanity. I remember meeting him at CRIT a decade ago and learning from him ever since. Rest in peace Rich💔

33

37

299

Sarah Wakeman

@DrSarahWakeman

3 years

This worst overdose crisis in history is result of decades of failed, racist drug policies. We know what works- harm reduction (overdose prevention sites, SSPs, naloxone, safer supply), low barrier MOUD, easy access to treatment, decriminalization, and true public health approach

Laura Santhanam

@LauraSanthanam

3 years

In 2020, nearly 92,000 people fatally overdosed. When I asked @DrSarahWakeman why that happened, she blamed "failed policies" and stigma and said, "No one should die from an overdose."

3

20

60

10

94

291

Sarah Wakeman

@DrSarahWakeman

3 years

Thinking about devastating, & entirely preventable loss of 93,000+ lives in 1 year because of bad drug policy, stigma, racism, & perpetuation of harmful myths instead of effective treatment, harm reduction, compassion, and an end to prohibition #InternationalOverdoseAwarenessDay

7

96

291

Sarah Wakeman

@DrSarahWakeman

3 years

This is unreal, especially given the capacity challenges right now. Fentanyl is used every day in EDs and hospitals and no one is wearing hazmat suits. The urban legend and mythology around illicitly manufactured fentanyl is bizarre and harmful. #WTFentanyl

3

76

278

Sarah Wakeman

@DrSarahWakeman

6 years

Seriously? Would you tell person dying from cancer to find someone in remission & do what they do? Addiction is a medical condition. We are medical doctors. It is on us to provide effective treatment, just like any other illness. Peer support invaluable; doesn’t replace treatment

Individual Daily Risk

@medicalaxioms

6 years

Tell people dying of addiction to find addicts who no longer use drugs or alcohol and do what they do.

47

15

106

20

57

277

Sarah Wakeman

@DrSarahWakeman

5 years

Patient stopped buprenoprhine b/c of external pressures. Got call from outside ICU weeks later that he’d suffered OD, cardiac arrest, days of mechanical ventilation, pressor support. Thankfully he will survive. Policies & attitudes that push people off MOUD early are deadly.

14

75

281

Sarah Wakeman

@DrSarahWakeman

3 years

New study showing widely followed 6-month abstinence rule for liver transplant NOT associated w/ superior patient survival, allograft survival, or relapse-free survival. So many approaches to substance use rooted in arbitrary judgment, not evidence. Hope this changes practice.

Nneka N. Ufere, MD MSCE

@NnekaUfereMD

3 years

New from @JAMASurgery - study examining association of duration of alcohol abstinence with post-transplant outcomes. @DrSarahWakeman @eaks790 @alcliverdoc @russpgoodman @DrKimSue #livertwitter

4

23

98

7

84

283

Sarah Wakeman

@DrSarahWakeman

4 years

Segregating care for addiction into a separate and unequal system completely cut off from the rest of healthcare has been disastrous and resulted in a profit driven system largely peddling snake oil and preying on desperation.

As Addiction Deaths Surge, Profit-Driven Rehab Industry Faces 'Severe Ethical Crisis'

Many drug rehab programs use aggressive sales techniques, price-gouge patients and provide substandard care. The system often pushes people struggling with addiction into debt, but not recovery.

www.npr.org

9

94

279

Sarah Wakeman

@DrSarahWakeman

3 years

The only difference between distributing one plastic tube (syringe) vs glass tube (pipe) to reduce risk of infections & other preventable health harms is bias & racist mythology. #harmreduction is public health, evidence-based, & at its core is radical love for other humans. 2/2

2

62

270

Sarah Wakeman

@DrSarahWakeman

3 years

Welcome to all the new @mghmedres interns! Careful who you sit next to at intern orientation- you might end like me & @Bostonstreetdoc 😉🥰👨‍👩‍👧‍👧

6

2

276

Sarah Wakeman

@DrSarahWakeman

3 years

Doing the final textbook proof edits & I am so excited to get the amazing writing of so many star friends & colleagues out into the world! 💫 @drjodyrich @DrAyanaJordan @do_less_harm @WalterLingMD @DrKimSue @maiasz @ZachWritesStuff @DrJessIsomMDMPH @DrChinazo @LizSamuel & others

20

38

268

Sarah Wakeman

@DrSarahWakeman

5 years

Hot off the press! @LeoBeletsky , Dr. Kevin Fiscella, and I wrote this piece on Physician health programs not allowing opioid agonist therapy in @NEJM : “denying clinicians access to effective therapy is bad medicine, bad policy & discriminatory.” @HiJAction @MassGeneralNews

18

85

258

Sarah Wakeman

@DrSarahWakeman

4 years

Was wearing my VP @KamalaHarris shirt and Saint John Lewis hat when I heard the great news about @JoeBiden as President-elect! Chills, relief, and gratitude that love has trumped hate, and decency and science have prevailed. And our first woman as Vice President!! 🙌🙌🙌

13

1

257

Sarah Wakeman

@DrSarahWakeman

6 years

Beautiful portrait & wise words to docs/nurses: “if you treat [ppl w/ addiction] w/ the compassion & respect they deserve, thank you. If instead you see a ‘junkie’ or thief or liar rather than a human being in need of help, consider a new profession.”

18

84

248

Sarah Wakeman

@DrSarahWakeman

3 years

We don’t punish pregnant ppl w/ other health conditions that can affect them & their babies or report them to CPS- we treat them! “Punishing pregnant ppl w/ SUDs has been ineffective; it’s time to prioritize approaches that support pregnant ppl & families”

Pregnant Women with Substance Use Disorders — The Harm Associated with Punitive Approaches | NEJM

Behavioral health conditions in pregnant women are often associated with negative health outcomes. But there has been an alarming trend among states to punish pregnant women with substance use diso...

www.nejm.org

4

61

246

Sarah Wakeman

@DrSarahWakeman

6 years

“The U.S. is suffering its worst addiction epidemic in American history. In Portugal, meanwhile, the drug-induced death rate has plummeted to five times lower than the E.U. average and stands at one-fiftieth of the United States’.”

9

158

231

Sarah Wakeman

@DrSarahWakeman

6 years

$39,268,159 paid by one state's Medicaid program over 4 years for drug testing. Lots of $$$ to sober homes requiring high frequency testing for all. Imagine what we could do with $40 million invested into making treatment & harm reduction more accessible.

8

104

232

Sarah Wakeman

@DrSarahWakeman

3 years

Person continues “feels like people think it doesn’t bother me being treated that way, like I don’t have feelings.” Thankfully able to access care through mobile van & in primary care w/ me. No phone so we write appt time down before visit done. “I trust you & doc on the van” 2/3

1

7

241

Sarah Wakeman

@DrSarahWakeman

1 year

Thanks to @clairezagorski for the 🌟 pin

3

29

230

Sarah Wakeman

@DrSarahWakeman

3 years

“Myth of the drug-crazed Negro has exonerated police from barbaric killings of Black Americans. This will change when the humanity of people who look like George Floyd is valued, by the dominant culture, equally to that of white women” ⁦ @drcarlhart ⁩

The claim that drugs killed George Floyd relies on a racist trope

In the Derek Chauvin trial, the defense’s attempt to blame George Floyd’s death on drug use relies on retrograde and racist myths.

www.vox.com

6

70

226

Sarah Wakeman

@DrSarahWakeman

3 years

PSA: Refusing to provide medical care (be it a transplant, joint replacement, skilled nursing facility, or other) because someone has substance use disorder and/or is treated w/ MOUD is not only heartless but also illegal and a violation of the #ADA 📢 📢

U.S. Attorney's Office Settles Disability Discrimination Case With New England Orthopedic Surgeons

BOSTON – The U.S. Attorney’s Office reached an agreement today with New England Orthopedic Surgeons (NEOS) in Springfield, Mass. to resolve allegations that the practice violated the Americans with...

www.justice.gov

5

68

233

Sarah Wakeman

@DrSarahWakeman

2 years

These harms are preventable & it’s up to all of us to stop deeming certain lives disposable. We can start by ending the drug war & family regulation; making treatment & harm reduction accessible, affordable, available; banning discrimination; and holding systems accountable 7/7

10

27

224

Sarah Wakeman

@DrSarahWakeman

4 years

Thinking today of Kalief Browder, 17 yo kid jailed 3 yrs at Riker’s, much of it in solitary, for allegedly stealing backpack (died by suicide after this trauma). In contrast white supremacist terrorists are getting organic meals in jail? Our racist INjustice system #TwoAmericas

4

48

223

Sarah Wakeman

@DrSarahWakeman

1 year

Powerful description of the non person-centered way people with opioid use disorder are treated and why we need to #LiberateMethadone #UnshackleMethadone @MethadoneLib via @Filtermag_org

I Chose Fentanyl Over the Humiliation of Methadone Treatment

I already knew that my methadone clinic didn’t give a fuck about me or my fellow patients—that much was clear ...

filtermag.org

22

74

225

Sarah Wakeman

@DrSarahWakeman

3 years

Ran into family member of patient today in store. Person told me with tears of joy how thankful they are that their loved one is healthy & meeting his life goals today. Addiction is a *good* prognosis illness & we don’t talk enough about the absolute joy & privilege of this work!

1

21

226

Sarah Wakeman

@DrSarahWakeman

4 years

Goodness goodness- thank you!! I promise to put this blue check mark to good and thoughtful use!! 🙏🏽

7

8

224

Sarah Wakeman

@DrSarahWakeman

2 years

3) Harm reduction is critical full stop. Not because “dead people don’t recover.” Not as holding place until someone engages in treatment. Because (see #2 above) not all people need treatment if they don’t have SUD & all deserve to not die, including those of us who use drugs 2/3

3

24

222

Sarah Wakeman

@DrSarahWakeman

5 years

Day so far: 1am feed baby. 2am pat 3 yo’s back. 4am feed baby. 6am alarm. Make lunches, bfast. E-mail & feed baby. 3 yo up. Edit study protocol while she shouts “I woke up on the wrong side of the bed!” 8:45 finally drop off, late to work & time to pump. #backtowork #workingmom

17

5

222

Sarah Wakeman

@DrSarahWakeman

6 years

Man w/ hx of incarceration went to outpatient addiction program. Minor miracle for him to go & get there (doesn’t drive). Told at start if late >2x he would be discharged. Recounting to me “I’m too old to be treated like a child” never went back. Treatment models need to change!

16

53

218

Sarah Wakeman

@DrSarahWakeman

3 years

Primary care & addiction medicine is just the greatest. In clinic today I went from walking a patient through how to do a low dose buprenorphine initiation in one room, to the next room talking through breastfeeding support for a postpartum mama. #lovemyjob ♥️

8

10

225

Sarah Wakeman

@DrSarahWakeman

5 years

First day of my yearly stint attending on the medical wards and all of the new admissions have substance use disorder. Addiction is and must be a part of general medicine!

9

34

214

Sarah Wakeman

@DrSarahWakeman

3 years

Keep the “clean/dirty” descriptors for laundry or bath time. Can we please never use this language to describe human beings and their use of substances?

13

42

219

Sarah Wakeman

@DrSarahWakeman

4 years

As I was kissing my four year old goodbye at drop off she turned to the dad of her friend and said, “you know, my mommy is really a love expert.” And with that my Monday is off to a very good start (pandemics notwithstanding) 😍 😘 @Bostonstreetdoc

10

5

220

Sarah Wakeman

@DrSarahWakeman

9 months

Important piece showing methadone & buprenorphine both associated with decreased risk of overdose death compared to no treatment. Non-medication treatment (“detox” or “residential” etc) associated with *increased* risk of death. Meds not beds save lives

7

92

216

Sarah Wakeman

@DrSarahWakeman

4 years

Got a call from someone trying to find OUD care after paying $14,000/month at “wellness center for addiction treatment” for reiki & massage. 😱 Massages are lovely for sore muscles or maybe as a complement to lifesaving MOUD but fleecing patients $$ for snake oil treatments is 👎

17

34

211

Sarah Wakeman

@DrSarahWakeman

3 years

TFW you’re a million weeks pregnant, both kids got exposed to COVID at two separate schools on the same day and we are now starting I-forget-what-number-quarantine, husband is on inpatient service, and you have a packed work schedule #danieltigerandencantowillgetusthroughtheday

29

3

213

Sarah Wakeman

@DrSarahWakeman

6 years

#HarmReduction (or clinical medicine broadly) could be summarized as meeting someone where they are but not leaving them where you found them.

Jonathan Giftos, MD🗽🚵🏼‍♂️

@JonGiftosMD

6 years

I think there’s a misperception by some that harm reduction equates to giving up on someone. That by accepting someone for where they are we’re shutting down prospect of change. I think this is wrong. Giving up on someone is letting them die because they can’t change fast enough.

5

82

233

6

77

206

Sarah Wakeman

@DrSarahWakeman

6 years

“We will never be able to address addiction without address[ing] the myriad factors that contribute to it—biological, psychological, behavioral, societal, economic. But viewing it as a treatable medical problem from which people recover is crucial.”

8

119

203

Sarah Wakeman

@DrSarahWakeman

3 years

Hot off the press from @HHSGov new practice guidelines exempting providers from additional training requirements to prescribe #buprenorphine for OUD for up to 30 patients. Not exactly a full #XtheXwaiver but a really important step forward! @LeoBeletsky

10

62

201

Sarah Wakeman

@DrSarahWakeman

3 years

Honored to join ⁦ @DrAyanaJordan ⁩ & Dr. Brody in this. “Excited delirium” is flawed diagnostic construct used to justify police violence against Black people. Racist pseudoscience, rooted in Black enslavement, taints medicine, drug policy, & policing.

Excited delirium: valid clinical diagnosis or medicalized racism? Organized medicine needs to take...

The syndrome of excited delirium does not serve as a diagnostic construct should: a defined set of signs and symptoms used to identify a person in distress. Instead, it is contributing to greater...

www.statnews.com

6

91

208

Sarah Wakeman

@DrSarahWakeman

3 years

Michael Williams wrote an amazing letter decrying the war on drugs to be “a war on people –more specifically, black & brown people, whom it has sought to demonize & silence, criminalizing generations of youth of color.” Using drug war tactics in response to his death is an insult

The Daily Beast

@thedailybeast

3 years

After Williams’ fatal overdose, Deputy Chief John Chell had instructed his detectives to treat it as a homicide. “Treat this case as if Michael K. Williams was hit by a bullet,” Chell remembers telling the detectives.

15

85

232

5

72

200

Sarah Wakeman

@DrSarahWakeman

4 years

If I can drop two small humans off at daycare and bike to work in 90% humidity safely in a mask, you can wear one to the grocery store! 🚲 😷 #WearAMask #MGHProud

7

13

205

Sarah Wakeman

@DrSarahWakeman

4 years

For anyone who has been told that imprisonment is a helpful intervention for people who use drugs or people with addiction, read this. #SupportDontPunish #changingthenarrative ⁦ @HiJAction ⁩

11

111

200

Sarah Wakeman

@DrSarahWakeman

3 years

“Passive fentanyl exposure is not a health risk for overdose responders. It’s time to kill this myth for good.” 📢📢📢📢 via @Filtermag_org @clairezagorski @HillPharmD @RyanMarino @LeoBeletsky @jeremyfaust

5

71

196

Sarah Wakeman

@DrSarahWakeman

3 years

Great to see mainstream media challenging the misinformation spread with fentanyl hysteria and interviewing actual experts ⁦ @RyanMarino ⁩ ⁦ @LeoBeletsky ⁩ “You cannot overdose from secondhand contact.” Thanks ⁦ @nytimes ⁩ ⁦ @igrullonpaz ⁩

Video of Officer’s Collapse After Handling Powder Draws Skepticism (Published 2021)

Medical experts said the video promoted a false narrative and confusion about fentanyl and ways it can lead to an overdose.

www.nytimes.com

7

55

199

Sarah Wakeman

@DrSarahWakeman

4 years

If this is true it’s an amazing & long overdue step forward to expand access to lifesaving treatment for opioid use disorder. Restricting access to medication that reduces mortality in the midst of our deadliest drug overdose crisis has never made sense #xthexwaiver @LeoBeletsky

Dan Diamond

@ddiamond

4 years

SCOOP: HHS to get rid of the “X” waiver that limited which doctors could prescribe buprenorphine for opioid addiction. Physicians have clamored for this as opioid epidemic worsened.

14

118

367

6

37

191

Sarah Wakeman

@DrSarahWakeman

6 years

Great piece! “As we grapple with the overdose crisis, communities and policymakers should heed three key lessons from the fight against AIDS: Stigma is the enemy, activism is the accelerator, and medicines work only when people have access to them.” #truth

How lessons from HIV/AIDS crisis can apply to the opioid crisis | Opinion

As someone who participated in AIDS activism in the early '90s, and now works on ending the overdose deaths, the lens through which I view these parallels begins with this insight: every public...

www.inquirer.com

9

124

188

Sarah Wakeman

@DrSarahWakeman

4 years

Excited to share new paper describing 5 yrs of @MGH_SUDs initiative treating 7,036 unique patients across inpt consult team, Bridge clinic & OBAT w/ recovery coaches. Integrating SUD care into medical settings is feasible, effective, & incredibly rewarding

15

37

192

Sarah Wakeman

@DrSarahWakeman

3 years

Thinking of affluent, white woman who occasionally used alcohol in pregnancy. Infant wasn’t labeled “substance exposed,” no drug testing w/o consent & she was not reported to CPS for abuse/neglect. Example of how racist #WarOnDrugs plays out differently by substance & race/class.

2

29

190

Sarah Wakeman

@DrSarahWakeman

5 years

Seen on my run to work. Evidence of a life saved (I hope). #CarryNaloxone #NaloxoneSavesLives

3

21

190

Sarah Wakeman

@DrSarahWakeman

2 years

I remember meeting @BasgozNesli on my interview day at @MGHMedicine @mghmedres for residency. I am lucky to have trained under thoughtful and incredibly smart physicians like her. What a boss!

How a Boston doctor diagnosed the first US case of monkeypox - The Boston Globe

After a few days, the doctor noticed a telling change. The patient’s rash consisted of fluid-filled blisters that had a dent in the center. His rash looked like smallpox.

www.bostonglobe.com

13

23

195

Sarah Wakeman

@DrSarahWakeman

4 years

Our drug policies & societal attitudes towards people who use drugs are racist. White people dying from overdose? We call it a public health crisis. Black, Indigenous, or Latinx people? We launch mass incarceration, separate families, justify police killings @MassGeneralNews

JGIM Journal of General Internal Medicine

@JournalGIM

4 years

Racist/classist ideologies and institutional discrimination have repeatedly shaped responses towards opioid use and addiction in the US. @daniellefineMD @DrSarahWakemen @dhbuffalo

1

6

15

5

65

185