I’ll be presenting with my @cocoalition.bsky.social colleagues at this year’s National Healthcare for the Homeless Conference in Baltimore! If you’re attending the conference, come learn about no barrier buprenorphine dispensing on street medicine. 🔥

It was great to reunite with MGH Addiction Medicine at ASAM this week!

Welcome ASAM attendees!!! I’m sorry you were tricked into thinking the conference is in Denver. They told us not to tell you. They threatened our families. (Kidding) See you all in Aurora soon!

Here’s what 8 years as a doctor has taught me: GO SEE THE PATIENT In medical school: every patient, as much as you can In residency: when the nurse is worried at 3am on your 28-hour call shift As an attending: when the hospice social worker calls your cell phone

Some days I love being a doctor and some days I hate being a doctor and sometimes those are the same day.

Also same! 😷

Anyone checked the price of eggs lately?

With only 1 month left to go, can we get a roll call for April’s American Society of Addiction Medicine (ASAM) Conference in ✨Denver✨???? Who wants to hang out 😎 (and also learn I guess)

My gynecologist, very diligently talking me through each step of my one millionth pap Me (on my phone): Yeah man, do what you gotta do

If you can generate a new research question about SSRIs that has not already been investigated in peer-review form since the first major US study on SSRIs in 1974 then you’ll actually have my vote for new HHS Secretary.

One of our supporters shared this with us—people are getting creative tonight!

Is anyone able to explain to me how removing the word “transgender” from corporate training manuals is supposed to lower the price of eggs? Anyone??

I need a new stethoscope. Should I get one of those fancy electronic ones? I’ve never used one. Do they work? Will I finally be able to hear a pleural rub?

How am I supposed to write learning objectives when I have exactly no idea what I will be talking about??? 🙃

Any addiction med folks have experience guiding patients through bupe quick starts either with 7-day Brixadi or IN naloxone followed by SL bupe rescue? I’ve read most of the case studies, just looking for some additional pearls of wisdom/lessons learned. Post below or DM me!

Hmm. One week in and this is already going very poorly. Appalling. Shocking. Who could have foreseen such an outcome.

This is a disaster for people experiencing homelessness, who may not know to expect this drastic temp drop. At these temps, frostbite can occur in <30 minutes. In most cases this is less time than it would take someone to walk to the nearest emergency center.

For the record, for my employer, I’ve done 0/3 of these things.

Apropos of nothing, I still think about this clip like once a month. #Sayitnicer

I’m an addiction medicine specialist and I drink alcohol. I fully support adding the cancer warning label to all retail alcohol products. Reducing harm always starts with understanding and acknowledging risk.

Most pills taste like nothing so WHY does Augmentin taste SO awful?!?! I’m taking it after a dog bite and I can barely choke it down. It even smells bad????? Truly a foul medication 😭

In partnership with our local emergency medicine residency, we’re piloting the use of ultrasound on street medicine and other satellite locations (this happens to be at a transitional tiny home village.) Excited to see how it changes our management! 🔥 Pic taken and posted with permission

If you think you’re having a bad Monday, at least Matt Gaetz’s day is worse.

Medical training

No spoilers in case, like me, you’re watching it 20 years late, but season 4 of Dexter with John Lithgow is VERY STRESSFUL

LOOK what happened when I was 2-factor authenticating my millionth buprenorphine prescription of the day!!!

Aw, thanks. Our outreach and street medicine teams go out just about 365 days/year in all weather. I’m incredibly grateful that I get to work 8 hours and come home to a warm house.

Just a friendly reminder that “if you continue to deny this medically necessary treatment and my patient dies as a result, I will sue you with their family” is a thing you can say to insurance companies.

Me when a patient tells me their unlicensed, unaccredited #sober living house won’t let them be on #buprenorphine or #methadone

If you were undergoing Senate confirmation for a cabinet position, what disqualifying dirt would they find? In 3rd grade, I wrote “Carolyn loves Peter” on the bathroom wall, in sharpie, to frame a girl I didn’t like when, all along, it was actually I who loved Peter 😭

Updated information is that this incident appears related to over consumption of alcohol, not “tainted cocaine” or fentanyl. One student remains hospitalized. Harm reduction is for alcohol too! We need more education and cultural support for this on campuses. www.denverpost.com/2024/12/10/k...

There’s a house in my neighborhood with a cute custom mailbox full of dog treats that Jayde now wants to visit on every walk. So I made a collage of every time she posed next to the mailbox for treats and I’m going to give it to the neighbor along with a big box of Greenies to replenish the stock 🤣

Ah, well, he’s seen it firsthand, so. I guess that settles it. All doctors are corrupt. Noted. 🫡

I’m glad these kids are going to be OK. Sounds like someone noticed they weren’t doing well and got them help in time. They were lucky. Every @cuboulder.bsky.social frat house should have drug testing strips and #naloxone freely available. www.denverpost.com/2024/12/08/b...

Driving around in my car with the driver’s side sun visor that’s been broken and flopping around for more than a year: My brother: Get that shit fixed already. You’re better than this Me: I’m really not 🤷‍♀️

If I was a billionaire I think I would live in a tastefully restored 5br/3ba early 1900s Denver Victorian, drive the nice Honda Accord with all the upgrades, buy myself a $2,500 road bike, and then mind my own damn business. NOT, you know, whatever this guy is doing.

Real question is…what the fuck happened to me in October to account for this very odd genre progression? The world may never know. (Nothing. My #wrapped is just a bubbling cauldron of chaos generating more questions than it answers)

Listen, I’m sorry a guy got killed. Sorry for his family, mostly. But, to be clear, United Healthcare has been killing people for decades. All private insurance companies put profit before people, but United Healthcare is notoriously the worst of them all.

I sure do feel refreshed after that 6 hours of sleep jam-packed with dreams about medicine, scheduling, and laundry. 🙄

Thinking about getting some type of poisonous plant tattoo so I’m casually googling things like “what poisons did women use to murder their husbands” and I don’t see what could possibly go wrong here. Have a favorite pretty poisonous plant? LMK

Omg there should be a medical sketch comedy group called In Stitches, right? Right?

My mom just called me out of the blue to ask if people, like turkeys, also have light and dark meat. ……. I honestly didn’t know. Thoughts?

Thank God for this timely PSA from 2014

How many times will I open Bluesky when trying to open the butterfly mobile ultrasound app, or vice versa? Stay tuned.

Bluesky, meet Jayde: the 3-year old epileptic pitbull with no chill. I adore her.

Introduce yourself with your worst feedback from work/school. My grandfather offered to pay for RN school on the condition that I give up the idea of going to medical school because he (a doctor) didn’t think women make good doctors. But he’s dead now and my loans are almost paid off, so 💅🏻

Me when I’m busy: “ugh, I’m stressed.” Me when I’m not busy: “ugh, I’m bored.”

@jabarocas.bsky.social omg follow me you doofus 😝

Surely I misheard. There’s no way Dr. Oz, the OG grifter, president of grift university, has been tapped to lead the largest and most influential US healthcare entity.

Oh, that’s fun. 1. Hopefully, my thoughtful and informative tweets about addiction and homelessness 2. Realistically, the pet cam photo of my dog standing on my table, and the time I trolled Brett Kavanaugh’s face until one of his staffers DM’d me asking me to stop 🤣