Honora Englander

"We are bearing witness to what fear can do to the health of a community"
A poignant piece @NEJM about the Minneapolis devastation
"We care for our patients because they are human beings. Our patients are being harmed. People are dying unnecessarily."
www.nejm.org/doi/full/10....

Portland OR Hands Off Rally

Oh wow: Portland Oregon is NOT KIDDING
#handsoff

Those trying to understand the tariffs as economic policy are dangerously naive.

No, the tariffs are a tool to collapse our democracy. A means to compel loyalty from every business that will need to petition Trump for relief.

1/ A 🧵 to explain his plan and how we fight back.

March saw the third-highest number of layoffs in U.S. history, and 80% of them were caused by DOGE

This was before the tariffs

It's just...unbelievable

The entire SAMHSA staff that manages the National Survey on Drug Use and Health has been terminated. This is the only survey that tracks mental health and substance use trends in the US.

We really are flying blind now.

Federal Health Workers Make Up Less Than 1% of Agency Spending (Gift Article) Health Secretary Robert F. Kennedy Jr. suggests that laying off thousands of federal workers would tame a massive budget. But nearly all of the agency’s money goes to hospitals, doctors and nursing ho...

HHS doctors, scientists and tobacco control staff, rare disease experts, cancer drug wizards -- all fired today or leaving in recent weeks.

Yet.

🚨 At HHS, staff make up less than one percent of the overall agency budget. 🚨

www.nytimes.com/2025/04/01/h...

‘One of the darkest days’: NIH purges agency leadership amid mass layoffs In shock move, four institute directors at the US biomedical agency are removed from their posts.

"This will go down as one of the darkest days in modern scientific history." Story on the decimation of NIH by @maxkozlov.bsky.social www.nature.com/articles/d41...?

@salisburyafshar.bsky.social @amersa.org @jefbratberg.bsky.social @marlenemartinmd.bsky.social @ohsu-chse.bsky.social @ohsunews.bsky.social

I'm still getting my legs about me on #BlueSky so not sure who's here, but for starters, tagging a few including: @maiasz.bsky.social @levfacher.bsky.social @suenlw.bsky.social@stephenhrnrp.bsky.social @drscotthadland.bsky.social @drsarahwakeman.bsky.social @yaleadm.bsky.social @suenlw.bsky.social

Huge thanks to #USFulbright #FondationNeurodis #LeCentreHospitalierVinatier, my ✨hosts @benjaminrolland.bsky.social @marieroustide.bsky.social, our participants, and a long list of ppl who helped mentor, teach, and support this work

Seeing this in practice offered such a sharp contrast to the the US. And, it offers not only a critique but an alternative to policies and practices rooted in punishment and control.

My hope is that clinicians, policy makers can use this to better recognize our assumptions & move forward in the US

We also found that to accomplish this, clinicians balanced flexibility and structure, weighing clinical decisions and risks in context /7

The biggest Qs that I have heard from US clinicians about this is: "are you saying abstinence is bad?"

My reply: No! The point is not that abstinence is bad, or that we shouldn't support people when that is their goal. But if the system imposes it, there are unintended harms. / 6

This is so different than the US, where in subtle and very overt ways, the whole system prioritizes abstinence.

Even among healthcare clinicians who embrace harm reduction, harm reduction is often positioned as an intermediate or lesser goal. Not THE goal of MOUD /5

What did we find?
Participants described pt engagement as the #1 goal of OAT. They felt imposing or expecting abstinence was harmful and might obligate patients to lie or “lead a double life,” lead to mistrust, missed care opportunities, and “losing patients” who disengaged from care /4

Comparing methadone policy and practice in France and the US: Implications for US policy reform - PubMed Despite being among the most effective treatments for opioid use disorder, methadone is largely unavailable in the United States, due primarily to federal and other policies that limit its availabilit...

We compared methadone policies in US and FR (below).

Here, we interviewed healthcare stakeholders (MDs, nurses, pharmacists, drug user union activists, policymakers) to explore how they approached methadone and bup, drawing lessons for the US and elsewhere.
pubmed.ncbi.nlm.nih.gov/38878588/

I spent a year studying methadone and bup care (OAT) in France where 87% of ppl with opioid use disorder receive OAT vs <20% in the US

w the brilliant @benjaminrolland.bsky.social & Marie Jauffret-Roustide, I wanted to understand *HOW*. Turns out: clinicians and systems prioritize engagement/ 2

Sage Journals: Discover world-class research Subscription and open access journals from Sage, the world's leading independent academic publisher.

Hot off the press in @sajamersa.bsky.social: “Un attracteur de soins”: Bringing People Into Care. Interdisciplinary Health Care Professionals’ Attitudes Toward Opioid Agonist Therapy in France: a Qualitative Study with Implications for the United States/ 🧵

journals.sagepub.com/doi/full/10....

The entire National Survey on Drug Use and Health (NSDUH) team at SAMHSA was terminated today.

Do not listen to the platitudes of this administration when they say they care about drug overdose, addiction, mental health, or suicide.

American Science in Peril This Viewpoint discusses the importance of federal funding of biomedical research from the National Institutes of Health to scientific discovery, advancements in individual and public health, and the support of the US’ community of scientists.

Viewpoint: Recent disruptions and funding cuts at the NIH undermine the infrastructure and stability of US scientific research, threatening the nation's global leadership and scientific productivity. https://ja.ma/3FLvqHS

Congrats to @suenlw.bsky.social & team (& @amersa.org Board Members!) for receiving the 2024 SAj Most Downloaded Paper Award: " #Methadone Resurgence in Bridging the Treatment Gap in the #Overdose Crisis: Position Statement of #AMERSA, Inc).Science into advocacy! journals.sagepub.com/doi/full/10....

Hello Bluesky!
📣If you haven't heard it yet, check out our latest episode of "Behind the Evidence" w Dr Ayesha Appa - produced with BMCs Grayken Center for Addiction. We talk with authors about innovative research with real-world practice and policy implications rss.com/podcasts/beh...