A true paradigm shift would start with recognition that the experiences we call mental illness are essentially “normal” human responses to psychosocial factors such as inequity, abuse, poverty, housing insecurity, unemployment and trauma. apadivisions.org/division-32/le…

Restricting access only to OTP not only limits access and increases stigma, the concentration of so much power over vulnerable people into these siloes generates opportunities for abuse of both clients and financial fraud - overcharging Medicare for inferior or fake services.

A friend in the US recently had to turn down a great career opportunity due to being tethered to an OTP. Her dream job would've been an hour and a half drive time to the nearest methadone clinic.

Rule #1 for methadone clients - CLINIC STAFF ARE NOT THERE TO HELP YOU. Rid any illusions of support, or god forbid you're naive enough to think you'll be getting tx, get those delusions out of your head. These are gatekeepers who will throw you under a bus if you pose liability.

"Lifestyle" sure is a weird way to say, structural violence, poverty, and lack of preventative care contribute to negative dental outcomes. pubmed.ncbi.nlm.nih.gov/19055091/#:~:t….

On reflection, it blows my mind CMS was ever thought of as "one of the good ones". Such is the deathscape that people in the US, dependent on opioids operate within - orgs who literally collaborate with institutions that are killing you are still seen as doing better than most.

Receiving texts today from friends in US who are still prisoners at methadone clinics, and the guilt I'm feeling at having escaped the abuse posing as support at OTP is hitting me a bit hard.

This is the methadone clinic near my house in Sydney Australia. Unlike 1-size-fits-all system in US, OTP are only 1 of several option available. There are many + differences between Aussie/US clinics, you'll see there is a syringe vending machine outside. No NIMBYs here.

The emetic quality of these self-congratulatory posts from US-based "nonprofit" drug trauma profiteers is as consistent as death and taxes.

Jail increased her risk across all causes of death. Her vulnerability to exp a deadly OD multiplied >10x. We will spend millions $ research on OD prevention - as if the horrific answer isn't staring us in the face. #SocialMurder stacks.cdc.gov/view/cdc/14594…

If you're interested in community research, you're welcome to attend this talk with myself & Dr. Beth (bethmeyerson.bsky.social) 🏳️‍🌈🏳️‍⚧️. 🐨 April 9th 10-11am (Sydney time) 🍔 April 8th 4-5 pm (LA) UNSW Centre for Social Research in Health UNSW Social Policy Research Centre Kirby Institute, UNSW

Many people here in Australia pick up their methadone from the pharmacy and check in with their general practitioner every ~30 days initially, and afterwards ~90 days or so. In US, profit motive of methadone clinics is central over client safety/wellbeing

Thinking about how I've been drug tested once in the almost 1 year I've been on methadone here in Australia. This would be unimaginable in the US OTP system - which would never center my needs and safety like this. US methadone clinics center profit and surveillance posing as tx

The resistance to increasing accessibility to methadone in the US via misrepresentations like "Program Not a Pill" isn't evidence based. Found this systematic review of psychosocial interventions, which really contradicts the BS these US clinics spout. journals.plos.org/plosone/articl…

Oh wow! They can "earn" up to 1 methadone take home each week they participate in these (as usual) misguided methadone clinic punishme...erm I mean initiative. The language in USA of "earning" medical care and basic dignity is revolting.

If the obsession we observe among some doctors for buprenorphine wasn't occurring because it gives them more control over patients and adheres to a carceral ethic they operate under, then they wouldn't refuse to rx subutex (bupe sans naloxone - the "joy" police) even when asked.