iiinova — where your digital self keeps evolving

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 06/10/2026

In research we do "secret shopper" studies where we pretend to be patients/drug buyers/whatever role to assess real world practices. I think as long as the actor is able to freely make the decision to participate and is aware of the risks, I trust them to make that call!

010

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 06/10/2026

And I would argue that in many (most?) cases, medicalization of course changes the nature of stigma, but without necessarily eliminating core drivers of prejudice and discrimination towards the condition. Examples: cleft palate, autism, substance use disorders

020

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 06/10/2026

I cannot think of a single case where the medicalization of a condition led to complete de-stigmatization of that condition. Reduced stigma? Sure. But never the elimination of all forms of stigma toward that condition. Can anyone think of a disconfirming case that proves this wrong?

110

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 06/10/2026

"Half of men ages 18-49, say they have an active sportsbook account." The "controls" offered on platforms require opt-in, so "gamblers are left to regulate themselves." As the mom of young boys and as an addiction researcher with problem gamblers in my family, this is bad for me but also everyone.

121

Reposted by Erin Fanning Madden, PhD, MPH

David Ho @davidho.bsky.social · 06/10/2026

Oh look, US National Science Foundation-supported science won the Nobel Prize in physics.

101108201

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 05/10/2026

I'm so so so sick of reading admissions essays that are clearly written by AI. An overwhelming number of international applicants are doing this, but also many who do not have the same language hurdles are too. I already hate admissions commitee work and this just makes it that much worse.

020

Reposted by Erin Fanning Madden, PhD, MPH

Claire Zagorski, PhD, MSc, EMT-P @clairezagorski.bsky.social · 25/09/2026

If your pain needs an additional 50 mg of morphine to be reduced enough for sleep, that’s not opioid-resistant pain. If your fever needs three Tylenol instead of two to break, it’s not medication-resistant. If you need an additional dose of naloxone to see effect, that’s not naloxone resistance.

A post from KXAN on Instagram: Is cychlorphine in Austin?
EMS says Narcan-resistant overdoses could suggest so

35820

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 14/08/2026

The authors end on this note, which I 100% agree with: "Given the substantial burden these infections impose on individuals and healthcare systems, there is an urgent need for high-quality research or well-powered observational studies, including in low- and middle-income countries."

000

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 14/08/2026

Not saying the authors did anything wrong here. But as the US fed govt increasingly promotes an anti-harm reduction stance, the timing of this paper is... not ideal.

110

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 14/08/2026

The interpretation here should be that we need more funding for studies assessing harm reduction's impact on skin and soft tissue infections, but it's also likely people will use this paper in bad faith arguments against harm reduction funding.

120

Reposted by Erin Fanning Madden, PhD, MPH

American Journal of Drug and Alcohol Abuse @ajdaajournal.bsky.social · 10/08/2026

Recovery housing and harm reduction don't have to be at odds. National survey: 98% of recovery residences keep naloxone on site, but many still limit access for people taking medications for substance use treatment. There's room to bridge the gap. www.tandfonline.com/doi/full/10.... #HarmReduction

011

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 11/08/2026

I'm gonna go ahead and say that it's a big red flag when the police are more empathetic and patient-centered than hospital staff towards someone coming in with adverse drug-related health issues.

010

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 11/08/2026

New fear unlocked for me as a writer who never uses AI: "Academic writing is collaborative... That means that all of us have the ability to end each other’s career... GenAI adds the possibility that other people will introduce writing into your paper that can be credibly accused of plagiarism."

000

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 11/08/2026

Oof, yes. I never use AI for any writing task because I love to write and am vain enough to think I do it better than AI anyway 😉. But I also never check with my co-authors about their use of AI when they're the ones writing up the manuscript.

000

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 05/08/2026

Excellent succinct critique of the updated version of the Modernizing Opioid Treatment Access Act (MOTAA) introduced into the US senate. It still overregulates this lifesaving medication. We can do better.

010

Reposted by Erin Fanning Madden, PhD, MPH

Filter | harm reduction journalism @filtermag.bsky.social · 22/07/2026

"Some states are represented by a single county; others by up to nine counties. There’s no standardization in how many sampling sites each county included, or whether multiple sites were spread out versus concentrated in one area."

filtermag.org

White House Shares First Data From Wastewater Drug-Testing Project - Filter

The Office of National Drug Control Policy (ONDCP) has published its first report on wastewater-based drug testing, something that wasn’t ...

175

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 01/07/2026

Just submitted a comment on the HHS "Great American Recovery Initiative," which proposes to end federal support for harm reduction other than naloxone. If this sounds like a bad idea to you too, submit a comment! Comments will be accepted until 7/5. www.federalregister.gov/documents/20...

federalregister.gov

HHS Request for Comment on Chronic Disease of Addiction

Thanks to President Trump's leadership, since 2017, the country has made significant progress in addressing mental health and substance use. However, President Trump and HHS Secretary Kennedy realize ...

010

Reposted by Erin Fanning Madden, PhD, MPH

Drug Policy Alliance @drugpolicy.org · 26/06/2026

Methadone is one of the most effective treatments for opioid addiction, yet federal law still limits access by making people to go through through specialty clinics. A new bipartisan bill would allow physicians to prescribe methadone directly through pharmacies, expanding access to life-saving care.

statnews.com

Bipartisan bill seeks to allow direct prescribing of methadone for opioid addiction

Methadone for opioid addiction has been available only at specialty clinics. A bipartisan bill would greatly expand access.

063

Reposted by Erin Fanning Madden, PhD, MPH

Gregg Gonsalves @gregggonsalves.bsky.social · 23/06/2026

OK, people. It takes 2 minutes to write a letter to Congress, a few extra if you personalize it. Russ Vought's attempt to take over ALL federal grant funding is anti-democratic and dangerous. We need MORE letters. Let's tip it over 2000 today. actionnetwork.org/letters/oppo...

actionnetwork.org

Oppose OMB Proposal to Put ALL Federal Government Funding Decisions in the Hands of Political Appointees

On May 29, 2026, the Office of Management and Budget issued a Notice of Proposed Rulemaking (NPRM), OMB-2026-0034, Regulation for Federal Financial Assistance. The scope of this proposed regulation is...

6253166

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 18/06/2026

I got curious this year & asked my MPH students about their use of AI. A resounding "yuck" from all 20 students. One said she hates it but uses it because a prof said her writing was "too much like how she talks" and made her self conscious. Surely laziness drives use sometimes, but insecurity too!

0125

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 10/06/2026

2 of many decisions that risk reversing our progress: "SAMHSA caution[ed] against the long-term use of methadone or buprenorphine... the Trump administration appointed Michael Stuart, a former WV state lawmaker best known for introducing legislation to ban methadone treatment, as the top HHS lawyer"

000

Reposted by Erin Fanning Madden, PhD, MPH

Daniel S. Goldberg @profgoldberg.bsky.social · 05/06/2026

👀

283

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 08/06/2026

Holy moly. Not surprised at the findings (casual and unquestioned weight stigma is the norm in the academic medical settings I've worked in), but impressed with the analysis!

011

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 08/06/2026

I am generally opposed to sharing qualitative data outside of a study team! It would be great if we could do so and guarantee anonymity, but good qualitative data is detailed, so its very nature makes it impossible to truly de-identify and still be useable.

000

Reposted by Erin Fanning Madden, PhD, MPH

Jess Calarco @jessicacalarco.com · 08/06/2026

NEW from me in @pnas.org on the risks of data sharing with qualitative research: "Today, confidentiality risks are amplified by social media, surveillance, and AI tools, which make ample data about people publicly available, thus making deidentification less effective" www.pnas.org/doi/10.1073/...

Article in the Proceedings of the National Academy of Sciences: "With qualitative research, the risks of data sharing can outweigh the rewards." June 5, 2026.

626398

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 04/06/2026

I'm all for providing scientific findings for free to the public, but my god clinicaltrials.gov is hell. I truly loathe reporting to it. There must be a better path than this. Can't we just make all scientific journals free and require empirical papers have a single 1-page lay summary of results?

010

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 21/05/2026

The majority of MH clinicians in our study had relatively positive regard for patients with addictions. Little if any disdain! And so the training and policy interventions didn't cast the stigma problem that way. The problem was patients getting tossed around &/or not having their use addressed.

100

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 20/05/2026

So #1 is a personal preference issue, #2 is more of a training/institutional resource issue, and #3 is a slight regulatory issue, but #1 was the more common reason. All 3 contribute to patients with addiction being excluded from mental health care and thus are drivers of stigma, imo.

100

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 20/05/2026

3) some states limit primary addiction treatment to specialized providers but all mental health providers in any state can address secondary addiction diagnoses among patients with a primary mental health condition

110

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 20/05/2026

Clinicians usually excluded patients seeking mental healthcare who presented with co-occurring addiction because they 1) preferred working on different diagnoses & had enough demand to fill their panels with those preferred patients; 2) felt unprepared or under-resourced to address addiction;

110

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 20/05/2026

It was mostly a failure, but one that hopefully we all can learn from?!

220

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 20/05/2026

And this link to free access will expire in July 2026, after which please see doi.org/10.1016/j.jo...

doi.org

Redirecting

100

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 20/05/2026

3) 🚫 mental health clinicians are worried about working outside of what they see as their personal scope of practice, and largely disagree with the idea that excluding substance use patients constitutes stigma, even if the end result is patients not getting consistent care (4/4)

130

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 20/05/2026

2) 😖 if you let clinicians pick a stigma reduction intervention, you might end up one that's easy to implement, but doesn't actually make anyone change anything about how they think or behave (3/4)

131

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 20/05/2026

What we learned: 1) 🦄 mental health providers are a pretty unique category of clinicians when it comes to stigma and typical substance use stigma reduction approaches probably aren't right for them! (2/4)

140

Reposted by Erin Fanning Madden, PhD, MPH

Pam Herd @pamherd.bsky.social · 26/04/2026

I now require students to add a hyperlink to the actual article. Journals should be requiring this as well.

828440

Reposted by Erin Fanning Madden, PhD, MPH

Pam Herd @pamherd.bsky.social · 22/04/2026

The number of NIH competitive awards is down 50% from 2025, and down ~70% from prior years. Even if they catch up by the end of the year, only wealthy institutions can bridge these huge funding gaps.They're killing science-and violating the constitution-by weaponizing the bureaucracy

figure showing the trends I detail in the tweet text

8215157

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 22/04/2026

PSA to my non-sociologists studying stigma: Please stop saying "stigma and discrimination." Stigma is by definition inclusive of both prejudice and discrimination. Adding "discrimination" implies stigma is only attitudinal, which is wrong. Thanks, a sociologist.

031

Reposted by Erin Fanning Madden, PhD, MPH

Filter | harm reduction journalism @filtermag.bsky.social · 07/04/2026

"Medetomidine can be thought of as the direct successor to xylazine. It's not associated with soft-tissue infections, but has distinct side effects of its own, including a withdrawal process that can require intensive hospital care."

filtermag.org

CDC and ONDCP Issue Health Alert for Medetomidine, an Unusual Move

Medetomidine is the direct successor to xylazine. It's not associated with soft-tissue infections, but has distinct side effects of its own.

076

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 07/04/2026

I think this journalist needs to get that memo: www.nytimes.com/2026/04/06/o...

nytimes.com

Opinion | San Francisco Sobers Up

000

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 06/04/2026

Also weird to frame this as a "failure of progressivism" and not a feature of, oh I don't know, our systemic housing crisis or healthcare crisis.

050

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 06/04/2026

Any SF harm reductionists want to weigh in on this *interesting* claim?: "Treatment and recovery became secondary goals, if they were goals at all... Harm reduction providers did not want to push users into treatment, worried [it] could [scare clients] away. The approach was all carrot, no stick."

120

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 26/03/2026

And I made a typo because I found this so jarring, I guess!

000

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 26/03/2026

I don't sped much time on the CDC website, so maybe I'm late on this, but this disclaimer is psychotic.

Disclaimer on CDC "psychosocial pathways" page reads: "Per a court order, HHS is required to restore this website to its version as of 12:00 AM on January 29, 2025. Information on this page may be modified and/or removed in the future subject to the terms of the court’s order and implemented consistent with applicable law. Any information on this page promoting gender ideology is extremely inaccurate and disconnected from truth. The Trump Administration rejects gender ideology due to the harms and divisiveness it causes. This page does not reflect reality and therefore the Administration and this Department reject it."

240

Reposted by Erin Fanning Madden, PhD, MPH

John Travis @john-travis.bsky.social · 11/03/2026

Few of the things I work on at Science are purely fun, but the Dance your Ph.D contest is an exception. I'm always impressed by the creativity and enthusiasm of the entries. Graceful electrons and pole dancing analysis of pee? See this year's winners! www.science.org/content/arti...

science.org

And the winner of Science’s 2026 ‘Dance Your Ph.D.’ contest is …

A physicist and professional dancer takes home the grand prize, and Science awards its first trophy for an AI-assisted dance concept

1318

Erin Fanning Madden, PhD, MPH @efanningmadden.bsky.social · 11/03/2026

Every time I have to go through the single IRB process as the relying (nonprimary) site it doesn’t really feel much shorter than having to go through a full IRB review. I thought the whole point of the single IRB model was to avoid multiple unnecessary IRB reviews?

000