Nicole Baker, MPH

i could’ve dropped my croissant

[Afshine Emrani MD FACC @afshineemrani]

I'm a cardiologist. Hayden Panettiere died at 36. Toxicology is pending, and I won't speculate about what killed her. But I want to say something about what her death should force us to confront, because I think we're going to get this wrong the way we always do.

She had already done everything we tell people to do. She spoke publicly about addiction. She named the postpartum depression. She wrote the memoir. She was told her liver damage could kill her within five years and she said it out loud, in interviews, to an audience of millions. She did the disclosure. She did the reckoning. She got the applause for being brave.

And she died at 36 anyway.

Here's the uncomfortable thing I need you to understand: that is not a contradiction. That is the disease. Addiction is a chronic, relapsing brain disorder with high fatality rates even among people who have insight, support, resources, and genuine periods of sobriety. Relapse is not a moral failure or evidence that someone wasn't really trying. For a substantial percentage of patients, it is the expected clinical course. The body does not care how eloquently you articulated your trauma, or how many people celebrated your journey.

We have built an entire cultural performance around public recovery, and we have quietly confused disclosure with protection. Someone tells their story. We call it progress. We share the interview. We buy the book. And we feel, collectively, that something has been solved. Nothing has been solved. The underlying drivers remain exactly where they were — untreated or incompletely treated psychiatric illness, unaddressed trauma, easy access to potent opioids, the neurobiology of tolerance and craving that does not respond to insight, and the systems and people who enabled it in the first place.

A memoir is not a treatment plan. And I want to say something specific about naloxone, because it's the piece most misunderstood. Naloxone reverses opioid-induced respiratory depression. It is extraordinary. It saves lives when it reaches someone in time, and everyone reading this should have it and know how to use it. In most states you can get it at a pharmacy without a prescription. But naloxone is harm reduction, not treatment. It buys minutes. It does not rewire the circuitry that drives someone back to the next dose after years of trying to stop.

And in my own field, I'll add the part rarely said: opioid overdose kills through respiratory arrest that becomes cardiac arrest. By the time the heart stops, hypoxic injury to the brain and heart may already be irreversible. The window is measured in minutes. Which is precisely why the drug has to already be in the room, and why someone has to be there to give it.

Here is what actually reduces mortality, and it is unglamorous:

Medication for opioid use disorder — buprenorphine, methadone, naltrexone. These substantially reduce overdose death, and they remain badly underused, badly stigmatized, and hard to access. If you take one clinical fact from this post, take that one. Treating the psychiatric illness underneath, properly and continuously — not as an afterthought to the addiction. Naloxone in the home, in the bag, at the workplace, everywhere. And sustained care long after the public has moved on — which is the thing our attention span is structurally incapable of providing.

Hundreds of thousands of people have died of this same physiology, under the same mechanism, without a single headline. We notice when the face is familiar. We extend more grace when there's a redemption arc attached. That selective attention is itself part of the problem — because it means our response is shaped by narrative rather than by mortality data.

Toxicology will eventually clarify the mechanism. It will not answer the harder question: why a woman who had already named the danger, with every resource available to her, still ended here at 36. That question belongs to all of us — to medicine, to an industry that consumed her from childhood, and to a culture that prefers the drama of a fall and a partial recovery over the tedious, expensive, imperfect work of keeping people alive for decades.

Addiction is not a story. It is a high-mortality disease. We should treat it like one — with medication, with sustained care, with naloxone in every home, and with a great deal less applause for disclosure and a great deal more funding for treatment.

Rest in peace, Hayden. Thirty-six.

[🇬🇩 @OhCoco]

The people are yearning for the Charged Lemonade. Plz bring it back and make us sign a waiver @panerabread

[Democrats Deliver @DemzDeliver]

🚨Homicides in Baltimore are at the lowest number ever recorded, falling 60% since 2021.

[philip lewis @Phil_Lewis_]

We profiled the important work of Ms. Shirley during the pandemic. Please read:

https://t.co/3UFqM1A0Kz

[Acyn @Acyn]

Mamdani: I am in support of abolishing ICE. What we see is an entity that has no interest in fulfilling its stated reason to exist. We're seeing a government agency that is supposed to be enforcing some kind of immigration law but instead it's terrorizing people no matter their immigration status, no matter the facts of the law, no matter the facts of the case and I'm tired of waking up every day and seeing a new image of someone being dragged out of a car, dragged out of their home, dragged out of their life.

[Mayor Muriel Bowser @MayorBowser]

DC has shelter space for everyone who needs it.

It’s going to get colder in DC in the next few days—this is your reminder that anyone can anonymously call the shelter hotline for free transportation to a safe, warm space.

DC Shelter Hotline: [phone]

[Tone Digs @ToneDigz]

AND THEY SAID BOWL SEASON WAS DEAD. Embrace the gimmick and we will survive!

[Melanie D'Arrigo @DarrigoMelanie]

Megachurches don’t pay taxes because they are expected to provide public benefits, such as charity, education, and social support.

This would have filled a lot food pantries and helped lots of people struggling to afford basic necessities.

Tax churches.

[Shannon Watts @shannonrwatts]

Many studies suggest a major cause of autism is the mutated sperm of elderly fathers, but in a centuries old tradition (see everything from schizophrenia to eating disorders), men have decided to blame women for taking Tylenol while pregnant (despite no valid supporting studies).

[matt bernstein @mattxiv]

are we supposed to pretend it’s normal that they’re ushering in authoritarianism because you’re not allowed to criticize maga’s favorite podcaster

[✰ⓝ🅴🅿︎🆃🆄🅽🅴ⓦ🅰︎🆅🅴🆈✰ @neptunewavey]

IT’S OUT!!!! https://t.co/sv0urXfD1v

[sai @sighduhh]

they didn’t believe in us. they called us delusional. nicolandria hive, we did this! #LoveIslandUSA

[Pope Leo XIV @Pontifex]

From #Gaza, the cries of parents rise to heaven ever more intensely as they clutch the lifeless bodies of their children, searching for food and shelter from bombs. I renew my appeal to leaders: cease fire, release all hostages, and fully respect international humanitarian law!

[Pope Leo XIV @Pontifex]

The situation in the Gaza Strip is increasingly worrying and painful. I renew my heartfelt appeal to allow the entry of dignified humanitarian aid and to bring an end to the hostilities, whose heart-rending price is borne by children, the elderly, and the sick.

[Craig Spencer MD MPH @Craig_A_Spencer]

Thousands of the best experts at FDA, NIH, and all across HHS are being terminated right now.

These are the people who make sure the medications you and your children take are safe.

These are the people who perform and oversee research on cancer, infant health, and so so so much more.

These are the people who make sure new devices that physicians and patients use are effective.

These are the people who keep workers safe on the job and help prevent devastating injuries for workers all around the country.

These are the people who track what drugs and medications are experiencing shortages so we can adapt.

These are the people who help tackle HIV and other infectious diseases, asthma, lead poisoning, and everything else that makes many Americans sick.

And now, thousands of them are gone.

There is no way this makes Americans healthier.

We will regret this.

[Neil Stone @DrNeilStone]

Enormous lies here from your new HHS Secretary

The HPV vaccine (Gardasil) is safe, effective, and is on the way to ELIMINATING cervical cancer!

RFK Jr is an anti vaccine fanatic who would rather your daughter got cervical cancer than a vaccine

Horrible, horrible man.

[ᴇᴠᴇʀʏᴛʜɪɴɢ ɪꜱ ʟᴏᴠᴇ @limonadjuice]

I don’t have a valentine but I do have Beyoncé tickets so I’m happy.

[COWBOY PHIL 𐚁☆▷ @GrandpaHive]

I love Beyoncé concerts with all my heart, I really do, they’re the best thing in the fucking world, but my god do I hate the process of getting there 😂

[Rich Raho @RichRaho]

MAJOR BREAKING: Pope Francis has written a letter to US Bishops saying he’s following “major crisis” of “mass deportations;” takes on Vance saying “The true ordo amoris that must be promoted is that which we discover by meditating constantly on the parable of the “Good Samaritan”