Why Is Fentanyl Used to Cut Other Drugs If It Kills So Many People?

The drug crisis in the United States has taken many twists and turns, but today we are faced with the most challenging chapter yet. Recent data has shown the number of drug-caused deaths hitting the 100,000 mark, the highest it has ever been. Driving this parabolic increase is a drug known as fentanyl. This drug has been the topic of many headlines because of its potency. At 50- and 100-times greater strength than heroin and morphine, respectively, it takes only a tiny amount to cause overdose and death. There have even been reports of unsuspecting individuals (usually police during traffic stops1) that have come in contact with fentanyl and overdosed. With such small amounts of fentanyl causing such outsized consequences, it can seem baffling that illicit drug producers would include such a compound in their formulations. After all, don’t profits rely on the user staying alive? Let’s dive in.

A Short History of Fentanyl

Fentanyl is a synthetic opioid drug FDA-approved in the 1960s as an anesthetic and analgesic – for pain relief. In other words, fentanyl has legal use in treating chronic and acute pain after injury or surgery. Today, fentanyl is produced in several forms, including lozenges, effervescent tablets, sublingual tablets, sprays – sublingual and nasal, skin patches, and as an injectable intravenous drug. Typically, the drug enters the black market via legal prescriptions that are distributed illegally or by illegal production and distribution rings (most often found in Mexico and China).

The common signs of an opioid overdose are:

  • Pinpoint (very small) pupils
  • Falling asleep or losing consciousness
  • Slow, weak, or no breathing
  • Choking or gurgling sounds
  • Limp body
  • Cold and/or clammy skin
  • Discolored, often blue, skin (most commonly in lips and nails)

Linda Dolin, Medical Director at SBMHC, discusses this worsening trend. “Fentanyl, like some other opioids, hit the market with good intentions and a real use case. Unfortunately, its potency is decimating a generation of adolescents and young adults, destroying their potential and sadly cutting their lives far too short. If in doubt, even if you believe the person is high on drugs, assume it is an emergency and get help immediately. If you have Naloxone, administer it right away. You could save a life by assuming the worst.”

Can You Avoid Fentanyl?

While it would seem logical to avoid fentanyl, it is very difficult to tell it apart from other drugs. Powdered fentanyl can be mixed with heroin, cocaine, methamphetamine, or even manufactured to look like other opioid prescription medications. The user would have no idea, just by looking at it, that the drug contains fentanyl. Similarly, fentanyl can be produced in liquid form as part of nasal sprays or eye drops. Only fentanyl test strips can detect if the product contains the drug. While these test strips are inexpensive and offer a relatively rapid result, it’s unreasonable to expect someone taking illicit drugs to test every time.

How Can Fentanyl Be Profitable?

Fentanyl production is extremely cheap, so manufacturing in China and Mexico has proliferated. These producers do not care about the toll on human life, and quality standards are non-existent. Unlike many other drugs that require significantly more intense production requirements, to the degree that manufacturers would be financially hurt by a law enforcement seizure, the sheer quantity of fentanyl production makes the occasional seizure less problematic from a financial perspective.

Furthermore, tolerance can often occur more quickly because of the drug’s potency. And while fentanyl is laced into other synthetic opioids, it is often added to less addictive drugs (think Adderall, cocaine, and Xanax), increasing the potential for dependence and continued use. While thousands are dying from fentanyl overdoses, many more are getting hooked.

Is an Overdose Death A Win or Loss for a Drug Dealer?

With many smaller dealers cutting blends of fentanyl-laced drugs, the question remains whether an overdose death is good or bad for business, and it depends on how you look at it. On one hand, an overdose death would suggest that a dealer’s drug is potent. For someone highly dependent, usually resulting from long-term usage, this may be a reason to buy from them. On the other hand, overdose deaths trigger investigations that can ultimately bring down a drug dealer or their syndicate. Unfortunately, the rise in fentanyl-related deaths has overwhelmed law enforcement resources, often letting dealers and manufacturers get away if the deaths are sporadic or seemingly unrelated. Further, for every dealer put away, another usually waits to take their place.

Tackling the Fentanyl and Opioid Crisis

You may remember in the early 2000s when there was a proliferation of pain management clinics, colloquially known as “pill mills,” prevalent in various areas around the US, particularly in Florida. These clinics employed licensed healthcare practitioners prescribing pain medication to virtually anyone who requested it. The result was an incredible rise in opioid abuse and deaths. A subsequent crackdown stopped this proliferation by making it far more difficult to acquire these pills through medical sources and driving the price of illicitly acquired prescription opioids higher. As mentioned above, however, fentanyl is produced so cheaply overseas that it is far more difficult to prevent its distribution. As such, the solution to the current crisis requires a multi-pronged approach starting with addressing underlying factors.

Addressing Why People Start Taking Drugs

For most, drugs represent an escape from their day-to-day, often punctuated by physical or emotional trauma. While a substance abuse disorder must be treated as a chronic illness and not as a simple case of willpower, the choice to start taking drugs is just that – a choice. Intervening at this earliest time can stop what otherwise could become a lifelong fight that can, at any point, result in paying the ultimate price.

Often, the feelings of emptiness that lead children and young adults to start abusing substances come from trauma. Trauma can mean different things to different people, but one of the clear underlying causes of addiction that we see at SBMHC is an undercurrent of past negative experiences that have caused the person to alter their outlook in some, usually dramatic, way. If they do not receive appropriate psychological care at this early stage, many turn to substances of abuse to fill that void or at least temporarily remove themselves from the pain.

To this end, families play an important role in the development of and recovery from these events and resultant addiction or mental illness concerns. We often say that the mental health or addiction concerns of a single individual make the entire family sick; this necessitates the entire family coming together to promote and support the recovery and therapeutic process, and why the family program at SBMHC is such a big part of our therapeutic process. We consider it our crown jewel and a primary differentiating factor from other mental health facilities.

Today, there has been a significant push through the legislature and law enforcement organizations to address the fentanyl problem. However, as it always has been, the community is a significant part of the solution. For one, the stigma associated with addiction and mental illness must be addressed. As a society, we have made huge strides in improving access to care and talking about mental health and addiction issues without judgment. But we have a long way to go. Today, we must view the fentanyl crisis as a challenge every bit as important as the pandemic and other medical concerns like cancer and heart disease.

Resource:

  1. https://www.wfla.com/news/florida/video-florida-cop-treated-for-overdose-after-possible-fentanyl-exposure-police-say/

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Marion Weston, executive director

MARION WESTON

Executive Director

Marion Weston, Certified Interventionist, has been sober since November of 1989. Since then, she has sponsored many women through the 12-steps as well as being heavily involved in service. Also, Marion has led step workshops and has given talks in Nebraska, South Florida, Washington, New Jersey, Sweden and many other venues.

She has been involved since her first days in recovery with her Church and has enjoyed years of success in the chemical addiction field. Originally from Bellingham, Washington, Marion now resides in South Florida. Her favorite phrase is “turning scars into stars”.

Peter and Marion have a combined sobriety time of nearly 60 years, and a combined 40 years being in service to others in the field of treating substance use disorder.

Marion has been involved in recovery for over 25 years. She has walked many women down the path of recovery on both a personal and public level. Having been a part of 1-on-1 mentor-ship in recovery guiding women towards freedom, to leading various workshops to educate groups of men and women on the practical approach to a sober lifestyle. Marion strives to better herself and be of service to those around her.

Women recovering from alcohol addiction sometimes find it extremely difficult to survive without medications, the Through The Archway program helps them learn different dimensions of life and get over with addictions eventually.

Andrea Morganstein MS, RD, LDN, CDCES, Registered dietitian

ANDREA MORGANSTEIN

REGISTERED DIETICIAN

Andrea Morganstein MS, RD, LDN, CDCES is a registered dietitian and certified diabetes care and education specialist who received her Master’s degree in Nutrition and Dietetics from Florida International University in Miami, Florida. Some of her certifications include weight management, functional nutrition, fitness, and diabetes.  She currents owns a private practice in Davie, Florida and works one-on-one with individuals helping them achieve a healthier lifestyle using conventional nutrition as well as functional/integrative nutrition concepts. 

She started her career in Sports Nutrition and weight management but over the years has expanded her knowledge and expertise to include diabetes, mental health and substance abuse. As a contractor for multiple local addiction and mental health facilities, Andrea shares her passion and knowledge about nutrition in conjunction with behavioral changes with her clients suffering from mental health disorders including disordered eating and substance abuse. She works with them individually as well as in a group setting.

Alex Lizardo, Group facilitator

ALEX LIZARDO

GROUP FACILITATOR

Alex Lizardo is an entrepreneur, writer, speaker, philanthropist, and an unshakable optimist. She is an obsessive learner who spends time reading, writing and creating strategic projects to help individuals make their dreams a reality. She is was born and raised in Venezuela, having moved to the United States in 2010 and established presence as a certified life coach with a specialization in spiritual psychology. A mechanical engineer and marketer by trade, she is currently a yoga and meditation instructor, reiki master, theta healer, and pranic healer. Her work focuses on trauma in inner child wounding and emotional codependency. She is a bonafide mental health advocate, and her passion for helping others is evident in all of her interactions with the Sylvia Brafman family.

Vinny Richards, Group facilitator

VINNY RICHARDS

GROUP FACILITATOR

Vinny Richards is a unique therapist who went from working as an in-house therapist in various treatment centers to being a successful group facilitator bringing motivational enhancement lectures and relapse prevention programs to the mental health therapeutic community. His direct, authentic approach resonates greatly with the patients at SBMHC. Originally hailing from New York City, Vinny has also engaged in individual therapy with hundreds of clients over the last several decades.

Talia DeLuca (ACE, PPSC), Group facilitator

TALIA DELUCA

GROUP FACILITATOR

Ms. Talia DeLuca is certified fitness coach (ACE, PPSC) who is passionate about helping others to understand the important interplay between fitness, exercise, and mental health. She attended Boston College where she received a B.S. in Political Science and minored in Managing for Social Impact. During her time spent at BC Talia earned her personal training certification and became an instructor at the university recreation center. Talia further discovered her passion for fitness and mental health during an internship with Happify in her Junior year of college, where she helped to create an exercise program for app users to alleviate feelings of anxiety and depression. She is now a trainer at Anatomy in Midtown, Miami.

Talia grew up in a small town in Rhode Island and has spent the majority of her life in New England before moving to Miami in June of 2021. Throughout her youth and in school she struggled with anxiety, depression, disordered eating and other mental health challenges. Exercise has become a necessary aspect of her life that has helped her to better manage and overcome these challenges. In addition to training and fitness, Talia loves to spend time with her dog, eat, and travel.

Linda Milano, board certified Psychiatric Mental Health Nurse Practitioner

LINDA MILANO, PMHNP-BC

PSYCHIATRIC NURSE

Mrs. Linda Milano is a board certified Psychiatric Mental Health Nurse Practitioner who is passionate about incorporating a whole health approach in the treatment of psychiatric disorders. She attended Florida International University where she first received a Bachelor’s of Science Degree in Psychiatric Mental Health Nursing, and later a Master’s of Science Degree in Psychiatric Mental Health Nursing. She has over 25 years of experience treating patients with substance abuse and mental illness. She is certified by the American Association of Nurse Practitioners. Mrs. Milano also runs a private practice with over 200 patients. She grew up in a small town in Virginia. When she is not working, she enjoys spending time with her family and friends.

Jim Magner, Director of business development

JIM MAGNER

DIRECTOR OF BUSINESS DEVELOPMENT

Jim Magner has worked in the field of substance abuse and mental health for the last 15 years. He has always had a passion for helping others. Jim has held many leadership positions over the course of his career and draws on his own recovery experience to assist families and their loved ones.  Born and raised in Lynn, Massachusetts, Jim now lives in Coral Springs with his wife Courtney and 2 kids. When he’s not working or playing with his family, Jim’s hobbies include golfing, fishing, working out and watching Wheel of Fortune, which he was a contestant on back in 2017.

Linda Newman, Primary Therapist

LINDA NEWMAN

PRIMARY THERAPIST

Linda Newman was born and raised in NJ. She received her Bachelor’s degree from Monmouth College followed by her Master’s degree from Georgian Court University. She started my career in 1993 and have been working in the counseling field since then in different arena’s. I started as an A/D adolescent counselor for 5 years until my second child was born. At which time, I took some time off to raise my family. Upon returning to work, I did some counseling in the school setting for some time. I also spent some time on the alliance in my town and assisted in creating programs for the school district regarding alcohol and drug education. She relocated to Florida in 2011 and have been here ever since When I moved to Florida, I went back to SA/MH which I’ve been doing consistently since then. I have 2 amazing children.

Michael Lenok, MA, Primary Therapist

MICHAEL LENOK

PRIMARY THERAPIST

Mr. Michael Lenok, MA, is a primary therapist at SBMHC.  Michael has been working in the field of substance use and mental health disorders since 2017. Michael is proficient with individual therapy and case management. He takes a very personalized and individualistic approach to treatment, and works in collaboration with each and every client to help them realize their true potential. Michael excels at group facilitation. His group curriculum and material is personally created and original. Michael’s unique approach to treatment for co-occurring disorders is something that is unique to SBMHC.

Michael has a Master’s degree in Addiction Counseling: Integrated Recovery for Co-Occurring Disorders from the Hazelden Betty Ford Graduate School of Addiction Studies. He received his undergraduate degree in Psychology from Syracuse University. Michael is a native New Yorker but is settling in Florida after spending the past 3 years in Washington and Massachusetts. He is a diehard New York Knicks fan, and makes far too many basketball references. He spends most of his free time chilling with his dog, Mamba.

Tricia Taylor, Clinical Nurse

TRICIA TAYLOR

CLINICAL NURSE

Tricia Taylor a detailed oriented Licensed Practical Nurse with extensive experience in business operations, patient services and work well with team members and doctors.

Possesses exceptional team building, communication, and interpersonal skills and the ability to quickly adapt to the ever-changing business environment. Creative problem solver that works closely with doctors and staff to provide real time solutions.

Cynthia Ingram, Director of admissions and case management

CYNTHIA INGRAM

DIRECTOR OF ADMISSIONS & CASE MANAGEMENT

Ms. Cynthia Ingram has worked in the field of mental health and substance abuse treatment for over 25 years. Cynthia, through her own personal experience, strength, and hope, has worked closely with many treatment centers, community providers, courts and other organizations who walk with the same vision and purpose, to help those who struggle with mental illness. Through this journey her purpose is clear: to give back what was so freely given to her.

Valeska Medel, Director of operations

VALESKA MEDEL

DIRECTOR OF OPERATIONS

Ms. Valeska Medel has been a professional in the healthcare industry for the past 17 years, with a primary focus on the operational and administrative functions. She comes with 15 years of experience as the Executive Assistant to the Administrator for a skilled nursing facility and an additional year as a Business Development associate for a Behavioral Health Hospital. Valeska attend Florida Atlantic University where she received a Bachelor of Science degree in Health Administration.

She has certifications from Broward College in Business Operations, Business Specialist, Accounting Technology Operations, and Human Resources Management.

Valeska grew up a small town in Chile and moved to the United States at the age of 28 where she learned and became fluent in English. Outside of work, Valeska enjoys Latin dancing, travel, and cooking.

Jaime Blaustein is Co-Founder and CEO of Sylvia Brafman Mental Health Center

JAIME BLAUSTEIN

CO-FOUNDER & CEO

Credentials & Accolades

  • Credit Suisse – Investment Banking
  • Lord Abbett – Institutional Sales
  • Morgan Stanley & Wells Fargo – Wealth Management
  • Duke University – MBA
  • University of Michigan – BA

Mr. Jaime Blaustein is Co-Founder and CEO of SBMHC. Prior to this role, he was an investment banker at Credit Suisse in its Global Industrials coverage group in New York City. Here he was responsible for advising clients in the basic materials sector on strategic matters, including mergers, acquisitions, divestitures, leveraged buyouts, restructurings and various debt and equity financings. Prior to this role, he worked in institutional sales at Lord Abbett, a mutual fund manager overseeing ~$150 billion in assets under management. He previously worked in wealth management at Morgan Stanley and later Wells Fargo, advising a wide array of clients on investment strategies.

Jaime received his undergraduate degree from the University of Michigan and his M.B.A. from Duke University. He is an unapologetic NY Giants, Duke Blue Devils and Michigan Wolverine fan. His interests include fitness, steakhouses, international travel, meditation retreats, and quality time with friends. Jaime is a newly minted resident of Miami. He is actively involved in sponsoring dozens of men in recovery and is beyond excited to marry his business expertise with his passion for helping others make a comeback from the depths of mental illness and addiction.

Peter Marinelli, executive director

PETER MARINELLI

EXECUTIVE DIRECTOR

Through the Archway

Credentials & Accolades

  • International Circuit – Speaker
  • Certified Interventionist
  • National Council on Alcoholism – Speaker
  • Through The Archway – Founder
  • FHE Health Sober Living Program with Peter Marinelli

Peter Marinelli, Certified Interventionist and published author, has been sober since 1988 and has dedicated his life to helping others recover from alcoholism and drug addiction. The spiritual emersion program at Through The Archway has been created by Peter Marinelli. As an international circuit speaker, Peter has given hundreds of talks across the U.S. and Europe on subjects related to recovery.

He has spoken at numerous treatment centers, universities and medical organizations to both sufferers and clinicians alike. Peter has also been invited to speak for the National Council on Alcoholism and has been a guest on talk radio and has done workshops on spiritual transformation for various religious organizations.

He has spent the majority of his sobriety in the Treatment Center industry. Peter Marinelli’s mission is to help addicts and alcoholics recover from their fatal illness. He is the Founder and CEO of Through the Archway, a 30-day program designed to help suffering addicts reclaim their lives.

Dr. Linda Dolin, Medical Director of Sylvia Brafman Mental Health Center

DR. LINDA DOLIN, MD

MEDICAL DIRECTOR

Credentials & Accolades

  • Destination Hope –  Medical Director
  • House of Hope –  Medical Director
  • Florida Medical Center – Internal Medicine Physician
  • Florida University Hospital – Internal Medicine Physician
  • Milestones in Recovery – Internal Medicine Physician
  • MedPsych Consultants – Founding Partner

Dr. Linda Dolin is the Medical Director of SBMHC. She received her medical degree from Chicago Medical School and went on to complete her residency at Weiss Memorial Hospital in Chicago. Dr. Dolin brings nearly 32 years of experience as a practicing internal medical physician to her role as medical director at The Sylvia Brafman Mental Health Center. Her medical practice consists entirely of inpatient and outpatient clients with psychiatric diagnoses.

Dr. Richard Seely, Director of psychiatry

Richard Seely

DIRECTOR OF PSYCHIATRY

Credentials & Accolades

  • Psychiatry & Addiction Medicine – Board Certified
  • Florida Medical Center – Psychiartrist
  • Florida Society of Addiction Medicine – Officer & Director
  • Profes sionals Resource Network – Evaluator & Provider
  • Princeton University – AB
  • Jefferson Medical College – MD

Dr. Richard Seely educated at Princeton University, Jefferson Medical College, and University of Miami residency in psychiatry, Dr. Rick Seely is Board-certified in psychiatry, child and adolescent psychiatry, and addiction psychiatry, and also in addiction medicine by the American Board of Addiction Medicine. He serves as an evaluator and provider for Florida’s Impaired Professionals Programs and for professional sports teams, and as a consultant to the Florida Board of Bar Examiners.

Dr. Seely is an addiction medicine psychiatrist who has served as medical director of addiction treatment centers in South Florida since 1990 and has had the privilege of assessing and treating over 100,000 individuals suffering from the disease of addiction. He has taught addiction psychiatry at medical schools for over 35 years and supervises psychiatric resident physicians in addiction medicine.

In long-term recovery from addiction himself, Dr. Seely empathizes with patients and provides clear, consistent, and compassionate guidance in their recovery efforts. He imparts his experience and knowledge in a manner consistent with humility and dedication to spreading the message of hope and recovery.

Ben Brafman, MS, LMHC, CAP, Co-Founder and Clinical Director of Sylvia Brafman Mental Health Center

Ben Brafman

CO-FOUNDER, CHIEF CLINICAL OFFICER

Credentials & Accolades

  • Destination Hope –  President & CEO
  • The Academy for Addiction Professionals – President & CEO
  • Rx Angels – President & CEO
  • Sullivan Pharmacy – President & CEO
  • Barry University – Mental Health Counseling and Family Therapy

Mr. Ben Brafman, MS, LMHC, CAP is Co-Founder and Clinical Director of SBMHC. He has founded a multitude of programs focusing on addiction, men’s issues, eating disorders and personality disorders. Ben was Founder, President and CEO of Destination Hope, a treatment center specializing in substance abuse and mental health disorders, established in 2007. Ben is also the founder, President and CEO of The Academy for Addiction Professionals. The Academy is a school geared toward preparing professionals for the field of addiction by assisting students in getting their CBHT, CAS, CAC, and CAP. Additionally, Ben is also Founder, President and CEO of Rx Angels, a non-profit organization. Its main purpose is to help families that cannot afford medication and treatment for their mentally ill loved ones.

Ben has been in the field of behavioral health for 25 years. He has developed several programs in the South Florida area and has been instrumental in teaching other professionals how to effectively manage their clinical programs. Ben is recognized as a leading authority in behavioral health and a pioneer in clinical services. He is also actively involved in several community services programs. He has helped families all over the country from Atlanta, Georgia to Santa Barbara, California. He is a published author in the area of dual diagnosis and behavioral health. Additionally, Ben is a leading expert in family issues related to addiction and its impact on the system of family, having positively influenced thousands of families in his career.

Ben has a dual Masters from Barry University in Counseling and Family Therapy. Mr. Brafman is a Licensed Mental Health Counselor. He is also a Certified Addiction Professional and trains supervisors in the state of Florida to supervise others effectively. He resides in Parkland, Florida with his wife, Suzanne, and his 3 children Abigail, Jacob and Elijah. He has completed several marathons and is currently working on publishing books in the area of addiction, mental illness and behavioral health.