Amanda and Tommy - F-Fentanyl
Welcome to Addiction and the Family, Episode 67: On the Front Lines of the Opioid Crisis with F*** Fentanyl.
Welcome to Addiction and the Family. My name is Casey Arrillaga. I am a licensed clinical social worker and addiction counselor at both Windmill Wellness Ranch and Recovery Tree Counseling. I'm the author of several books, including "Realistic Hope, the Family Survival Guide for Facing Alcoholism and Other Addictions" and the children's trilogy based on my book, "Mommy's Getting Sober." I've been in recovery from my own addiction since 1998, and I'm married to someone in recovery. The first 10 years we were in active addiction together and since then, we've been in recovery together. Join us as we share experience, strength, and realistic hope on how you and your family can learn to grow and recover together.
All right folks, we've got a great episode for you today, really honored. We're gonna be talking with Amanda and Thomas, AKA Tommy, from F*** Fentanyl, which is an organization that they started to bring education, also free naloxone, sometimes better known as Narcan, out to everywhere from elementary schools to raves.
They are on the front lines of fighting, especially the fentanyl crisis. In that, we've been seeing that overdose rates have been going down, and these guys are part of the reason. They're part of that nationwide effort. Just an organization out there dedicated to helping people.
So we're gonna be able to hear from them, what motivates them, what their work looks like, and how it is that you can get free help for you or anyone that you love. So we're gonna hear about all of that after a quick word from one of our sponsors.
[00:01:28] Casey: Addiction and the Family is brought to you in part by Windmill Wellness Ranch where I happen to work. We are nestled in the beautiful Hill Country of Texas, and we've been rated as the number one treatment center in the United States by the Trac9 independent rating system. And that's based on our ability to bring down addiction relapse rates, anxiety, depression, and also increase optimism, increase resilience, increase people's commitment to recovery.
When you see the results, that's what counts. Now, we are so confident of our ability to help people that we offer the Windmill Guarantee. The Windmill Guarantee states that if somebody comes to treatment and does all the stuff that we suggest, and then also does all the follow-up that we suggest, and still needs to come back to treatment within one year, they can come back at no cost.
If you wanna find out more about the Windmill Guarantee and everything else that we have to offer, visit windmillwellnessranch.com or call our admissions line. While I've got your attention, we also offer a free family course to anybody. You don't have to have any association with Windmill, but if you wanna just get a taste of what we offer for families, sign up for our family course at windmillfamilycourse.com.
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Again, anybody, anywhere who needs what we have to offer is free to sign up for the course and get those resources.
Welcome back. All right. Without further ado, let's go ahead and get into that interview with Amanda and Tommy.
[00:03:06] Casey: Welcome to Addiction and the Family. Great to have you both with us, really looking forward to this conversation.
And Amanda and Thomas, would you each take a moment, introduce yourselves and tell us what are you doing on a show called "Addiction and the Family?"
[00:03:17] Tommy: Yes, I'll go first. My name's Thomas Guerra. Happy to be here. Thanks for having us. I'm here because I work in harm reduction and overdose is a huge issue in the United States today. So We're here to talk about overdose. I'm also a person in long-term recovery since September 12th, 2014. 
[00:03:33] Amanda: Hey there.
My name's Amanda Nicol and I am also a person in long-term recovery. I actually celebrate this month, which is exciting. May 29th is my anniversary. I'll celebrate 24 years. And I too am working in harm reduction. Tommy and I both work with F-Fentanyl, which is Tommy's nonprofit.
We're here talking about the harm reduction we do in Miami-Dade County. And we're thrilled to be on the podcast. Thanks for having us, Casey. 
[00:04:03] Casey: Thanks so much. So glad you're both here. Maybe Thomas and then Amanda, maybe take a few minutes and just tell us what got you into this work. 
[00:04:11] Tommy: Sure.
I, like I said, I've been in recovery 10 years, but that doesn't mean it took me 10 years. It took me probably 20 plus years to get 10 years. And so, along the way there was a lot of bumps in the road. But throughout my own recovery journey, I discovered that I enjoy helping other people.
Service is huge in the recovery if you go to certain fellowships. And I took that and ran with it as " Hey, maybe I could do this as something for a living." And I pursued mental health counseling was my first attempt at working in the field and doing service.
And throughout that, I discovered different avenues of providing service to people. First being a substance abuse counselor, then going into collegiate recovery, which was focused at students in the university. And then starting a nonprofit called the Miami Recovery Project, which is a recovery community organization,
and then transitioning to where I'm at today, which is harm reduction and overdose preventions, which focuses on a bigger population than just recovery. It's pretty much everybody and letting everybody know about the dangers and so we can reduce the stigma as well and save some lives along the way. 
[00:05:28] Casey: Absolutely. And I love that you mentioned the idea, like it sometimes it takes people 20 years to get 10 years of recovery. And I relate to that. I've been in recovery for a little over 25 years now and coming up on 26 that I've been in program and working on it. And that's even like officially working on it.
But before that, I'd think, " Okay, I need to stop this. I need to slow down and need change," and yeah, it took me a few years of actively working in recovery fellowships to get to the point where I could plant a flag and say, "Okay, yeah, from here on out, this is it."
And that's managed to stick, and I'm very grateful for that. But I'm also aware that takes sustained effort. And so hearing what you said about service being of emphasis, that's a big thing. I don't know of any recovery fellowships, and I study this stuff and pay attention to it partly as my living and partly just 'cause I like it.
And any of them that I've seen, I don't care if Recovery Dharma, any of the, " fill in the blank, Anonymous," SMART Recovery, all of them emphasize the idea of helping other people. And so that's a pretty vital thing. And seeing you get into where you can do that on a professional level, also really just carries a lot of power and impact. And so Amanda, I'd love to hear from you same sort of thing. What got you into doing this? 
[00:06:31] Amanda: So the short answer is I literally got introduced to a woman that was doing this in Miami. And she just needed someone to fill a seat.
I'm a very long-winded person, so I'm gonna tell you the long story. So I was looking for work and had been in partnerships in Princeton, New Jersey. And my girlfriend Jenny said, "Hey, I have this neighbor. I don't know what she does,
but I think you should talk to her. Okay." So I did, and it turned out she had this nonprofit called Project Opioid South Florida. She did not know I was in recovery, but she was writing a grant to do harm reduction, and she needed someone. They literally had all of this momentum built up in Miami, but no one to roll it out. And here I am with partnership background, as well as the gift of gab, as well as decades in recovery. And it was the perfect opportunity. I also had a nonprofit background, but the beauty in it was I was able to bring all of that skillset to something that I never thought I would be doing.
It brought me to meeting Tommy. And we were able to now do the work that we do with F- Fentanyl. I met Tommy in Miami and we really, I love Tommy and I love the work that we do.
And it was it really was a God shot. There's a picture of us at an event that I threw. We had the state attorney we had the local head of police. It was a full-on panel discussion. It was a pretty powerful event. We were able to start doing this work together. And the freedom that we have to do many different things because it's not just under one umbrella. We're able to reach so many people. I mean, we go to music festivals, we go to, universities, we go to grammar schools. Right now I can't go up to somebody and say, I'm the fractional executive director for Fuck Fentanyl, without someone telling me a story of their experience with someone who's OD'ed or been poisoned.
And it's, Park Avenue to park bench. So it's been really an incredible experience for me. We were at Ultra Music Festival recently. I had people coming up to me and hugging me at this music festival, which I'm not an EDM person. I'm a Grateful Deadhead. And it was the same experience.
It was the same like love and giving community. They were just so happy that we were there saving lives. It doesn't matter what side of the aisle you're on, what kind of music you listen to, what color hair you have, what your background is. Everyone wants to save somebody's life. So it's really, it's wonderful to be able to take, " love and tolerance is our code" and bring that into my work. 
[00:09:18] Casey: Lots of great stuff in there.
I want to touch on something that you've both brought up, which is you mentioned harm reduction. And I know for a lot of people in the recovery community, and also frankly, 'cause we have a lot of family members who listen to these podcasts. Yeah. They think of recovery as being sort of all or nothing, like either someone's in recovery, they're staying sober 24/7, or they are like sleeping under a bridge. And this is often the image that people have.
And I'd love to talk a little bit about harm reduction, because working in the treatment field and working in addiction recovery for some time now, I can say that a lot of times we're doing harm reduction even though people speak in the absolutes of all or nothing. And I'd love to hear what you guys have to say about that and what gives you that perspective on harm reduction.
And maybe explain for our audience who doesn't understand that term as well, what you mean by that. 
[00:10:06] Tommy: I'm one of those people that didn't understand harm reduction in the beginning because I was a all-or-nothing person as well, because coming from a treatment center and then going to meetings and then it's abstinence and that's the only way, and I get that. But along the way my, my mind started changing as I saw, hey if you can't help somebody that is in need of help, but they're not necessarily ready to stop using, that means that you're shunning them away, and you know they can die. There's no chance of coming back.
So harm reduction is really just meeting them where they're at. How can I help you with where you're at? I mentioned I have 10 years. It took me 20 years. If the drugs and the potency of the drugs that were available was out to when I was trying to get sober initially, I don't know if I would be here.
And so the fact that, people are dying without even hitting a bottom. They're hitting the ultimate bottom, which is death, right? But they're not necessarily losing their job and doing the, living on the street and they're just taking something for the first time and passing away or taking something recreationally and passing away, right?
And so harm reduction's, not just limited to people with substance use disorder. It's everyone. And if abstinence worked for everyone, then we wouldn't need harm reduction.
But the fact is that not everybody will get it the first time. Not everybody will get it the second time. And those recurrence of use can be deadly. Or the, those times where people don't have insurance and they're waiting for a bed in treatment, right? Could be a week, could be a month, whatever. That person's in danger of dying while they're waiting for a bed.
So, using harm reduction in the meantime can save that person's life to get to that treatment bed. So basically harm reduction is just taking the judgment out of somebody that uses and just meeting them where they're at and providing those assistance services, which is Narcan, test strips, safe use, all these different things that they can do so that they can, live another day and make that decision another day if they wanna stop.
But somebody that passes away can't make those decisions anymore. So that's really what the harm reduction's really about. 
[00:12:20] Casey: And Amanda, what would you like to add to that? 
[00:12:21] Amanda: Yeah, the other thing that what is really important about harm reduction, it's the education aspect of it.
Because what's going on currently with the fentanyl crisis is that we have 10 to 17 year olds being poisoned. They're not drug addicts, so the educational aspect of harm reduction. We wear a seatbelt, we have fire extinguishers we have EpiPens, and that's all harm reduction. So what we do with harm reduction is educate people that this is something that you may need, God forbid.
We don't want you to ever have to use it. And we are partnered with uh, poison control. 
And a lot of people , they're not drug addicts or alcoholics or using drugs on a regular basis. And they'll push away, "Oh, I don't need that. I don't use drugs." So harm reduction isn't just about talking to drug addicts.
It's literally educating an entirely new population about what's going on and reframing the conversation and the stigma around a crisis. It's the leading killer of 18 to 45 year olds in the United States right now. So that's something that needs to be talked about and lumping it into a, "this is a drug addict problem" is dangerous.
[00:13:40] Casey: Absolutely. And I'm so glad that you're speaking to that. I love just you covered an overview of here's some of the things we do. So we do education, do Narcan it's test strips, stuff like that. We did an episode with Addiction and the Family, audio only, but it's out there, on Narcan a little time back. I would love to get an update from a couple people working directly in the field, working directly with people. What's the state of Narcan? How necessary is it? What is it for our listeners that may not know much about this part? 
[00:14:07] Amanda: It's naloxone is the name of the medication.
It's an opioid reversal medication. 
[00:14:13] Tommy: It's an antagonist. So basically blocks the opioids from attaching to the opioid receptors. And so like Amanda said naloxone's the active medication. But there's a lot of different brands and a lot of different routes of administration.
The most common one, of course, is Narcan. And so people just naturally call it Narcan. But there are different brands like Revive. There's Kloxxado. There's intermuscular. The fact of the matter is that naloxone has been saving lives, at an alarming rate.
So much so that the overdose rate has recently been released and down around 27%, from a hundred plus thousand to around 80,000. There it is right there. That's the Narcan, which is a nasal spray, which is the easiest way to administer it, because there's other routes of administration that involve using syringes, which the lay person is not really the best way or the people are afraid of using needles. Watch this. Go ahead. 
[00:15:09] Amanda: This is Narcan. And all this is, it's a nasal spray. That's it. 
[00:15:17] Tommy: That's how easy it is to administer Narcan. Just pressing the plunger, basically going into the person's nostrils and waiting two minutes for it to take effect. And for the most part, it's gonna take one administration, one dose. You'll see cases where you need more than one, but for the most part, it is gonna be one dose, right?
And, Narcan has four milligrams, whereas other brands like Revive has three milligrams, Kloxxado has eight milligrams. 
And then you have these intramuscular that have five milligrams. There's so many different kinds.
[00:15:50] Amanda: Intramuscular is one that is injected into your body. But the majority of the popular ones are nasal spray because that's something that everyone can administer, and it's an easy way in which to save someone's life. But the most important part is you dial 9 1 1 immediately. In order to save someone's life because it doesn't last that long.
 
[00:16:11] Tommy: So it lasts 30 to 90 minutes. So basically naloxone is to buy time so that the 9 1 1 ambulance can get there to address the situation, 'cause they may need more naloxone and to ensure that person doesn't overdose again. But it is a lifesaving medication.
The only side effect is if that person is using opioids, that it'll block the opioids and that person may be in withdrawal after it
Uncomfortable. Yeah. Very uncomfortable.
They'll 
be, they'll,
[00:16:39] Amanda: It's much better to be alive than it is to be, overdosed and dead. 
[00:16:43] Casey: Okay. That seems like a good spot to take, a quick break to hear from one of our sponsors, and we'll be right back with the rest of that interview.
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Welcome back. Let's have the rest of that interview with Amanda and Tommy from F*** Fentanyl.
 
[00:17:47] Casey: I don't know if you guys know this or not. At time that we did our last episode, research had come out actually showing that Narcan's applicator was the most effective. And it's one of the reasons that I still name it by name.
Naloxone is the overall medication that's behind everything but Narcan is simple and they seem to have a really good applicator. So that being said, I know some people would say everybody should carry this with them, give it out for free on street corners, all that kind of stuff. How do you guys feel about that, and what would you recommend including for family members that might be listening to this?
[00:18:16] Tommy: Sure. I agree with with that. Absolutely. Just like anybody would carry Epipen or a first aid kid or, just in case, having Narcan just in case. That way you you can address the situation immediately. Put it in your purse, put it in your bag, and even taking it out of the box because the box comes with two doses. You could take 'em outta the box and keep 'em each dose in a separate location.
It's easier to carry. We distribute it everywhere. For the most part you don't know when you're gonna see an overdose, right? There's hotspots of course, where people are actively using, but there's a lot of overdoses that will happen in a school, that will happen in a library, that will happen in a convenience store, I see that they have 'em on the planes now, on the cruises now.
It's part of what they have, because an overdose happened and then they said, "Hey, let's change this policy to have naloxone on these planes and these different areas." And some places are not there yet. And that's where we come in and we try to educate and break some of that stigma as to, "Hey, this is something that you may wanna have in your establishment just in case, and you can save somebody's life."
Because, it's the exact same principle behind having an AED machine on the wall, having a fire extinguisher on the wall, having a first aid kit on the wall. They're not expecting to see that every day, but they have it prepared just in case a situation like that arises. The numbers are in, it's working.
20,000, almost 30,000 less deaths in one year? That's because of the access to Naloxone. That's because of the access to harm reduction information. That's because of education. And hopefully it stays that way, with the numbers going down. But it is a very tricky climate of what's going on with funding.
But again, everybody should have it. Everybody should have it. 
[00:20:07] Amanda: Talk about the expiration date, Tommy.
It just came out, this research. 
[00:20:12] Tommy: Like any medication they have an expiration date, which is three to four years. But the research shows that the active ingredient, which is naloxone, is still 90% effective up to 30 years later after expiration date.
So if all you have is expired naloxone, you can still save somebody's life. And if you wanna switch it out for something newer, that's fine too. We can do that at our organization.
But don't throw it out. You can still use it and still have it. 
[00:20:40] Amanda: The other thing that's really important to talk about too to update your podcast on education for Narcan, naloxone, we have a relationship with DCF and Florida we give it out for free.
One box of Narcan is about 50 bucks and everybody can buy it without a prescription. Literally this happened to me last week. Someone said, "Hey, I'm going back to Tennessee. Can I get some Narcan from you before I leave?" I wasn't able to get with this person. I Googled, "Tennessee free naloxone" and I found a contact there for this person to get it. So you can probably in your state Google where to find it if for some reason you can't afford the $50 to buy it over the counter.
Because there are lots of organizations like us that give it out for free.
[00:21:29] Tommy: And I got a locator is the National Harm Reduction Coalition. They have a national locator for free Naloxone. 
And then there's an organization called Next Distro that will actually give you not all states, but a few states that will send it to you in the mail 
[00:21:47] Casey: Nice. It's really good to hear and good to know for our listeners. I'm gonna ask you each to talk a little bit about what this work means to you emotionally and personally. What keeps you doing this?
[00:21:57] Tommy: For me, it's working directly with the people, right? Boots on the ground. We're a grassroots organization. We're out doing street outreach where we meet people, where they're at. Some of these folks are experiencing, houseless situations and you get immediate feedback.
You hear when the Narcan has been used. And those are amazing stories to hear, getting an email from a bar that, "Hey, we used two doses of Narcan last night on one of the clients that was here. Or hearing a situation where I went to a treatment center and they used a Narcan to save somebody's life.
So hearing these situations where people were saved as a result of that. And then on the other end of things is when we are doing trainings or we're talking directly to people and you hear somebody change their point of view, right? They learned something that changed the way they view what somebody with a substance use disorder looks like or somebody that would use Narcan looks like. That was me. I was not a harm reduction advocate in the beginning. I was like, "What do you mean you're encouraging people?" And it's not that, it's just about saving lives. And when people actually get that too, you could put that in the box of this person is gonna advocate now for harm reduction and to save lives.
And they may educate the next person. And the next person. And the next person. And that was a trickle effect of what we did from training to distribution to all these different things. So when that happens, it's amazing. That's why we do this work, is because of the service,
the feeling we get from helping other people at least for me that's why I do it. Definitely the money is not lucrative. There's not a lot of money in this. It what it is really, a purpose driven job. And I wouldn't change it for anything. I love to do what we do.
[00:23:42] Amanda: I have had this similar experience. It's definitely about the community. I too came from abstinence, and I didn't understand harm reduction and the work that I'm doing. So, Ultra Music Festival is 55,000 people. 55,000 people and me. I'm an alcoholic and a drug addict.
Okay? I was a total garbage head and I did it and I'm still judgemental. So 55,000 people, tripping their faces off at an EDM concert, not my people, coming up to me and hugging me. Literally picking me up and hugging me and thanking me for being there, for distributing. 'Cause I'm all in my F* Fentanyl gear and we had 10 overdoses that we knew of during the festival.
We were able to give out 4,000 doses of Naloxone. I literally was like crying. It was magical. I was part of being able to get Naloxone into the public school through research that I was able to do.
'Cause one of the board members from the school called me and said, "Hey, I hear what you're doing. We need research help. Can you help us?" And I like to do research, so I reached out to some people and I found that there were 105 opioid related incidences between the hours of 8:00 AM and 3:00 PM under the age of 17.
And to hear that was gut wrenching. I don't have children, but I couldn't believe it. Because I would've been one of those kids that no one really cared about and didn't take care of. So to be able to do that work and be an advocate for these children that no one at the time was doing anything for.
And now there was a program in the schools for two years and Tommy and I are actually meeting with the head honcho next week to bring the program back to the public schools here in Miami Beach. 'Cause Miami-Dade Public School is the third largest district in the United States. I have goosebumps thinking about it right now. We're here to save lives. It's amazing. I feel like I'm a superhero. It's been a gift and to be able to do it with Tommy is really great.
[00:25:39] Casey: Thank you so much.
And so what we'll close out with, I'll ask you each to just like a 30-second elevator pitch. What do you wanna say to family members out there or people that might be thinking about this sort of thing for the first time out there in podcast land?
[00:25:52] Tommy: This is something that everyone should have on their radar. Everybody either has an 18 to 45-year-old in their family or knows somebody 18 to 45-year-old, or is 18 to 45-year-old. So this should absolutely be on the radar. Everybody should carry Naloxone. And it is free in most areas.
You can go to our website: f-fent.org, look up some of the resources that we have nationally and some of our partners. And follow us on Instagram. It's @f_fent_ We have a lot of information and we're happy to answer any questions that anybody has. Everything we do is completely free and we're happy to help.
[00:26:29] Amanda: What was the question again? Casey? 
[00:26:32] Casey: Amanda, I want you to go off script a little bit from your usual elevator pitch and just gimme like 30 seconds. What do you wanna say to people, especially family members that might be out there just listening to this and thinking about it maybe for the first time?
[00:26:44] Amanda: I think Tommy said it really well.
[00:26:46] Casey: Then just speak from your heart, like whatever it is that comes up for you around this that you'd wanna tell a family member. Like you were talking about like having been that teenager, maybe no one was paying attention.
What would you tell the adults back then?
[00:26:58] Amanda: Talk to them. I think the most important thing is to have honest conversations, and go and do the research and, contact the local organization like ours in your community, and ask them questions, and talk to your teenager.
Talk to your preteen. Ask some questions about what's going on. Because you might be surprised about what their experience is with just in their school whether or not they even know what naloxone is or what Narcan is, or if their school district has it or if they've been educated on it.
And if they don't, go and get educated. And obviously if you're listening to this podcast, you've already drunk the Kool-Aid. But, go and start talking to the school districts and your principals and your teachers and ask, ask questions and be your own advocate.
[00:27:47] Casey: Beautiful. Yeah. Thank you so much for coming on here. Appreciate you all and your time, and especially for the work you're doing. It's just amazing work. We'll have links in the description and all that kind of stuff. Where to find more information, especially on F*Fentanyl and any other organizations or things that you think we should know about.
[00:28:05] Amanda: Yeah. Thank you so much, Casey. 
[00:28:07] Casey: Cool. 
[00:28:07] Tommy: Thanks so much.
[00:28:07] Casey: Thank you. 
Man, that was a great interview. Thank you so much for being here with us, and stick around for the end credits. There's lots of cool stuff.
Thanks for tuning into this episode of Addiction and the Family. This program is recorded, produced, written, floors swept, the whole bit by, myself and my wife, Kira. Just so happy to have you with us. If you'd like, you can always look us up on Facebook. We are tweeting on Twitter, whatever they're calling it these days, and we can be found on Instagram, we can found on Blue Sky, we can be found on Pinterest.
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