Mitchell S. Rosenthal: A Celebration of Life

The Life and Legacy of Our Founder and President

Mitchell S. Rosenthal, M.D.

One day in 1967, a young psychiatrist named Mitchell S. Rosenthal entered a dilapidated building on Manhattan’s Upper West Side where nine drug addicts in detox were living in squalor and trying to make it on their own. Mitch, as everyone called him, surveyed the situation and offered something they had never known before: hope. The roach-infested building would eventually become the hub for Phoenix House and its nationwide drug rehabilitation network that changed the face of drug treatment in the U.S. and abroad.

As we look back on Mitch’s extraordinary life and legacy following his sudden death in November at age 87, this encounter of many decades ago was a crucial turning point. At that time, the medical community and healthcare agencies routinely neglected substance users, who were held in contempt, considered outcasts, and stigmatized as deviants and moral degenerates. Few publicly funded drug treatment programs existed. Mitch changed all that by promoting a new therapeutic model he had learned about and pioneered as a Navy lieutenant treating drug addicted Vietnam War veterans.

Central to this idea was compassion. Mitch advocated serving the needs of those struggling with substance abuse, regardless of their circumstances. Equally important was addressing the psychosocial contexts and other forces that drive the condition, and creating a community-based model to counter it with support from professionals and peer counselors. Inspired in part by the original residents of Phoenix House, who all recovered from addiction, the organization grew to include 55 residential treatment centers in 10 states, with more locations around the world, as well as programs in prisons.

Mitch was the driving force behind this success. He became one of the most prominent voices for drug treatment in the United States, constantly urging government officials not to ignore the plight of those who were suffering. At the same time, he encouraged cultural and corporate leaders to support and contribute to Phoenix House. In the corridors of power and at galas and fundraisers, Mitch told hopeful stories of recovery and the potential of treatment to help individuals lead drug-free lives.

After decades as chairman and CEO of Phoenix House, Mitch stepped down in 2007 and established our organization. The work of the Rosenthal Center focused on advancing best treatment practices and conducting studies about the dangers of drugs, whether high-potency marijuana or lethal prescription opioids. Mitch continued to speak out, write commentaries, and leverage social media to warn a wider audience about the continuing scourge of addiction.

In the last years of his life, Mitch was appalled by the spiraling addiction and overdose crises that, over the past two decades, have killed more than 500,000 Americans. Believing we can end this tragedy, Mitch proposed policies to facilitate comprehensive treatment for all who desire it. His thinking evolved to include newer approaches such as medication-assisted treatment (MAT) and harm reduction—provided that they offered a pathway to treatment.

We at the Rosenthal Center and all those who knew Mitch are grateful for his guidance, wisdom, and strength. We remember him as a warm, generous, and engaging personality. He was a mentor, friend, and leader whose vision has had a profound impact on the lives of many. It is fitting for the final edition of the Rosenthal Report to honor his memory and values, which will continue to inform everything we do, both individually and collectively.

 Ernest Beck

Francine Gonzalez

Diane Rush

Charles Sullivan

Leo Da Silva

Norwig Debye-Saxinger

Judi Wallace

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 An Appreciation: Mitchell S. Rosenthal, M.D.

The New York Times fondly remembers how Mitch "rose rapidly from a minor New York City official into the public face of residential addiction-treatment therapy nationwide."

The New York Times:  Dr. Mitchell Rosenthal, Phoenix House Founder, Dies at 87

 Nov. 19, 2022

“Mitch was a dear friend and mentor to so many. I have learned so much from this man.”

Kevin Sabet, CEO and President, Smart Approaches to Marijuana

“He was a hero to me. I served on his board at Phoenix House for more than 20 years and witnessed his uncanny ability to not only save lives but also to resurrect them. Under Mitch's leadership, Phoenix House became the most important drug rehabilitation center in America. He was a best friend, who was always there when one needed him. I will always miss that larger than life personality and his warm friendship.

Larry Leeds, Former chairman of Buckingham Capital Management

Published by New York Times on Nov. 17, 2022.

“Getting to know Dr. Rosenthal over these few years and hearing him speak about his legacy at Phoenix House, you felt as though he would live forever doing the work he so loved. For the many lives he touched and will continue to touch, since 1967, we are forever grateful. Rest in Power, Mitch!”

Ann-Marie Foster, President and CEO, Phoenix Houses of New York & Long Island

“Mitch was instrumental in establishing and developing the drug treatment field in America. Through his pioneering work he allowed so many of us to create programs, evolve treatment strategies, all the while de-stigmatizing addiction. Personally, Mitch showed me support and compassion throughout my career, most recently embracing the work of Odyssey House. I will remain indebted to him and do my best to honor his legacy.”

Peter Provet, President and CEO, Odyssey House NYC

“Mitch had a profound impact on my life. We knew each other for fifty plus years and he was a very present fellow traveler during my journey. He was a mentor that provided encouragement and guidance during times of growth and support during times of challenge. He will be deeply missed and always remembered by me and all whose lives were changed and improved by his presence.”

Ronald Williams, Colleague

On behalf of all of the members of Treatment Communities of America (TCA), I would like to send my deepest condolences to Mitch's family. Mitch was a great leader and pioneer in the SUD field, and he will surely be missed. Mitch was part of TCA at the very beginning. Our organization would not be what it is today if it were not for Mitch's guidance and leadership. May he rest in eternal paradise!

Patricia Clay, Executive Director, Treatment Communities of America

Mitchell S. Rosenthal, M.D., Drug Treatment Pioneer Dies at 87

We are saddened to report Mitchell S. “Mitch” Rosenthal, M.D. passed away quietly in his sleep Monday night.

Dr. Rosenthal was truly the living embodiment of service, compassion, health, and commitment. As the founder and president of the Rosenthal Center for Addiction Studies, the founder of the Phoenix House drug treatment centers, the chair of the New York State Advisory Council on Substance Abuse, a psychiatrist at the U.S. Naval Hospital, and a philanthropist, Dr. Rosenthal committed his life to serving others. He always had time for people in need, whoever they were. Anyone that knew him – whether underprivileged, wealthy, suffering from drug addiction, or healthy – recognized Dr. Rosenthal for the man he was: a saint.

We at the Rosenthal Center will carry on our work for as long as it is practical. Dr. Rosenthal’s memory, values, and approach to life will inform everything we do, both individually and collectively.

Dr. Rosenthal was 87.

Playing Politics with Drug Policy as Overdoses Soar is Wrong

Biden Administration Expands Access to Addiction Medication for Pregnant Women

ROSENTHAL REPORT - NOVEMBER 2022

MARIJUANA LEGALIZATION AND THE MYTH OF HARMLESS POT

 A decade ago, Colorado became the first state to legalize marijuana in a landmark vote that jump-started a remarkably powerful cannabis reform movement. Today, recreational marijuana is legal in 19 states, two territories, and Washington DC, plus medical cannabis alone in an additional 39 states. In the upcoming midterms, five more states—including generally conservative Arkansas and North Dakota and South Dakota—will vote on legalization. If passed, almost half the states will have legalized recreational weed. One factor driving legalization is heavy lobbying by tobacco and food and drinks companies that have invested heavily in the $33 billion U.S. marijuana market. Yet, there’s also been a dramatic shift in perceptions: an overwhelming majority of Americans now believe that marijuana is essentially harmless—despite a growing body of scientific evidence indicating that it can be dangerous for many individuals.

Doctors are concerned about marijuana-related illnesses

 Studies show that a rise in pot use since legalization, especially among young people, is leading to severe health and mental health problems. These include cannabis use disorder as well as a unique, unusual syndrome that causes severe intestinal distress and uncontrollable vomiting. Pregnant women are using marijuana in increasing numbers, despite warnings that it can cause low birth weight and slow cognitive development of their newborns through adolescence. Teens who vape marijuana often experience heightened mood disorders, depression, anxiety, and suicidal ideation. Equally worrying, doctors report a steep increase in cases of severe psychotic episodes, caused by the high-potency pot that today can contain up to 90 percent THC (the psychoactive component of marijuana). In Colorado, for instance, doctors have reported a 24 percent increase in marijuana-related psychosis cases in the five years since legalization, while emergency room physicians in San Diego have also seen a staggering increase.

Market controls are essential

 Even as the legalization movement grows more confident, there are still opportunities to curb commercialization. One measure would be to cap the THC level in cannabis products, which only Vermont and Connecticut have had the foresight to do. Another is to crack down on the mislabeling of products and demand more accurate information about dosages, possible side effects, and potential long-term harms. As the delineation of medical and recreational marijuana blurs—consumers in Washington D.C., for example, can now “self-certify” their need for medical pot rather than going to a physician. We need to clearly state that these products are not a panacea for any health condition, as many have been led to believe.

 Safeguarding public health must be a priority

While nobody should be arrested for smoking a joint, the new market for marijuana requires tougher regulations. Young people, in particular, must understand the risks. Dispensaries should adhere to strict rules and regulations on marketing, packaging, and sales to underage consumers. State agencies in charge of overseeing the industry should not hesitate to take action when violations occur. If we can’t stop legalization, we can—and must—do everything to safeguard public health.  As the delineation of medical and recreational marijuana blurs—consumers in Washington D.C., for example, can now “self-certify” their need for medical pot rather than going to a physician—we need to clearly state that these products are not a panacea for any health condition, as many have been led to believe.

Rhode Island Opens Safe Sites for Drug Consumption—But Without a Pathway to Treatment

President Biden Shifts Marijuana Policy

Oregon's Drug Decriminalization Law Isn't Working

Canada provides a "safe supply" of illicit drugs - and the U.S. might be next

ROSENTHAL REPORT - OCTOBER 2022

IT’S TIME TO UNITE AROUND A COMMON DRUG-CONTROL STRATEGY

Drug overdose fatalities continue to surge in every corner of the country, destroying families and communities and exacting an economic toll of nearly $1.5 trillion in 2020. Yet even as more and more Americans die—a record 108,000 overdose deaths last year alone—there’s little consensus about the best way forward. Amid an unfolding tragedy, advocates of three different approaches—harm reduction, decriminalization, and treatment—appear to be in opposing camps, rather than working together to address a public health crisis.

Saving lives is a priority

 Harm reduction refers to measures that keep drug users safe, including supervised injection sites where drug testing strips, medical personnel, and overdose reversal medications are readily available. Until recently, such programs—technically illegal—have been controversial, with critics claiming they promote drug use. But now harm reduction is gaining ground with support from the Biden administration and city officials who want to quickly curb overdose deaths. New York City—which experiences one drug death every four hours—currently has two supervised sites and data indicates that they are preventing some overdoses and deaths. But very few individuals who are saved subsequently enter treatment, instead returning to the streets and a life of drug use.

 The same holds true under a groundbreaking decriminalization program in Oregon. According to the law, passed two years ago, anyone caught possessing a small amount of illicit drugs, including heroin and cocaine, are given a citation and fined $100 (much like with a parking ticket), which can be waived if they merely call an addiction recovery hotline to discuss services. So far, the program—which includes a voluntary treatment component—hasn’t reduced the high rate of addiction in the state, with overdose fatalities increasing by nearly 20 percent last year. Of the 16,000 individuals who’ve received citations, less than 1 percent entered treatment.

 A united front

 Harm reduction, decriminalization, or treatment alone cannot sufficiently address the escalating addiction and overdose crises. Alternatively, we can combine all three into a comprehensive, nationwide program backed by extensive funding and resources. It should feature harm reduction on the front lines, decriminalization to shift the focus from incarceration to healthcare, and finally, a pathway to safe and effective treatment, which today is only available to a small fraction of those with opioid use disorder. 

 Focus on treatment

 A core principle of this effort would be to create incentives to encourage and motivate users to enter a variety of treatment options, such as outpatient, long-term residential, or medically assisted. The goal is not to coerce or force people to take this step, but rather to build trust and provide them with a bridge to recovery. Drug courts, for instance, which offer a choice between jail and rehab, have been successful in this regard, as has a pilot program to guarantee employment to potential job candidates if they complete treatment and stay clean.

 To make progress against this drug scourge, we must embrace a strategy that brings together harm reduction, decriminalization, and treatment—and not simply regard each alone as a panacea.

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Gov. Hochul - It's Time To Declare An Overdose Emergency

ROSENTHAL REPORT - SEPTEMBER 2022

GOVERNOR HOCHUL: IT’S TIME TO DECLARE AN OVERDOSE EMERGENCY

Last year more than 5,700 New York State residents died from a drug overdose, a 15 percent increase over the year before. And with an average of one fatal overdose every 5 hours in New York City alone, there’s no sign of a slowdown in 2022. Yet even as the death toll continues to climb, Governor Kathy Hochul has so far not declared a state disaster emergency for the addiction and overdose epidemic—as she recently did for the monkeypox virus outbreak. An emergency declaration from the governor concerning overdoses—which have been growing steadily over the past decade, both here and across the country, and surging over the past few years—would allow the state to mobilize resources and personnel and raise public awareness.

There are other measures the governor can take as well. First, she should appoint a “drug czar” for New York State to oversee and coordinate all agencies that are responsible for healthcare, addiction, overdose prevention, and other social services associated with substance abuse. Much like the federal drug czar, who is responsible for national programs and reports to the White House, an Albany-based position would ensure that state efforts are having the desired impact, funds are reaching all communities in need, and that a data-driven initiative is introduced to track and map the state’s overdose response system.

To accomplish this, we urge the governor to work with state agencies to distribute as soon as possible the expected $208 million from opioid litigation settlements to treatment and other service providers. The money, along with federal block grants, represents a significant boost in funding levels that were frozen or reduced during the COVID-19 pandemic. The funds are badly needed to expand overall treatment capacity—especially in rural areas of the state, where services are generally lacking—but also to recruit, train, and retain staff. In particular, we need more residential treatment facilities and programs to both increase the ranks of peer counselors who work directly with substance users and provide a strong support system to help in recovery.

 Most of all, Governor Hochul must lay out a multifaceted drug-control policy. She has already begun doing this by endorsing harm reduction as a focus of state efforts, allocating more funding to substance use and prevention organizations, and removing barriers to addiction treatment. And beyond harm reduction—which by itself is not a solution—much more can and should be done. As author Beth Macy pointed out in a New York Times commentary, “harm reduction isn’t harm eradication.” Although strategies such as safe sites, drug testing strips, and overdose reversal medications do save lives, our goal instead should be to ultimately change lives.

Harm reduction must therefore be coupled with safe and effective treatment programs that we know work, and are made readily available to anyone who wants it, on an on-demand basis. Declaring an addiction and overdose emergency would be an important step to reaching this goal—and giving thousands of New Yorkers a better chance to lead a drug-free life.

Biden Administration Poised to Endorse Harm Reduction

Vancouver Starts Supplying Fentanyl To Drug Users

More Opioid Settlements Add Funding for Drug Treatment

ROSENTHAL REPORT - AUGUST 2022

The Rosenthal Report, published each month by the Rosenthal Center for Addiction Studies, brings its readers insights and commentary on current issues of drug use.

 A STRATEGY TO REDUCE SOARING OVERDOSE FATALITIES IN PRISONS AND JAILS

As the U.S. confronts an unprecedented overdose crisis—12 individuals die every hour, or more than 108,000 per year—a shadow epidemic receiving far less attention is growing in the nation’s prisons and jails. According to the Pew Charitable Trusts, the drug overdose death rate in prisons increased fivefold from 2009 to 2019, outpacing the national drug overdose rate that itself tripled in the same period.

Blame the increase on the misguided policy of locking up individuals for drug offenses (currently estimated at one in every five, or more than 406,000, of the country’s 2.3 million inmates). Equally troubling, an estimated 65 percent of the prison population has an active substance use disorder. Yet, very few prisons and jails offer treatment of any kind, thereby forcing inmates into harsh detox conditions without services or support. For example, only 12 percent of prisons and jails offer medication-assisted treatment (MAT), which has proven to be a particularly effective method that combines medications such as methadone and buprenorphine that ease cravings with behavioral therapies and peer-based counseling.

The same methods, along with harm reduction, can be used throughout the criminal justice system. First, drug users should be diverted from entering the criminal justice system altogether, where they don’t belong in the first place, as nobody should be arrested and imprisoned for being an addict. Diversion strategies such as drug courts that offer those arrested a choice between jail and treatment are a good starting point. Meanwhile, individuals with opioid use disorder remanded in jail for short-term processing should begin MAT immediately, as they will soon begin to experience withdrawal.

Second, prisons must establish a continuum of care starting with being administered overdose-reversal drugs, followed by MAT programs that serve as a bridge to peer counseling with former addicts. Doing this requires training programs for both inmates and outside staff in recovery to work with those in prison who identify as addicts. Peer counselors function as role models who can help lead substance users to self-understanding and, eventually, long-term sobriety. We know this works: An MAT-focused program in California—the largest of its kind in the U.S.—has reduced the overdose death rate by nearly 60 percent over the past two years.

Finally, we must help released inmates reintegrate into communities. Studies show that the formerly incarcerated with substance use are up to 40 times more likely to die of an opioid overdose than are the general population. Re-entry services must include job and vocational training, transitional housing, and, most importantly, continued access to long-term drug treatment and recovery counselors.

As a society, we must help the incarcerated struggling with substance abuse. Let’s make sure they don’t suffer in isolation, despair, and loneliness. We need a more humane approach that helps inmates attain sobriety—both in prison and after they’ve served their time.

Exceptionally High Overdose Death Rate Disproportionately Harming the Black Community