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Welcome to "Connections," the podcast that bridges the gap between addiction and mental health through the prism of policy and practice. Join the hosts, Morgan Coyner and Sara Howe, as they unravel the intricate connections within the world of addiction. In each episode, they dive deep into the intersection of prevention and recovery.
Welcome to Connections, the podcast from addiction professionals of North Carolina, where we explore the nuances of addiction and mental health through policy and practice. We're your hosts, Sarah Howe and Morgan Koiner, and we're here to help you see how it all connects. We are here live at the APNC 2024 Spring Conference.
We are out in Lake June, Alaska, and we have the honor of having over 300 people join us. Um, attendees from all across the state, all across the Substance Use Continuum, and a whole slate of great speakers as well. So we are so excited to get to bring some live guests to you for some in person conversation.
So one of the great things about being here at the conference is we can bring some of our speakers that we wouldn't normally have here in North Carolina. So today we have Nate Metz and Doc Henry from Lafayette, Indiana with Phoenix Paramedic Solutions. So welcome Nate. Welcome Doc. Thank you. Thanks for having us.
We're excited to have you on the podcast and thanks for coming back to the conference. Of course. Thanks for inviting us. Of course. We're so happy you guys are here, um, to kick us off. So. Y'all do a lot of things, which is an understatement. Um, but one of the things that sort of is at the core of your work is being paramedics.
And that sometimes feels like it's adjacent to substance use or kind of a totally separate thing. Or we've talked, uh, a lot in, in recent years about, oh, well, paramedics should care about substance use because they're the ones who respond to overdoses, but y'all have kind of taken this work way past that sort of initial contact.
And so I'd love for you to kind of just start us off with like, what is the paramedics role in substance use and, and this field and, and the fight that we're fighting? Yeah. You know, I think it's a question, uh, whose answer actually changes over time, right? It adapts. It's healthcare systems adapt. If you look back at the history of paramedicine, EMS in general, right, we were initially started because there was a lot of accidents occurring on an interstate and it was costing the public way too much money and too many lives.
And so they developed the 911 emergency medical systems to respond to that. Very simple mission, simple task. As communities needed more and more, the system adapted. And you saw that adaptation go from trauma care to intensive cardiac care. To now you, you see EMS agencies in different parts of the state that are doing, you know, cut downs, they're putting chest tubes in people, they're hanging blood in the field.
And these are all adaptations based off of the needs of the communities that they're, they're trying to serve. And so, you know, the crossover is that even as a paramedic myself, I have been treating individuals who have been struggling with some form of addiction or mental health issues for a very long time throughout my career.
The truth of the matter is, in the beginning part of my career, very early on, I was very ill prepared and ill equipped to handle these needs in my community. Even if you look now in the National Associations or the National Registries curriculum for a paramedic, you know, addictions is only really mentioned once, really briefly, in one chapter.
And the majority of the educational material that they provide for EMTs and paramedics is actually on acute reactionary response to an individual who suffered an overdose. And so our training was really about that acute reaction. And so what we found though, and I did an EMS, and you'll find frustrations within your first responder community because of this, is that, you know, the system wasn't working.
It still isn't in many communities. And instead of getting frustrated as a paramedic, seeing the same individual over and over again and having that recidivism, which in my case, and I talk about this freely as a paramedic, It's shameful, but I have to talk about it because I know it's pretty prolific throughout the emergency medicine community, not just EMS, not just first responders, but even in the emergency rooms, the way that the first responder community and paramedics, both in my past have treated individuals who have overdosed was pretty shameful.
I mean, I remember innovating people just for the sake of innovating because they were yelling at me or talking to me, right? When I was a young, arrogant paramedic, I thought that, uh, Um, you know, I'd wake someone up from an overdose with Narcan and my 15 minute lecture on the way to the emergency room was going to fix them.
I remember once I woke a father up who had overdosed in his bedroom and his kid was playing in the living room. Whenever this happened, he's the only one home. And I was so angry that after I woke him up, I made him sit in the living room right after giving him Narcan and apologized to his son before I left the scene.
And I say these things because you have to talk about them so that people understand that the way we treat things and our mentality about going into the communities and treating individuals who are struggling with mental health issues, which are usually obviously comorbid with an addiction issue, that that's really not the way.
Um, and, and also that it's a disease and they can't really, you know, they need more help than just a cocky, young, arrogant paramedic telling them that they need to stop. And so I kind of brought a lot of those lessons with me. Whenever we started Phoenix and then I was very, very lucky to, to have an opportunity to employ individuals in longterm recovery.
I was really early on and initiating the peer programs. And so then bringing their perspective into our work and in our organization then changed the way that we were able to help our community. And, you know, the families and the parents and the loved ones who are struggling with with diseases, uh, and I thought it was a really good change for us.
And that's kind of what pushed us over the edge to do a lot more. Yeah. And then on the flip side of that. So I came in on the other side of that. I came in as a recovering addict, um, person in long term recovery that had some run ins with paramedics like him and, and um, police force out there, you know, and it, and it actually created a bias with my children as well.
So before I started at Phoenix paramedic solutions, there was a complete bias, um, with, okay. You know, EMS in general with the police department in general, you know, because every run in that I ever had with them, um, was never good. I still remember early on when you first started working. I mean, your kids were kind of scared of me when I was in my class A's.
They were. I wore my class A's. They did not like my badge. They didn't like my dress blues. They were terrified because of the things that I had created, you know, but I wanted to create a different culture amongst my children, right? I wanted them to know that, you know, that EMS and the police force out there.
People out there in medical, in the medical field and they're not all bad, right? So what we did was, um, he dressed up in his dress blues there and I brought my children in. And then he walked them through it, right? Because what I wanted to do is, I work in this field now, right? Because like I said, I came on the other side of it.
You know, I work, I'm a recovering addict that works in the field, that works at an EMS company now. Right? And that's what happened. That's how it come to fruition with me. But like, I wanted them to see that what I'm doing out there, there's other people out there doing that same thing. So, um, he, he, he brought them in and he started just explaining things.
This is why, you know, so because we know education, Creates awareness and awareness creates, um, more awareness out there. And then with that, they understand a little bit more, right? So it's important to remember that. And then the movement that we have at Phoenix there, you said it in a nutshell. There's so much going on right now.
So much. I don't know another EMS company out there that, um, has paired with the addiction field and the mental health field like we have so far. Which is why I follow, um, Nate. Yeah, before we like keep going, how many years of recovery do you have? So June 13th, I'll have eight years clean. That's congratulations.
So we can't go past without saying how incredible that is. So how does that work for you being in recovery and doing peer support, being able to talk to individuals, whether they're just experiencing an overdose or you continue to support them in their longterm recovery, recovery. Tell us a little bit more about that journey for you as a professional.
So, you know, um, I found my passion early on in recovery, um, working with individuals seeking recovery because I wanted them to have the same fire that I had. And honestly, um, I would be lying if I didn't tell you they helped keep me clean. That is one of my biggest whys out there because our company is huge about whys, right?
Um, and my why is to give a voice to the voiceless. A voice that I never had, right? So I want to be there for that next person. And my family struggles with addiction as well. So I have a little brother that died by suicide about four years ago. So working in this field, um, I couldn't help him. So he struggled with addictions and mental health.
And then it affected me, you know, and I went introspective at that time. I went, you know, well, I couldn't even help him. How am I going to help someone else? Then an epiphany happened, right? Maybe I can help the next person. You know, and the next person, the next person, you know, and honestly, this is taboo to say, I don't go to recovery meetings as often anymore.
I don't. That's not who I am anymore. Because I have grown in my recovery. Now recovery meetings are extremely important. You know, I love the meetings out there. They're extremely important, but that's not where I'm at anymore. Because I'm much more than just my story. I'm much more than just what my past was.
I'm ready to write a new chapter in my book. I am because I know how to live that past. So what I do is I give them a glimmer of hope. Only thing I have to do is just plant a small seed, you know, a small, small seed in them and then show them that someone cares in return because we burn a lot of bridges out there when we're out there in our active addiction.
We know how to, we know how to tear shit up. I mean, excuse my, excuse my language, but we do. We do. I don't know another better way to say that, honestly. I mean, we know how to burn it down really good. You know, someone asked me, um, What are you scared of in your career? I'm scared of success. Because I know how to fail like a champ.
And I can do that so good. I know how to fail, but I don't know how to be successful because I've never been successful. I was a successful drug user. I was successful at putting my kids in foster care at one point in time. I was successful at catching felonies and doing what I do out there, but I've never been successful doing the right thing.
I gotta challenge you. Go ahead. Because you said you were good at failing. I was. And as I've developed you professionally, you weren't. Because failing means success. That's true. You weren't good at managing. How you failed, which means you're not good at it, right? So failure is a key to success. It is. You, you ran away from failure.
Now you run towards it. You're right. He's, he's absolutely right. But that's an awesome paradigm shift. But it took time to get to that, right? Someone like him willing to take their time. Someone that's a paramedic that's been in this field a very long time. Not only is he just a paramedic, but he's, he's the president of, of the IMSA of the state of Indiana.
He's, he's the president of several different things. Um, but he actually seen something in me. I didn't see in myself at the time. He gave me that second chance, you know, and then he made it okay to fail at work. When I think, I mean the common thread, I think both of y'all are highlighting is to do this work well, the bottom line, basic things you have to care about the people.
And that's, you know, your personal story kind of helps fuel that for you. And I think Nate, you were talking about that when you talk about At its core, right? Like paramedicine was started as a response to a need of the people, right? And, and even telling some of those stories that, like, we, they're hard to hear, right?
But it's, you tell them because, like, you see them differently now. And, and you've changed your entire company and made all these different moves and, um, Done things in response to the people you care about. So I'd love to hear a little bit about like what some of those changes and programs have looked like and sort of how they were born out of truly just caring for people who are struggling.
You know, the, the, the questions, uh, uh, it could be a complex one, right? We could probably talk for four hours because there's a lot of different components to it. But I probably say one of the first things we did as an organization at its core. was we decided as an organization that we were going to build a company and its action based off of a mission statement and live by the mission statement, no matter how much it hurts.
And that mission statement is to break barriers, defy tradition bias and make absolutely no exceptions when it comes to compassionately providing care to those in need. And so absolutely everything we do in our company, people say, you guys do a lot. No, we just, we just do our mission. The law is what it looks like, and you heard doc alluded earlier to, we talk a lot about our why.
And the reason why we do this, because whenever you concentrate on your why, what you can do to successfully get to your mission is actually limitless. Whenever we define our organizations based off of our credentials or our provider type, right? So I'm an ambulance provider. Well, that's emergency medical med or emergency medical services, EMS, right?
They're emergency right there in the front. People can look at that and then define their organizations by what they are, not their why. And whenever they define their organizations like that, their scope becomes limited. And they forget that as a healthcare provider, our ultimate job is It's to help people and make our communities healthier.
And one of the things, whenever we started getting into this, that was very frustrating for me and still is, is I see people with good intentions and organizations with good intentions who say their mission is to help people, but they forget to look at the leading cause of a lot of individual suffering in our community, which is actually system base.
And they're the ones in charge of systems. And so I don't know how in good conscious anyone could sit back and look at this and say, we don't have to change as organizations and how we care for people in our communities. If their goal is to help people and that's their why, um, then you need to sit back and look at the things that you're doing that hurt people.
And I mean, I'll name them out for some people like, right, there's organizations that exist all over the place. They have an individual who's a bipolar paranoid, schizophrenic, also suffering with substance use disorder, and they missed three appointments and they're kicked out of a program. Right. Well, yeah, they're going to miss appointments.
They're, they're, they're going through a manic episode right now. They also don't have a driver's license and they have all these balls that they're juggling and you're supposed to be the person in their corner. And so whenever they fail, the organization whose mission is supposed to help them goes nuclear on them and says, Nope, you're cut off.
And then what happens to them in the community? And I just, I look at things like that, you know, we're a very mission centric organization. And unfortunately we've all created ourselves to be a bunch of monsters inside Phoenix because we all see things that way now. Um, and I mean, I'm not great at it, but a lot of my other folks are really not good at it.
Whenever we see that, we call it out, um, and people either love us or they hate us. Um, but really that was the biggest paradigm shift is we decided as an organization that we weren't going to be an ambulance provider, that we were going to be an organization that goes off, goes off its mission statement.
And even whenever we have orientation, we do that exercise. And I tell everybody in that organization, you are a Phoenix first. You are expected to be a Phoenix first. Your credentials are just tools to help you be a Phoenix. And so everybody comes into our organization on an equal playing field because everybody in our organization, regardless of their credentials has the power to successfully complete our mission.
It doesn't matter if you're an MD, if you're a nurse, a licensed clinical addiction counselor, if you're a peer, if you're an EMT, or if you're a paramedic, we employ all that different demographic and community health workers too. It doesn't matter because taking a meal to someone who hasn't eaten in four days In the case of an occupational health call we had not too long ago, because we do occupational health too, which we integrate addiction care into it.
Um, you know, there was a woman who, who was, uh, asked to go do a drug screen by their supervisor because she was sleepy and tired and they were like, she's not acting right. Fell asleep at her station. Before we did a drug screen, we asked her what was going on. This was before the holidays. And she just broke down.
The poor girl had a full time job, but she was a single mother of four. And the holidays were coming around. She had not had anything to eat herself, but watered down milk for a week because she could only afford to give food to her kids. So instead of doing a drug screen, my team, bless their hearts, it chokes me up the story.
My team sent her home, got her help. So we're going to help you out. Next morning. She was also worried about gifts. Her kids have outgrown all of her clothes. She couldn't afford clothes for him anymore. Her pantry was completely empty, uh, struggling to keep the power on. Very next day, they invite her down to the clinic office and there are two giant, I mean, giant boxes.
Those boxes are filled with groceries. Those boxes are filled with all new clothes for all of their kids. Those boxes are filled with new shoes, toys for Christmas. Like, that's just, that's what we do. Okay, was I paid to do that from the place I worked for? No, I wasn't. Alright, but that's our mission. And if it means me ponying up my credit card to do it myself, I will, because that's what we all decided as a group that we were going to try to do together as an organization.
So that paradigm shifts what changed. One story of hundreds that, that we've done like that, you know, because it's much more than just helping someone that's in longterm recovery or suffering from mental health and or an EMS company. It's much more than that. I can't tell you how many people's feet I have washed.
Because I'm not above that. My title does not dictate what I do. I am in the trenches with my employees every day. Just like from the top to the bottom. That's what's expected of our company. You heard the mission statement. That's why I work as hard as I work. And that's the truth. What I think is really amazing too, knowing Lafayette, Indiana, knowing the area where you are, which is not dissimilar.
from anywhere here in North Carolina. You have a large university across the river. You have a working class business community. You have some large factories in Lafayette. You have a big group there. You have students, you have non students. You have a really thriving community and not unlike what we see here in North Carolina.
And you're talking about intersecting with all those individuals and really at their humanity level, right? That's really great. So, I know we're, we're running out of time, which is really bothersome because I want to do like five more hours of this conversation, um, but how has the community changed as you have changed and your organization has changed?
Well, that, that's been an interesting paradigm shift as well. So, one thing I, I would say with any change initiative, particularly whenever, if we're trying to loop it back even to EMS and first responders, because I hear from addiction professionals all over that kind of getting that group engaged in their projects and their communities can kind of be tough for some folks.
You, if you're familiar, if you want to get technical, be familiar with the Law of Diffusion of Innovation. Law of Diffusion of Innovation shows a simple bell curve and there's early innovators or entrepreneurs and there's early adopters. And then there's a critical point of mass that you hit somewhere along the line.
And once you hit critical mass and it's game on and then it's like an avalanche of support and you see this rapid change. But I'm telling you the rapid change is because of the years of work and persistence and strength that you put in ahead of time. And so I can't tell you how many times and as a young leader, um, even though I have a lot of experience as a young leader is always something that's very, very difficult and we're starting to see it come to fruition now where we're getting vindicated on standing our ground in our community and how we're going to treat people, how we're going to act with our patients, how we're going to treat our patients.
And to be honest with you, this happened from the very beginning, whenever I employed peers with records, I was outcasted when I first did that. In late 2016, outcasted that long ago, it wasn't, no, and so, but we stuck to our guns and we stuck to our mission and we make decisions based off of that regardless, even if it makes a partner mad, even if it, I mean, I have, I've walked away from lucrative contracts because it did not fit our mission.
And I'm telling you that persistence will pay off. But you have to stay the course and you have to stay, stay true to the mission. You got to do it for the right reasons. But we were just talking about this on the way down. Some things have occurred in our community recently where we're being vindicated again that decisions that we made a year ago that were looked at and criticized are now painting out and now all of a sudden it's not just criticized.
People are emulating and copying the models and the ideas and the care. So yeah, you know, things are going to go and then all of a sudden they're going to avalanche forward. Right. So, and you're not going to know when that's going to happen. You're just going to kind of see it one day in your community, but it will happen if you just keep, keep the course.
We are so grateful. First of all, it's not just in your community because now you're here in North Carolina talking about it. Yeah. So where you're making a movement, I think that's beyond Indiana. And we're excited that you guys are here to talk about it. I think this conversation can go on. Oh, yeah. In many different directions, so you might have to come back and do a part two.
I have like 900 follow up questions. We have all kinds of, kinds of follow ups, but we want to thank you both for the work that you do. And for being so open with your stories. Yeah. As well. I mean, Nate, you didn't have to share that. You easily could have said, Oh, I did some stupid things when I was younger and glossed over it, but owning that.
And then being a person in long term recovery and sharing that for others and giving them that hope, we appreciate that, Doc. Of course, thank you guys. Thank you for being here. Thank you all. You're very welcome. Thank you.