Recovered Addict Thanks N.H. First Responders
Mar. 23—Ryan Fowler was agitated when first responders woke him from an overdose, discovering him in his car where he had just injected an opioid while on his lunch break at work.
Hospitalized and released the same day, Dec. 17, 2014, Fowler walked away from his third rescue by firefighters only to inject once again eight hours later. That would be his last time, though, and his resulting road to recovery would lead him to give talks to firefighters about his experience, including to some who helped save him the last time he was revived.
"I owe my life to first responders," said Fowler, now 28. "It's a very common story that's not really told."
Fowler's talks, still in their infancy, have been held in Hampton, Salem and Derry since September, the goal being to expose first responders to the types of people they save from addiction after they have sought recovery. They are being organized through a collaboration of addiction recovery organizations like Safe Harbor Recovery Center in Portsmouth, where Fowler works.
It was during one of those talks in Hampton last month that firefighter Jed Carpentier realized he was at the scene of Fowler's last overdose. He recalled seeing Fowler stagger from his car with the help of North Hampton firefighters as he and firefighter Craig Jordan, who were responding to the scene to provide mutual aid, arrived. They checked Fowler's condition before having him transported to Exeter Hospital.
"The light switch went off," said Carpentier, recalling how he recognized Fowler during the talk. "I remembered the day quite vividly."
Being revived by firefighters is common among those who actively use opioids, but Fowler and Carpentier said both populations rarely have any other interactions.
"They see us at our worst," Fowler said, referring to first responders. "We are overdosing, we are committing crimes. We are at the bottom... they don't ever get to see the beauty of recovery."
For that reason, Carpentier said he hopes the talks will become more common. A month after Fowler spoke to Hampton firefighters, he reunited with Carpentier and Jordan for a deeper conversation about what happened the day of his last overdose.
"Was that the turning point?" Jordan asked Fowler, who replied the rescue was the start of a long, painful day that pushed him to seek treatment for good.
Fowler said he barely remembers what happened in the parking lot of the Route 1 North Hampton company where he was working a temp job. Until Tuesday, he was under the impression he was revived by the overdose-reversing drug Narcan by the firefighters themselves, but Carpentier said Fowler was actually awoken by physical touch. Narcan, he said, is not always needed.
Carpentier said Fowler was irritable, even "combative," like many awoken from overdoses who are frustrated at having their high disturbed. Fowler was alert, though, and told Carpentier and Jordan a little about himself, his job and what he was doing that day.
"The best thing for him was just to be compassionate and kind of let him do his thing, not aggravate him," Carpentier said.
The rest of the day was traumatic for Fowler. At the hospital, he said, he was still under the influence but coherent enough to beg and plead staff not to administer Narcan themselves, fully undoing the effects of his high in an excruciating manner.
Narcan, he said, kicks in symptoms of withdrawal that are agonizing and disorienting. One feels "hot and cold at the same time," Fowler said, "like the top layer of your skin is missing." He said he was given a blanket and told to "tough it out" as he exited the hospital.
"I went on my way and did what seemed like the only thing to do," Fowler said. "Go and just make myself feel better."
When Fowler injected again later that night, he was pulled over and arrested for driving under the influence by Exeter police, with whom he had run-ins before. In the past, police had been harsh, he said, but officers this time showed compassion that left an impression. That helped him see his addiction in a new light.
"I just kind of broke down at that point," Fowler said. "I was at that point I decided I needed to go back to residential treatment."
Fowler said he has since learned that people using intravenous drugs may not be as street smart as they always believe. He was convinced the drug that caused him to overdose in 2014 was heroin, which he said has a distinct taste and appearance in a syringe, as well as a noticeably longer half-life. He was shocked to learn a few weeks later through lab results that it was fentanyl, a more potent opioid that has become increasingly common among illicit drug users.
"I had done fentanyl. I had done heroin. I did know the difference," Fowler said. He described the revelation as "eye-opening to kind of the nature of street drugs."
Fowler now works full-time at Safe Harbor Recovery Center. Last year, he was approached by John Iudice, program director at Addiction Recovery Services in Salem, about organizing a circuit of talks among fire departments, inspired by Derry fire officials who said such talks would be helpful.
"Now I'm using all my experiences, no matter how horrible, to help others," Fowler said, "and it's been a really cool experience."
Fowler and Iudice both said they have learned a lot from working directly with the firefighters. Fowler said he comes from a social work background where the topic of compassion fatigue is constantly addressed, but he and Iudice scrapped the original name for the talks—compassion fatigue training—after firefighters indicated they were reluctant to associate themselves with that condition.
"It would be like saying family fatigue if your family member is dealing with the same issues over and over and over again," Carpentier said. "I don't know if fatigue would be the right word."
The talks have yet to be officially named, but Iudice said other fire departments are aware of the talks and have expressed interest in having them held for their employees. Iudice said state officials have also reached out to him about incorporating coursework on addiction into standard firefighter training. Iudice and Fowler said firefighting is among the fields that bring workers in close contact with addiction but for which training provides little or no preparation.
"I don't think anyone said they wanted to be a firefighter or a police officer so they could revive heroin addicts on a daily basis," Fowler said. "With this kind of addiction epidemic, first responders have taken on new roles."
Fowler said it is difficult to find people willing to share their story, admitting he was reluctant to himself when approached by Iudice. Carpentier said he admires Fowler for his willingness to talk about how he "dealt with his demons" and hopes more in recovery will hear of his work and do the same. He and Jordan also said they hope they too can more often be viewed as part of the path to recovery for the people they save.
"My role as a provider is not so much about treatment and resuscitation. It's about being that bridge," Jordan said. "The bridge to help them on the way to recovery."