The NOCE Dose: Opioid Crisis Unplugged

>> Speaker 1: CASAT Podcast Network.

>> Bianca McCall: Welcome to the NOCE Dose: Opioid Crisis Unplugged. The NOCE Dose: Opioid Crisis Unplugged is a concise and insightful podcast offering a deeper dive into the realities faced by professionals combating the opioid epidemic. Join us as we reconnect with expert panelists from our listening sessions, providing a behind the scenes look at their work and insights into the pressing issues of prevention and diversion, harm reduction, opioid use, treatment recovery, and reoccurrence prevention. Welcome to the NOCE Dose, brought to you by the Nevada Opioid Center of Excellence at nvopioidcoe.org. I am your host with the NOCE, Bianca D. McCall. And we're going behind the front lines with paraprofessionals and community members alike who support the opioid response programming in Nevada State to debrief after the nose sponsored listening session event of the quarter. Now, people are still buzzing about this and looking forward to continuing those conversations with our subject matter expert panelist, unplugged. And today's special guest is christina Boyd.


Bianca: Christina Boyd, how are you doing this summer

Christina, welcome to the NOCE Dose People are, like I said, still buzzing about what you contributed to those conversations with respects to motivational interviewing and just all things Christina Boyd and what you do from state to state across the fine us states. Christina, ah, how are you? This is what we want to start with. Inquiring minds want to know. The Nostos audience wants to know, how are you doing? And really, how are you doing?

>> Christina Boyd: Yeah, that's a great question. You know, Bianca, we were just saying right before we got started that sometimes we go through our day to day and we just kind of ask people and they say fine, and we go on. so I appreciate that. I appreciate the really on there. And, to be transparent, I feel like I really am doing well. I continue to have the opportunity to be involved in some amazing, amazing initiatives, projects, both in my state of Kansas, and across, as you said, in, ah, Nevada and other areas. And so, yeah, this summer has been good. I've been actually kind of taking some time to just be. The other night, I sat down on the porch, read a book. It was amazing. Fantastic. Like, didn't do anything, didn't go anywhere. It was amazing. yeah, as I become an adult, right, when you say, what did you do last night? And you say nothing, and it's like, I did nothing. That was amazing. That was so cool. So, yeah, life is good. I love summer. So, yeah, yeah. That was a very long answer to your very short question, but I appreciate you asking and yeah, I'm doing good.

>> Bianca McCall: Of course, of course I'm here for all of it. And like you said, we had this conversation about just the importance of, being available to have a conversation when you ask a question like that. How are you doing? I'm fine. Is, is an easy response and accepting that is also easy. but being committed, right, to being an active listener in this process of engaging, interacting with people, learning from people, growing with people, such a special position that we're in, with the NOCE Dose right, such a special platform, that we have to be able to do that. And I'm excited. Like I said, the community has been buzzing surrounding motivational interviewing, asking for more information, asking to be connected with you, to learn more. And I'm wondering what your response is from the listening session. Has anything been buzzing inside of you? Has anything been going on in your personal and or professional worlds, that you'd like to share with our listeners, perhaps something that you didn't even to happen from that listening session?

>> Christina Boyd: Yeah, I think, Bianca, one thing that really stands out to me and more and more it becomes solidified, I guess validated is that we need everyone, in this, approach to addressing all the complex issues that we see around behavioral health and supporting behavioral health and how much it's encouraging to me, I guess, that when I see individuals coming from the judicial system and the legal system and the behavioral health and medical and prevention and, you know, kind of recognizing that we've got to work together to address the issues about where we are today, there can be a lot of different reasons how we got here. And we need everyone, we need everyone's input into figuring out where, where do we go from here? Because, you know, if we're going to address substance use disorders, you know, mental health conditions, co occurring disorders, you know, all of these things, and it really truly address some of the crisis that's happening in our communities around opioids and other substances and mental health crisis, those kinds of things. It's going to take a lot of individuals working together to find the solutions and to find ways, that we can progress and prevent. That's the other thing that keeps coming up, is that we can kind of, in my realm, I was in direct treatment for so many years and starting to really put a lot of focus on that prevention because we can't keep doing it the way we were doing it right like that. You know, we're, we're ending up where we're incarcerating and we're trying to enforce our way out of these issues, and it's not working. It hasn't worked for years, and so really being able to. So, again, but to work together, because the people in the treatment field, you know, a lot. Right. We have a lot of knowledge and expertise and relationships and networking and those kinds of things. And so I think if we can get together with the prevention folks and. And not look at it so siloed, I think that's another thing from that particular learning or that listening session I loved is that we were all kind of from different places, not only geographically, but in our roles, which is awesome. So we can all lend a really nice view of our perspective of what's happening, what our strengths that we can bring to the table. And I really think that, to me, I kept thinking about how cool was that. We had folks from the legal system, and we had folks from judicial, and here I am coming from a university in Kansas and having been a social worker and a clinical addictions counselor. So I think that, Yeah, that continues to be something that I want to spend time on and continue to, further develop, I guess, even in the work that I'm doing and the projects I'm working in.

>> Bianca McCall: Sure. And, you know, Christina, you said a few things that, I think gonna start to shake some people up, right. Some things that. That might move us into the space of really discomfort. Right. That necessary discomfort in order to change. But here's what you said that made me feel like, ooh, we're shaking some stuff up on the NOCE Dose some things that you said. You said, we've got to do some things differently. Differently, right. We've got to change. Right. That word change. anybody, no matter who you are, what walk of life, what area of the continuum you serve in change can sometimes bring, discomfort. Right. It's almost synonymous with discomfort, in the growth process. And then you also said, get out of silos. Right. Get out of silos. And this has been a discussion for years that I've heard, right. Is that we've got to eliminate the silos. We've got to start working together, coming together. It's great that we have, platforms, like gnos and the listening sessions and the podcasts and things that bring people together. But what would you say to the professional and or community member that's listening to this? What would you say would be helpful? What are the first steps to breaking those silos? Right. What does it require? And I'm. Before I let you answer this with your undoubtedly thoughtful response here. I'm going to assume that a part of breaking out of silos has to do with some things that we've got to do for ourselves or pouring into ourselves.


What do we do to break these silos when we talk about change

So with that, tell me about my assumption, please, and tell me, what do we do to break these silos?

>> Christina Boyd: So I love this question. Yeah. Cause I do think this is something that we get comfortable. Like, again, you just described human nature, whether we're talking about providers or clients or participants. Right. And so when we talk about change, change is hard for everyone. And so, you know, you mentioned mi or motivational interviewing. I feel like there's some of those same concepts that work really well when we're talking about change for participants or patients or clients work really good for us, too, as providers. So, you know, part of that is recognizing, you know, if we're going to look at the care and treatment that we provide to a person, they're multifaceted. You know, people, don't function in a silo in that they are only one thing. So if someone comes through the door and maybe they're depressed, that doesn't mean that's the only thing going on with them. Right. We've got to look at all the different factors in order to really help them to move forward and make those changes that we're trying to help them, you know, and to build life worth living. And so I think as we look at providers, as we've functioned in these silos, right, like, we've maybe gotten comfortable in that. And I think it does take a willingness to be open, to be, to learn from others, to recognize our own strengths. I mentioned that earlier, bringing our strengths to the table and let's take this huge burden off of our shoulders that makes us, maybe at sometimes feel like we are the only ones that can help this person or that we are the only one that is responsible for being able to help this person and recognize, like, wouldn't it be great if we had a team, if we had help? And as we look at those silos, I think it also helps as we break those down to recognize it is change and it is hard and it may take more work now, but in the long run, it's going to take some of that burden off of our shoulders. We can work with other providers to recognize there's chronic illness. Someone might have, an infectious disease, a chronic disease that they're dealing with, dealing with that. If we don't manage that, gosh, it's going to be hard to help them with their mental health or their substance use, possibly. And all of these things affect each other. And I think we're also recognizing that there used to be this myth, Bianca. There was this primary and secondary. Do you remember? I remember even in diagnosis, in psychopathology, we learned there was a primary diagnosis in secondary and third whatever. We've really kind of moved beyond that to recognize we need to treat the whole person right if we're going to really embrace this concept of person centered care. That means that these silos aren't helping with that. We've got to be working with our community partners. Now, some agencies have really embraced that concept and are very interdisciplinary, and they have it all under one roof. That's amazing. Like, that would be cool if we could do that everywhere. I live in a rural area. I don't know if that's just not possible. Right. And so we've really got to, I think, be mindful and intentional about working with our community partners to provide all the different unique pieces of care that one person may require. And I know a specific example of this that came to mind as you asked that question. How do we break down those silos? I worked at a community mental health Center. So primary, mental health treatment, right. That's what we were doing one day. We were referring a lot to the primary substance use disorder treatment facility. So I just called them and said, hey, I have this, like, hour. Could I come by and meet the people that I'm referring to all the time? And they were, you'll be shocked by this, Bianca. They said, yes, right? Like, they were like, cool, come over. So I went over, we started talking, and that developed into having monthly kind of joint staffing time together, doing co lead groups together, because what we found out is that we could just get a release, and we really were kind of serving the same clients, a lot of. And so we could do a better job of that if we had releases in place, if we could talk to each other. We started doing some, like, co occurring group kind of things. It was amazing, and it all kind of stemmed. I mean, there was other people involved in that. I absolutely do not take credit for that happening. It did stem from the conversations of just talking to each other, like you said in the beginning, just kind of being human in a space and saying, hey, you know, I refer all the time to Peggy. I'd love to meet Peggy and hear about what you do and what makes you passionate and see if we can work on these things together. And I think when we do those things, you, also related it to kind of how do we, you know, part of the ethical responsibility. I believe in my field, being a social worker now, if you read in our code of ethics, now includes self care, part of that is being able to set some boundaries around I can't save the world. I can't do everything and be everything. For every client that I meet or participant or patient, I have to really, if I'm going to provide competent care, if I go back to that competence piece, I have to address all these pieces that this person needs, and I have to know my scope of practice and my boundaries that I can't do all that. And so if I'm reaching across those silos, those barriers there and trying to diminish that so that we can communicate, we can work as a team, that's going to take some pressure off for me. It's going to allow me to have some time, some space to take care of myself, to do the things I need to do, to be able to take the days off that I need to, because I don't have to be everything, that this client needs, right. I can rely on others and recognize that that's only going to strengthen this approach and hopefully help that person in that change process. So I think there's a lot of different moving pieces there. It's definitely harder than it sounds. I mean, there's a lot, right. It's going to take some time. I mean, there's. There's all kinds of things that make that hard, or funding streams make that hard, or billing, you know, those kinds of things. But I look at all of those things as opportunities, Bianca. I mean, anytime I'm, you know, I talk to people back this, and they're like, well, about this and all the buts, are opportunities. Those are opportunities for advocacy. They're opportunities. Just because we've done it that way doesn't mean we have to continue to do it that way. There are ways that we can talk with our state, with our, you know, advocate, for change that needs to happen because, yeah, once again, the rates that we're seeing, the overdose rates, the suicide rates, all those things are going in the wrong direction. They continue to, unfortunately, we have to do it different. We have to. And that's coming first. I've been in the field. I'm the person, like, I was doing direct care for a lot of years, and now I look back and think, I could have done that differently, right? And so now I know better. I'm trying to do better. I guess.

>> Bianca McCall: Absolutely. We know what we know. When we know better, we do better. And I love, I love the culmination of what you shared, with that statement. And for me, you said a lot of great things, right. And something that resonated with me is, things that we, that are within our locus of control, things that don't necessarily require funding or this systemic overhaul, right. Things like, taking that personal inventory, being, okay, reaching a level of acceptance with what we have the bandwidth for, you know, what we have the capacity for. And when you're talking, I'm thinking, oh, some of us have got to address, you know, that internal perfectionist that's holding us back and thinking that we've got to solve all of the problems today. and so there's some self care and there's some self, discovery as well, discovering, how we can contribute, right, in our fields and contribute, with our passions, right, and desires and willingness, along with our capacity to do so, and having a level of self acceptance, in that arena. I, think that there are some frameworks, there are some things that really allow us to take different positions, if you will, and ones that don't require the heavy lifting, the fast paced, intense, pathway to burnouthenne. Right. if we are more of a guide, in the treatment, right, in the treatment space, if we are more of a guide, with people and we're empowering the consumers of our services, to be invested in their own, pathways in treatment and things like that, to be invested in their success, in the successful outcome. These are the tenets of motivational interviewing, right.


Bianca: How can we better serve special populations with mental health issues

Which is something that you brought up, during the listening session and other things that you brought up in what you just shared. you brought up some special groups, special populations. When you talk about co occurring and it looks different, the guide, the journey, it looks different, when you have substance use issues, co occurring with mental health issues, and that was something that our audience, our participants from the listening session, they really want to know more about is how can we better serve and best serve, people that are experiencing, chronic issues, like being chronically unhoused, chronic substance use issues, and also having mental health needs. So what are your thoughts on that? How can we better and best serve, those folks, those special groups?

>> Christina Boyd: Yeah, I think that's a complex answer. I don't know how long we have, Bianca, but yeah, I think there's a lot of things, right. I think from even, you know, I'm in the realm of education. I think how we're educating folks to be prepared to serve these populations is shifting and changing. I know. I'm definitely advocating, you know, that we're infusing that we just. Research is too clear that if someone has a substance use disorder, the risk for having a mental health condition also increases their risk for being unhoused, increase their risk for, you know, all these things. If we add trauma in there. Oh, my goodness. Right. Like, we. That we could do a whole set of podcasts just on that, Bianca, with that, with that. But I think there's. There's a lot to think about there from even how we're educating, making sure that it's infused into curriculum, that it's nothing, a separate class that you might or might not take. Understanding the risk factors and the protective factors for substance use and mental health, for example, are very similar. It's very evident that when we have these risk factors, for one, we got to be asking about the other. I think that gets back to that. Prevention, I talk a lot of about screening, brief intervention, referral to treatment. I think it's so crucial in our, approach to care. It needs to be integrated in. It's evidence based. It's been shown to identify these issues early on and to identify individuals that may be having currently, either a mental health disorder or a substance use disorder. So being able to identify that early, I think for providers, too, just being aware of, look at evidence based practices, I think sometimes, again, in that siloing, we've started to think that we have to go back to school or that we've got to get this really specific training and to get that licensure. What I tell people all the time is you have really good skills. If you're already engaging with folks, you're building trust, you are engaging in empathy. Whatever theory base you're using, the likelihood that that's going to be pretty effective when it comes to one or the other is pretty high, right? Like, so I look at mi m. We've talked about motivational interviewing a lot. It's evidence based for both. It's evidence based for substance use disorders, and it's evidence based for mental health conditions. Same thing with things like DBT and other. Because I feel so strongly like that what works with human beings is going to work with other human beings. So whether I'm talking about someone who's dealing with their depression or their opiate use, we're going to talk about change, we're going to approach that, we're going to meet them where they are. We're going to work on empowerment, self determination, look at the change process, what do they want, what motivates them? They're humans. If we approach it from that stance, I think for providers it's not being, maybe so scared to look at that. I think for people that have maybe practiced in that mental health side, primarily, yeah, there's some things you can learn about substances and intoxication and withdrawal, and there's definitely things we need to know about. And there's a lot of things you're doing already that are probably going to work really well. Right. And vice versa. I think, you know, we always want to practice within our scope of practice, obviously, you know, I'm not encouraging folks to go out there, do things they're not ready or prepared or trained to do. I do think sometimes it's a matter of seeking out. Most states require continuing education to hold a license or a certification. Look at what kind of classes you're taking, you know, what kind of, ceus you're garnering, spending time also, like finding I can't advocate enough for good supervision. that's a whole other thing too, but like good clinical supervision, if you feel like you want to increase your skills on that, maybe you're again, on the sud side. You want to increase your skills around mental health, maybe seek out a supervisor that could do some group supervision with your agency or provide individual supervision that maybe has, a dual licensure or has experience in the mental health side and the sud side. Because again, I think it's not like it's dealing with new people. It's being able to treat the people that you're already treating better, to be able to really meet the needs of, the folks that you're already seeing, the clients that you already had, the participants that are already involved in your career treatment, and recognizing that sometimes, again, getting back to that idea of screening, if we're not asking about these things, people maybe aren't even telling us, we have to start asking if someone comes in to say on the mental health side. And again, I keep referring to these silos a little bit like the doors, right? But if they come in on the primary mental health side and we don't ask them about their substance use, we might get super frustrated with the progress, right? And they are too. Like if we're dealing with depression, they're taking, a psychotropic medication and they're drinking a six pack, you know, three or four times a week. That's really important information. And it might be affecting their chronic health condition of having some high blood pressure. Right. Because the byproduct of drinking, it gets metabolized and it's sodium. You know, like, there's these basic things that if we have a knowledge of, we can have those conversations with people to really, again, help them. If they're really focused on their drinking and the depression's there, we got to treat both. If they're really focused on their opioid use and their anxiety is out of control, we got to focus on both, and it's got to be at the same time. again, I think the old adage was when people would come in, we'd say, oh, we'll get this under control. And then when we do that, then you can go over there, and then you'll get that treatment for that. And then they go over there and they say, oh, no, no, no, you got to get this under control. And then when we get that managed, then we'll treat that well. What we found is people don't get better that way, right? If I'm hugely depressed, right, and they fall through the cracks and they don't come back, or they think people don't care, right, because, and treatment didn't work for them, there's no hope because they've already tried multiple times. And that's where I think, I hope, again, in our, in our systems of care, that we're moving towards this more person centered approach, treating things at the same time, especially when it comes to co occurring, when people have been through multiple treatment that has been unsuccessful, for them, I want to say it's not your fault. It's absolutely not your fault. The system was not set up to support you in the way that it needed. Let's try this. Let's get into, a system of care that really provides, and if it isn't one provider, again, it's working with those other community partners, those other people that are providing that care, so we can make a difference for the people that we're seeing. I mean, that's why we're all here, right? We're not making widgets. We're helping human beings. And it feels good. I know it felt good for me when people moved forward, when they made progress, when they built happy, healthy, productive lives worth living, right? That's what we're all here for if we're in this field.


Bianca: I think what we can do is look at education

so I think getting, I got way off. I think. I think Bianca, way in the weeds, I'm going to bring us back. I think that what we can do is, again, look at who we spend our time around. Are we creating interdisciplinary groups or teams? Are we looking at the education that we can continue to get, like in continuous? Are we looking at, even if we have influence over education, where people are learning about how to do this work, are we infusing that? Are we starting to, advocate and encourage? I'll be a guest speaker. Whatever it is, talk with your universities, try to get in with those, disciplines that you're a part of and maybe have an impact there, too, on this next generation coming forward.

>> Bianca McCall: Impact, impact, impact. we're largely focused on outcomes, and outcomes and impact. You know, there's a parallel there. Right. thank you so much. You brought up great things. What I'm hearing, and also speaking my language, right. Speaking to my heart, you're saying training and education to become informed, right. About what's out there in terms of evidence based frameworks and things that do exist, that do support also what we're saying and making those shifts and paradigm about, our own preparedness, our own capacity, our competence, but also confidence in being able to serve these communities. like I said, you're speaking my language. And when we talk about the Nevada opioid Center of excellence, it's also a platform that offers the training and the technical assistance for those providing services, doing opioid response programming in whatever state that you are in. but we are it for Nevada. And so, I love it. You're speaking my language. In terms of.


There are multiple roles within a conversations, right? And it requires balance

That goes throughout our session, today, you've talked about just really, I'm human. Right? You're human. The community. We're all a bunch of humans, right? And so let's get back to the basics, you know, let's get back to the basics of having real conversations, participating in conversations. And there's a distinction between talking and conversations, right? Talking. That implies that, yes, you found your voice. There's a platform that we've co created the safe space to be able to find your voice and to utilize that. But conversations, there's multiple roles within a conversations, right? And it requires balance of those roles wherever I. Sometimes you're doing the talking and disclosing, and sometimes it's important for you to be an active listener. Right? And you mentioned, receiving. Right. In terms of data and evidence and things like that. But if you are in a position to receive and, to be able to review the messages and the data and the intentions that are occurring in your everyday interactions, then that's how you can become empowered and informed to create change, to do something different. And the last thing that, you know, that I want to say that I really got from your conversation, Christina, is that, you know, it's. Let's see, how do I say this? It's, you know, you bring up special, special groups, co occurring groups. we talked about unhoused, but you also brought up, rural communities, and sometimes just by physical demographics. Right. By the geographics of the situation, it's creating, kind of these silos, right. And so, that's why platforms like nose platforms that integrate technologies and things could help, bridge those gaps, right. Because that's what we're all here for, is to be able to bridge those gaps so people aren't following through and not getting better. Right. We're not having the impact that, we intend to. So, with all of that being said, I mean, you brought up so many great things. Like you said, we can go on and on, for hours, for days. and I'm sure that we will. We have the incredible, Christina Boyd, the relationship that we have with you, that you, provide plenty of trainings, on these subjects, through cassette learning, through NOCE, and this platform. And so we're very grateful and thankful for that.


Christina, how do we get in contact with you? Where do we go

Christina, will you please let the listeners know how and where they can find more of you and have more of these conversations and to go into the weeds with you, back into the weeds. So, how do we get in contact with you? Where do we go to find, you and the trainings that you're doing?

>> Christina Boyd: Absolutely. So, Bianca, I don't know if you could tell, but I really like talking about these things. So, definitely a passion area of mine when it comes to everything that we've talked about so far. currently, I'm an associate professor of the practice with Ku. So I do some work through KU, through the School of Social Welfare. I also do a lot of work with the opioid response network. You had mentioned NOC being there in Nevada. I mentioned I grew up rural. I'm a country girl. I love free. If it's free, I am all about it. So I love being able to be part of. Part of organizations that offer trainings that I'm involved in for free, because I think we don't want to create any more barriers for folks and make it easy as possible to access. So, opioid response network is one way. I do a lot of work with them on trainings around all the things that we've talked about SBiRT, about co occurring disorders, about mi m, lots and lots of things as it relates to substance use and mental health, disorders and co occurring, Also, as you just mentioned, with Noc, with, CASAT University, of Nevada, Reno, have done a lot of, extended learning series, on different topics through, nfar, which is the frontier and rural kind of subset of cassatt, and as well as the mountain plains, ATTC. So all of those entities kind of. I've done some different, training and have different opportunities currently happening right now. I'm doing a series on co occurring, Also with the University of Nevada, With the medical school. We're doing an echo, which is really cool, is very much that interdisciplinary approach, around sbirts. So, again, that screening, brief intervention, referral to treatment we've done, I think this will be their second one this year that I'm part of. So, we'll see where that goes, if we have any more need for that. But, yeah, lots of different avenues. But, yeah, those are some of the. Kind of the main ways to get a hold of me. yeah, my name, phone number, all that stuff is out there. You can go to the Ku website, you can find all that. And I'm always truly open to people getting connection with me, saying, this is what I need. And then I try to, again, hook up with whatever entity might be able to pay for it, because, yeah, I want to help folks out and try to support, getting this information out there as much as we can.


Bianca, is there any lasting message you want to share with our listeners

>> Bianca McCall: Well, thank you so much. I know that I've taken up so much of your time today. is there any lasting message or information that you want to share with our listeners?

>> Christina Boyd: Oh, my gosh, Bianca, that's like, a lot of pressure. Like, I want to say something that'd be like, oh, that's profound. but nothing is coming to my mind. But I want to reiterate, too, though, how much I've appreciated to be part of this. And Bianca, you're amazing. I love this. And like I said, I feel like we could probably talk for a lot of hours. But I think one thing that does just. Just to always keep in mind as we go forward and as we're working with different individuals, I always want to approach every conversation. I want to seek to understand first, to really understand where folks are coming from and to really, like you said, listen. There's a difference between hearing and really listening to people. and it sounds easy, but it's super hard, but it's possible. And I think it takes practice. But I'm really listening to what people need when they tell us, people tell us all the time what they need. And so I think, you know, as you mentioned, being part of this human race, just taking the time to seek to understand others and, you know, thank you. I want to say very, very sincerely, thank you to all of those that are listening. If you are providing direct care to other human beings, you're amazing, and you don't hear it enough. So thank you. Thank you for everything you're doing.

>> Bianca McCall: Thank you. And, Christina, that was a mic drop. Seek to understand, be human, and thank you always in a space of gratitude. Thank you so much. Christina, thank you so much for joining us on this dose. Anytime, Bianca, thank you. We'll definitely have to have you back. I, can't wait to be able to release not only this conversation and content, but get more snippets of our listening session out there, get more people excited and involved with mi and some of these other trainings, becoming informed, becoming empowered, and, really reaching in, pouring into their humanity. Right. So thank you so much for all that you contributed to this conversation.


This podcast is brought to you by the Nevada Opioid center of excellence

My name is Bianca D. McCall. I am the hostess with the gnostness. This is the NOCE Dose Nevada opioid Center of excellence. Bring to you conversations with our paraprofessionals, with our community members that are a part of the opioid response programming in Nevada state. Christina Boyd in the state of Kansas, tapping in to be able to pour into Nevada state. Thank you so much for your time, for your contributions, and I look forward to reconnecting with you along the journey along the way.

>> Christina Boyd: Absolutely. It's been a joy. Thank you, Bianca, for having me. I'll come back anytime.

>> Bianca McCall: Thank you for listening to the NOCE Dose the opioid epidemic unplugged. we hope you found this episode compelling and informative. We ask that you please share this episode with your friends and colleagues. And if you want to learn more, please visit our website@nvopioidcoe.org, the Notion Dose podcast is brought to you by the Nevada Opioid Center of Excellence, or NOCE. NOCE is dedicated to developing and sharing evidence informed training and offering technical assistance to professionals and community members alike. Whether you are a care provider or a concerned community member, NOCE provides resources to support those affected by opioid use. Funding for this activity was made possible in whole or in part by the Nevada Department of Health and Human Services, the director's office, through the Fund for Resilient Nevada.

>> Christina Boyd: CASAT Podcast Network this podcast has been brought to you by the CASAT Podcast Network, located within the Center for the application of Substance Abuse Technologies, a part of the School of Public Health at the University of Nevada, Reno. For more podcast information and resources, visit cassatt.org dot.