The nose dose opioid crisis unplugged is a concise and insightful podcast Speaker A: 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 good morning for most and afternoon for some. My name is Bianca D. McCall, and I am your moderator for today's listening session, exploring the evolution of harm reduction and hearing from professionals in the field, advocates, and community members with incredible lived experiences. And our objectives here today are to develop a comprehensive understanding of overdose emergencies, including recognizing signs and symptoms, to understand and explain the significance and application of harm reduction strategies, and enhancing our preparedness to address overdose emergencies unique to our local communities and sensitive to the abiding cultures. I'll have the absolute pleasure of actively and assertively listening to champions of service in our opioid response community. Panelists include Katerina Pulver, Bethany Wilkins, and Donald Griffin Please help me to welcome our panelists for today's discussion. We have Katerina Pulver, an experienced health educator currently serving in areas of training and program development and community outreach with the Southern Nevada Health District. And Katarina has played a pivotal role in organizing events like the Overdose Prevention Summit and critical public health initiatives such as the fentanyl Test Strip program. And we also have Bethany Wilkins. Bethany, is an educator and advocacy community chair with the Northern Nevada Harm Reduction alliance and has over a decade of personal recovery and professional experience. She, founded Nevada County's first syringe service program in 2020, and has spent over ten years practicing harm reduction, including five years in street based outreach and public health. And then we have Donald Griffin, who serves as a peer recovery support specialist. he's a supervisor. is a community health worker, too, and is the co founder and director of Black Wall Street Reno, which is an organization leading the installation of narcan youth peer to peer programming, suicide prevention and other essential services and outreach teams. So our panelists and our team here at NOCE, we're delighted to have you participate in today's session. The first set of questions that we're going to ask our panelists, they're really designed to elicit some information about the issue. So let's get a comprehensive understanding of what the issues are, that we're currently experiencing in our community of opioid response. What are the signs and symptoms of an opioid overdose and how should we respond I'd like to start, the line of questioning by asking Katerina Pulver, Caterina, what are the key signs and symptoms of an opioid overdose that community members should be aware of, and how can they prepare to respond effectively in an emergency? So we'll start off by asking, that first part of the question, and then I've got some more that I want to dig a little bit deeper in that. But, Katarina, what do you think? What are the signs and symptoms that we should be aware of, and how should we prepare to respond effectively in an emergency? Speaker A: Yeah, so thank you. when it comes to responding to an opioid overdose, one of the biggest things is to know what the signs and symptoms of an opioid overdose are. some of those signs, like, the most common signs that we educate on here at the southern Nevada health District are that they will not respond to commands or stimulation. there's pinpoint pupils. There is slow or no breathing. We talked a lot that many people will see cyanosis, which is the blue fingertips or lips, meaning there's a lack of oxygen to the body in people who are lighter skin. However, with people who are darker skin, it's going to be gray fingertips or lips. People who are experiencing overdose will also have, clammy skin, typically, as well as a very faint pulse. we also like to just tell people that the best way to be prepared in case of an emergency is to always have the opioid reversal drug naloxone on you. whether you have it in your medicine cabinet, we like to say it's like a fire extinguisher. It's better to have it and not need it, then need it and not have it. So to have it in your medicine cabinet, we advocate a lot that people should just carry it around, because overdose is so prevalent that you don't know what you might run into in the street, particularly if you have little ones or dogs. If someone has thrown something on the ground, and they get into it, naloxone is so safe, you can use it on them as well. we do advocate for you just to have it on your personal times. At the very least, have it in your medicine cabinet. You can get naloxone at pharmacies across Nevada. and if you come to places like the SNHD pharmacy or your public health pharmacies or agencies, typically you could actually get that naloxone for free. So if you go to a pharmacy like Walmart or Walgreens or something like that is typically around $40 or so that you'll be able to purchase it there over the counter. Bianca McCall: Well, thank you so much. And such an interesting analogy, right, with the fire extinguisher. And I'm not sure how many, other people are much like me, but, the fear and having to use a fire extinguisher is, am I going to do this right? You know, like, am I going to know you how to respond and respond appropriately in that moment of emergency? Right. Southern Nevada health district focuses on education and advocacy around overdose prevention And so, katarina, I'd like you to expand upon, especially with your involvement with southern Nevada health district, how has that influenced your approach to harm reduction, particularly in the areas of education and advocacy, so that people can feel, ready and prepared in that moment of emergency? Speaker A: Yeah. So I've kind of had a unique approach to harm reduction. Specifically. I actually was not involved in substance use or harm reduction work until around 2020. In fact, a majority of my career has been in gender based violence. And specifically being an advocate to people who are in intimate partner violence relationships. and in these relationships where there's intimate partner violence present, these can be very dangerous and even deadly to victims and survivors, especially over time as the violence tends to escalate. but despite the danger, when we're advocating with victim survivors of intimate partner violence, our main focus is not to get that person out of the relationship or to, put the perpetrator in jail, but rather it is to what can we do in this moment and in this space to keep that victim survivor safe and as healthy as possible. So that means talking to them about who to call, what to say when they call, what rooms to run to, when the violence is breaking out, and if they plan to leave, great. But we also recognize that when it comes to victim survivors with intimate partner violence, they tend to return to these violent relationships about seven to eight times before returning for good. So we need to safety plan for them to return to the relationship or not. but overall, to just be there every step of the way and help them achieve the goals that they set up for themselves. So when I joined harm reduction and doing this work back in 2020, and I first heard of harm reduction, I had that initial knee jerk reaction of, doesn't this just enable people who do drugs? Because I've been exposed to drug related stigma my whole life. So that's a pretty normal knee jerk reaction to hearing about this. But when I sat back and thought about it a little bit, this is what I've been doing my whole career. This is just safety planning instead of talking about intimate partner violence and violent relationships. I'm talking to someone about how to use drug safely. What is Narcan? How to use it. What is naloxone? How do you use that? What's the differences in using those two things? How can they use drugs in a way that is safer to reduce their chances of wounds and overdose and to make sure talking to them about never using alone? Because ultimately, when it comes to harm reduction, it is its own part of the continuum of care. It's not just a stepping stone to recovery or treatment. just like when we safety plan with a victim survivor in a relationship back in intimate partner violence, it isn't to get them to leave. We want to meet that person where they're at in that moment, because ultimately, we just want to make sure that they're okay and that let them know that someone cares about them, and we want to make sure that they are safe and as healthy as possible. So that is what, you know, how I've kind of approached harm reduction. And then as a trainer, we tend to try to think about how to make things as accessible as possible, to as many people as possible. So, a lot of times, it's not always possible to hop on a call like this at a specific time of day. So here at the health district, we actually have a virtual online training, for how to use Narcan. So you can get trained in our four steps of how to deploy Narcan, how to react to an overdose. And so that way, people can feel prepared when they get that naloxone in their hands and that narcan in their hands, and they're able to use it effectively in that moment and know that they're protected by things like the good samaritan law. Bianca McCall: Gosh, so many great things, that resonate, with me. Katarina, thank you so much. one is that it's. It's harm reduction. Aligning that with just a safety first approach. Right. and really, the message becomes, how do we reduce, risk? Right. And we're taking out kind of the criminality of that. Right. And you talked about how, traditionally, a lot of us, we may be hesitant or apprehensive based on not wanting to enable somebody to continue with risky substance use. Right. but shifting that paradigm to. No, we're talking about safety. And not only, are we empowering people, to keep themselves safe and to focus on safety for themselves in the environment, we're also. We're looking at kind of whole person because you're bringing in some other concepts, right? You're taking us out of this binary way of thinking about things. and we're talking about continuum, right? We're talking about whole person and how we may be engaging the continuum. And you bring up, the violence continuum and how violence, the role of violence in, risky substance use, the role of violence in harm reduction, and also some of the intersects in some of our lived experiences, right? And so if we're experiencing, violence in intimate partner relationships, if we're experiencing, other risk, to our safety in our environment, that can be an indicator and also an invitation to come in with, with harm reduction. So I love, I love it. I love everything you said about meeting people where they are. And that, that is so important. it's especially important when we talk about, marginalized groups and communities that, have largely been disconnected, right, and left out of the discussion, of overdose and, of opioid overdose and of some of these, these high risk situations. Donald is a recovering addict and advocate for marginalized communities And so I want to shift the conversation to Donald, when we're talking about, marginalized, communities and for you, wanting to know just how your personal lived experiences have shaped your advocacy work and professional journey, and what impact do you see your initiatives having on, your community? Right. On marginalized communities. Donald Griffin: Well, I like to get in my comfort zone, so I'm going to introduce myself as if I'm in one of my recovery meetings. So, my name is Donald. Alcoholic, addict, and former criminal. My lived experience proceeds over 23 years. I got sober at the age of 37 years old. So all the way from a teenager all the way to 37, I didn't know how to function without some type of substance in my body. I didn't know how to hold a job down without getting the first paycheck and going to the either alcohol, liquor store or the drug man. So with that lived experience, I, took that. Once I got sober, I started recognizing throughout the reno, nevada area that between the ages of 16 and 20, if you're not in school or you're working, you have nothing to do. So that brought my attention to the youth, the youth in my community, of their usage, the homeless situations. So I talked about helping the community so much that one of my, job workers, say, what are you? New generation dare? You got that? That's my new work name, new generation dare. So I took my experience and I went out there to the streets, and I started beating the ground. I started letting them know that passing, out narcans sack lunches, anything I can get my hands on, just those that are still held back in their struggle of addiction that you can make it out. I ran into my business partner, Romar, where we started black, Wall street. And a lot of my work goes into the outreach, which would be going into the schools to teach all recovery. We work closely with wake up, Nevada. we established over 20 Narcan boxes where we took old newspaper stands, refurbished them, and placed Narcan boxes in them. Our sister partner, wake up, Nevada, have spearhead that took it out of our hands and hit the ground running. And it's a big success. We don't have the numbers of how many people we say. We just have the numbers of how many narcanous boxes we place in these 20, locations. We have developed, the peer to peer group settings where we take high school students with evidence based training and place them into the junior high and elementaries. With me going in there, I'm just an older gentleman telling them, hey, don't do this, don't do that. But when you have people that look like you and speak like you, then you kind of resonate a little bit more to them. We just finished, production on our, opiate and harm, reduction commercials. Kathy will wake up, Nevada. The president is an awesome lady who just did the radio commercial for us. Our tagline is recovery looks like us because in northern Nevada, we don't believe that opiate is a black man's drug or hispanic drug, because every advertisement is someone, of caucasian descent. So recovery does look like us in the native community, in the black community, in the hispanic community. So what that slogan brings, we are also working with CPS that we're bridging that gap, that, you know, if we have this peer to peer group setting. I don't like to say I lost my, son to CPS because I have to be honest with myself. I gave him away because the drugs and my lifestyle was more important than me being a father. I'd rather have that needle in my veins or that alcohol than to be a father that or just a man that my parents raised me to be. So we're working closely with them with no resentment. I have to show them that, hey, there are good people on this side of the spectrum of getting sober. You can get your family back together. We also take our students down to the police department. we also have to give them, outlet. Bianca McCall: Ah. Donald Griffin: That these are laws being passed that's in your community, and you don't have an idea of what's going on. So when I take my high school students, a lot of them of color, they don't want to go because it's the stigma that police officers are bad. You got good and bad people everywhere you go. But either you're going to get into the community and change it, or you still going to stand by and be a victim. So, with all that said, I like to call myself a superhero. I like to take this food pantry that we have, the diaper bank that we have, the donations that we get. We go out every Saturday, we pick a different apartment complex, and we go out there and we pass our food. It's like being robbed. You get from the rich to give back to those who have not. And those are the type of superheroes that superheroes do look like us. And when those calls come in about people losing their child, those are the hard ones. I work only. I don't want to say only, but I work directly with people with lived experience, like Darcy Patterson, Kathy. These women have lost something dear to their heart. And I've also lost my kid's mother, my son. Mother lost a, battle, to addiction. So when you get these group of people in the same room with the same thoughts and the same drive, there's nothing that can stop us. So just pay attention to black Wall street and wake up, Nevada, and the, changes that we're doing in our community. Thank you. Bianca McCall: Gosh, thank you so much, for being vulnerable, for being authentic, and for introducing us to you and the passion, that drives you and that drives the organization of Black Wall street. Ah, it brings attention to a conversation that simply is not being had. and like you said, recovery looks, like us. It looks like the community. and the conversation that may not be having had is opioid overdose deaths among, ah, black and African Americans. It exceeds, that, of Caucasian Americans in several states. Right. And when we see the co occurrence of mental health, issues and challenges and substance use challenges, specifically, opioid use challenges, and that represented in. In facilities, in justice facilities, in, being incarcerated, you see more and more of a need for this conversation and a need for representation, to your point. Right. and so you mention all these ways that you are. You absolutely are a superhero, a champion in our service community, and Black Wall street stands on those principles and that business. What are some of the challenges in promoting harm reduction strategies within marginalized communities what are some of the challenges that you feel like you face, Donald, in promoting harm reduction strategies within marginalized, communities? You mentioned, what we would consider to be bipoc. Right. Black indigenous and people of color. So Latinx, asian Pacific islanders, Alaska, indian and natives. Right. what do you see being, the challenges to promoting these strategies within communities that are, of so used to. Right. experiencing those disparities and being so disconnected. Right. And not relating to, some of the m materials that we have coming out in Nevada. Donald Griffin: I believe in the black community. That crack hit us so hard. So now you have, people who was traumatized by the crack epidemic, now is traumatized by the OPD. And if you're raised like I'm raised, what happened in this house stays in this house. So not only being traumatized, but now I'm unable to speak about it. And I feel that's big in the black community as well as when we take our students to the police, department. We live by this law of, what happens in this neighborhood, nobody's telling, nobody's snitching. In other neighborhoods, it's called community watch. We're the only people who don't want to step outside. And it's not. It's by design. Things that happened to the black community from years on end. However, I don't believe that we're structured to talk out loud about what's happening in our community, let alone to be able to go into a facility and say, hey, I'm struggling with this addiction. I think, that is our biggest, I think that is our biggest hiccup within the black community. And the Asians, they really don't really step out. I think they have a close knit base with their family. Like, we're going to deal with this with our own how we deal with it. And the same within the hispanic community, I think they go on the same guidelines as the black community. we don't say what's going on outside of our house, and they have a close knit, family type bond that they don't really step out into those, atmospheres, at least that I see in rental, Nevada. You might have a sprinkle here and there. They might, if they're close. Court ordered that they in, a treatment facility. For me, it took me eight different times to go into a facility, and I still didn't surrender that. Hey, I might have a problem. Mine's is I just like to drink because everybody around me always did it. My uncle's done and my aunties did it, and nobody ever said, hey, this is a problem. So in the black community, as far as I'm speaking, that I know, the ones I'm dealing with. It's not a problem until we're court ordered to have to go and address it. Bianca McCall: Yeah. No. Thank you so much. I mean, you're bringing up so many, Different avenues, right. That we can go down to really understand. you know, what's framing, the. What's framing? The notion that the addictions of people of color, right. Is deserving more of, This criminalization of punishment, of secrecy, of silence. Rather than being worthy of medical treatment. So many ways to have that discussion. And I think, It really. This is circling around a comprehensive kind of, ah. Cultural competency. And when we think about culture, we're not only talking about race and ethnicity, right? But we're also looking at other culture. Age, culture. I know Katerina brought up before. And Donald, you also brought up as. You introduced yourself as I'm an old man going into these schools and telling him, don't do drugs with, the glorified dare program. But, age. You're bringing up another, culture that we have to consider when we're talking about harm reduction. when we talk about, 70% of those that are seeking, Substance use disorder treatment are under the age of 50. But also that same percentage, 70% of the providers of treatment are over the age of 50. Right. We've got this age gap. And so we've got to consider, age as a culture. We've got to consider gender as a culture. And then also. Bethany, I'm going to shift the conversation to you. Because we also have to consider, Our location and demographics. Right. as a culture. When we talk about urban versus, And not versus, but urban, compared to rural, resources that are in our rural areas. Right. What are some common barriers to accessing harm reduction services in rural areas So I'd love to ask you what are some of the common barriers to accessing harm reduction services, substance use treatment and other support services in rural areas? And how can these m barriers be mitigated? Bethany Wilkins: Yeah, that's a great question. And, most of my work has been in rural areas. So, Yeah, I love talking about this. And I'll also just follow Donald and quick infection. I've been in various stages of recovery for over ten years. I'm a former iv drug user, formerly unhoused, from the east coast. That's where I did a lot of my harm reduction work. but yeah, that's me. And I'm so glad to be here. yeah. So some of the barriers that we saw, especially. And I lived in a very small community in rural northern California for almost eight years. And, there's things like transportation and things like stigma, but also just to kind of piggyback off of. I think what Donald said as well is if you only have. If you have limited outlets outside of school, there's increase for spare time, increase for boredom, there's increase in isolation, which can really fuel drug use and increase risk of overdose if someone's using a loan. So there's all of these barriers and risk factors that are associated with more rural drug using communities that I think are often overlooked. things like transportation assistance. That's, one of the first ones that comes to mind is, you know, if you're living in a community that's pretty far out, sometimes it's an hour or two round trip, right, to get into town to services. So we have people that not only are expected to take that hour or two out of their work day, or just make the time in general, but then also the gas, right. The gasoline for that, it's very expensive these days. a lot of people can't get that time off of work. those of us that maybe work from home or have that flexibility to be able to go into town. So if someone's trying to access harm reduction services, pick up narcan, pick up sterile syringes or smoking alternatives, testing kits, right. and they have to drive that far, and they don't have the gas, they don't have the time. that's a huge barrier right there. and then also if someone is on mat, medication assisted treatment, methadone, and they have to dose daily, that's a huge strain to be driving that far. some ways that we mitigated that at, yuba harm reduction collective is we got really creative with partnership within the community. It's a small community, right. What can we all do? Who offers transportation assistance? Where can we kind of find some wiggle room? And it says it's for medical transportation. Okay. We could kind of like, you know, fentanyl test strips is access to medical tools and ways can we make this work? you know, offering gas cards to participants. you know, the beauty of nonprofits is that there's a lot less red tape and bureaucracy of, like, working in public health, which I also do. So it's great ways to just be able to work together and see where you can direct resources to those people. so I think that, you know, that's a huge barriers. Transportation assistance. M we also offer warmline delivery of supplies. So even though our program was, is very rural. We offer warmline delivery where people can text or call and request the supplies that they need. And it can be a drop off on a porch, it can be meeting up in a parking lot somewhere. Right. and that helps with stigma, which I think is another barrier. people often aren't going to go into places to get the services that they need, even attending. If you live in a rural town, a small town, and you're attending an Na meeting or an AA meeting, and someone from your work maybe sees you entering or hanging out in the parking lot after, and they put two and two together, that can not only make you self conscious or worry, but it can also, affect how your work is treating you. It can affect employment and all these different aspects. So, stigma is a huge aspect of living in a small town. you see someone going into a harm reduction clinic that is the cousin of this person, and then you're texting that person. I think that ways that we try to mitigate that, and so much of harm reduction work in general is just actively dismantling stigma, you know, around drug use and around treatment, and dismantling it, and how our programs are running, how we're talking about our work, doing panels like this, and having conversations, educating ourselves. you know, I think that normalizing harm reduction tools and practices really is public health initiatives as part of that. is a way to kind of destigmatize people accessing mat and harm reduction services in general. so, yeah, I think those are a couple of the ones that speak out to me a lot within the rural community. Bianca McCall: Absolutely, and thank you so much. And it sounds like, in order to combat the stigma, right. In order to bridge some of these gaps that you've really taken, the route of education and information starting these conversations. And it starts with building a relationship, and you use the word partnership, and I love to understand a little bit more of what does a partnership look like. I think we've all used the word, we've all, subscribed to the notion that we've got to eliminate the silos, and we've got to work together, and we've got to get out to our rural communities. This all sounds good. What does that actually look like? And in addition to that, I, think speaking for a lot of the folks on the line who may not, currently reside in rural areas, they may be in more urban areas. I'd love for you to help us to understand, Bethany, how do we ensure that educational materials and that these conversations, these courageous conversations, right. Things like, fentanyl test strips and things like that. How do we ensure that they are accessible and understandable to diverse populations that also, that live and reside in rural areas? How do we build this partnership? Bethany Wilkins: Yeah, so, dissolving those silos, it's, you know, I spent a lot of time and energy, me and the team, you know, doing that in Nevada county. And I. So much of it was intimate conversations and, like, having time to, you know, talk to directors of other programs when they, you know, call you and say, hey, I'm kind of on the edge of this concept again. Can you talk me through this? Can you explain to me those points again of why I should care about this, having those one on one conversations, providing widespread education on, like, what is harm reduction? We would host, like, harm reduction 101 educational three hour webinars, or in person, where it's totally a non judgmental space that's. We're all trying to kind of shift the way that we've been taught to, approach substance use, right? And we're trying to accompany a brand new, you know, not brand new, but more widely accepted way, of talking about people who use drugs and talking about treatment and talking about drug use. So I think in dissolving those, it's been a lot of, you know, intimate connection, a lot of one on one conversations, you know, forming of coalitions, getting people's input, that are other service providers, hearing them out when. When they don't understand an aspect of harm reduction. And also honoring that not everyone is going to see eye to eye. But where can we, Where can we ensure that we're at least, serving our participants in the way that's going to be most accessible for them? You know, we don't have to like each other and braid each other's hair and be best friends, but if we're both providing peripheral services, let's ensure that we know what we're offering so we can inform participants accurately. Let's make sure that, you know, we're staying in touch. When we see overdose spikes. That's another huge, huge part of it, right? It's just like, okay, we have a spike. Let's text, you know, this behavioral health team, they're going to saturate this area with naloxone. we're going to go do a street based outreach emergency distro in this area. So really working together, to serve the population. Jamie Bianco: First question is who actually needs help during overdose crisis And then the second question, just around educational materials, is, I think so important. And I think that it's really often overlooked. And I think centering the question of who are the people that are most impacted in your community by the overdose crisis? And are we building services around their needs. Right. Not who we think, but who actually needs them? And determining that not only through, point time surveys or needs assessments or relying on demographic intake data, but also, what are the people that are on the ground doing this work? Who are they serving? What are they seeing? What's the need and trusting what they're seeing when they're doing this outreach, really centering. Really centering that over kind of an assumption of who we're serving, and then really making sure that we have, you know, spanish speaking materials. If we assume that our population is mainly, you know, English speaking, you know, men, and we're developing everything based off of that, and you have someone come into your drop in Center that their, you know, primary, language is Spanish, and they have no signs, no brochures, nothing that reflects the language that they speak. We're not fostering inclusivity. We're not fostering safety. We really need to pause and ensure that we're creating materials that are inclusive, atmospheres that are inclusive. And when there's so much on your plate, when you're a busy harm reduction group, when you're a busy street out based, street outreach team, and when you're training schools and you're doing all this stuff, it's hard to justify slowing down when you're like, oh, but I need to do outreach. It's like, we have. We have to slow down and ensure that things like educational materials are appropriate for the audience we're serving. And even if the data shows, or the on the ground response shows that we're serving mainly English speaking, still have those other materials, you know? And then. And the last point there, too, is something that I've been, like, a little bit, yelling about lately is just like, literacy levels, right? And learning styles. You see brochures where it's walls of text and giant words and acronyms that people don't understand. And it's like, can someone explain this in simple terms? So just having more graphics, having more pictures. If someone doesn't know how to read, how are we creating materials that have a lot of really simple imagery to really, at least they're going to be able to know how to give Narcan by looking at these images, if nothing else. Right? So I think that various levels of inclusivity include, you know, not only language access, but also, literacy and learning style and preference. Bianca McCall: Yeah. No, I love what you're saying. Bianca McCall: It takes us a step further from what the conversation has been, which is meeting people where they are. Right. And you're taking it a step further and saying, And understanding their experiences. Right. And understanding through surveys, through asking questions. Right. And, It's no mistake that we opened up today's session talking about how we're going to be actively and assertively listening. Right. Because as we assertively listen, we're asking questions to understand the thoughts and the feelings of the communities that we're serving. Right. And what their experiences are. Bianca McCall: We're not assuming anything. We're not assuming literacy. We're not assuming, the Persona, of what does somebody with an opioid, use disorder look like and talk like and things like that. We're coming into the communities, if we're not already from the communities. Donald Griffin: Right. Bianca McCall: So, speaking to those folks that are in urban areas, that are wanting to better support rural areas, we're not coming into rural areas. Assuming that we know, everything about the community and that we have the answers automatically or the resources and things. But we're coming in as assertive listeners and as learners of the community, to be able to know what the need is. That's something that you said, Bethany, that really stood out to me is, what is the need? What is the problem as you define it, as you experience it, so that we can get a better idea. And I would like to get a better idea, at this time. And I'm going to reach out to Jamie and see if we've got any comments or questions in the chat, that we can address before moving on to the second section of this listening session. Speaker A: Thanks, Bianca. How do substance use counselors address belief of silence in black community Speaker E: Yeah, we do have one question that came in, I believe, when Donald was speaking, that says, how do substance use counselors address this belief of silence that is part of the black community? Bianca McCall: Great question. And Donald, I'm going to give it right to you to respond. Donald Griffin: I like what they say. Meet them where they're at. It's like the lady with all timers where she believes she's in Hawaii. So I'd rather believe that I'm in Hawaii with her than trying to convince them that she's in Reno, Nevada. I think that goes with the experience. When you meet somebody where they're at, you let them do the talking. And whenever you can, interject or help them m wherever they need to be. I think that once they hear the story, it kind of opens it up that, okay, he's just not speaking out of a book. And I'm not knocking anybody who got the education. I just don't have that. I made it to about like the 9th grade. And you can pretty much hear it every now, jump out and say, okay, he didn't say that word properly, you know? And I take that that's. That's the badge of honor that my experience got me to where I needed to be. And when they see that, you know, because those children, they can read through that. You know, they can read through. If you just talking out of a book or you just talking nonsense, they're going to read that and they're going to eat you up. But when you just really down to earth and you working from a heartfelt place, anybody can see it. And I think that opens up the door. And there are more subjects that kind of listen a little bit more. And each session that you have with them, they kind of, you know, it's just not just sitting in a room. I like to go outside doors and help others. So when people feel like they're helping others, you. They open up a whole lot more and you can kind of see what issues need to be addressed with that. A certain client. Bianca McCall: Yeah. Thank you so much, Donald. Yeah. Meeting people where they are and just to kind of carry that piece of the conversation forward, there are a lot of programs across the country, in fact, that we've researched. And we've integrated, some of these evidence based, practices into, our curriculum that's delivered through NOCE and through other programs like cassette learning, where there's programs across the country that support, faith based organizations in black communities, delivering substance use prevention and treatment services, as well as education. Right. Because we talked about. Bethany brought that to the forefront of the conversation of education really needs to be at the Center of this. And informing people and helping them to understand. Helping diverse communities to understand. And then I also think, too, when we're talking about black, indigenous, and people of color communities, there has to be an inclusion of racial impact. Right. Racial impact assessments to talk about things like racial traumas, to talk about, cultural sensitivities and humility. Right. And that they're culturally responsive, linguistically appropriate, you know, practices that we're implementing, And having more, formal consideration. Right. Of, the community's interaction with some of the other systems. Donald Griffin: Right. Bianca McCall: And namely, the criminal justice system. Right. When we're talking about opioid response. And so, thank you so much Donald, for responding to that. I said the second part of the session, we want to discuss and invite ideas for solutions, right, and solutions to impact our current situation. How do you see the evolution of harm reduction practices with new opioids And so Bethany, I want to go, I want to go back to you and I, and ask you, since we're talking about from a standpoint of education, how do you see the evolution of harm reduction practices over the next few years, especially with the emergence of new synthetic opioids? And what steps, can we take, as a community to stay ahead of these changes? Bethany Wilkins: Yeah, I think it's encouraging to see more of a widespread acceptance of harm reduction as a practice, since I've started working in it and practicing it myself, but still seeing a little bit more acceptance towards the full scope of harm reduction, which does include mat and does include injection alternatives and does include peer support more than just naloxone distribution, which is so vital and important. so I think that my wish is that seeing the evolution of crime reduction kind of shift even more and more in that direction is prevention of bloodborne pathogens, et cetera. but I think that that's going to take more education and conversations and really getting money into the hands of grassroots organizations and people on the ground doing that work to show the efficacy of it and be able to demonstrate that, you know, with, with the new, you know, synthetic opioids, xylazine and such. I think that what's going to be so crucial is just staying in touch with people that have been doing this a lot longer. I think a lot of the time we can feel like we need to reinvent the wheel. And versus there are people that have been facing you know, xylozine within their communities in ways that we haven't for years at this point. So being able to stay in touch with partners, you know, back east and friends back east, staying in touch with your communities, I think that that's just so important is the taking the time to listen to the people that you're serving and what are they seeing drug trend wise? What are they experiencing? What kind of wounds are they seeing? Could those be zyosine related? Are we providing education on how to treat those wounds? educating ourselves as providers and as ah, people doing outreach, continuing education people, you know, providers in general continuing their education through things like the, things like these webinars, I think offering drug tracking in a safe space so that we're able to see, you know, not only what are the drugs that are entering our supply, how can we be prepared with educational materials, wound care, like, all of these different aspects, but also, how can we use that information to help keep the people we're serving alive, right. So that we can say, hey, we're seeing, like, a rapid increase in xylozine all of a sudden. Do we know a proper response to someone that might have this in their system if they're overdosing? Do we know proper wound care? Do we even know what it is? I think that so much of this is going to be, staying in touch with people that are getting first waves of it, learning from people that have been in this longer, learning from people on the ground, learning from the people that you're serving, centering the people with that lived experience and really amplifying their voice within this, and within all of that, that's dissolving the silos and building that connection and collaboration, and I also think that just centering more of people who use drugs, we're kind of witnessing. This is a contentious thing to say, but we're kind of seeing a co option of a movement a little bit. We're seeing harm reduction go from, you know, that it was a movement that's been going for decades, built on, BIPOC communities and LGBTQIA communities trying to keep each other safe and alive. And we're seeing a lot of funding generate for harm reduction, and we're seeing it go to organizations that don't have lived or living experience within their staff or kind of, missing the mark a little bit on what harm reduction really is. So I think that centering people who use drugs and, you know, not treating it as, let's check a box on a grant application that we have one person on our board that has lived experience, you know, but who are we serving? Does our workplace, like the comment said, does our workforce look like the people that we're serving, and really being able to center that lived experience? Like, those are the experts in this. Those people that have been through this are going to be the people that we're going to turn to and look to for these answers. Instead of sitting and I in rooms and groups and saying, oh, what do we need? What do we need to do? And asking ourselves, we need to sit down and we need to center the people that have the answers to those questions because of what they're living and what they've lived. So I think that that is going to be so crucial to these next few years within harm reduction is just keep centering the people that have been there and are there right now. Bianca McCall: I love that. Thank you so much for. For that. And the major takeaway being centering people who use drugs. Right. Centering, and identifying the significance of involving a, lived experience right in our practices. I absolutely love that. I think that, there's economic constraints, there's legal barriers, there's cultural resistance, there's political factors that all impact our, abilities to implement harm reduction, especially in diverse communities, and centering people who use drugs, honoring that lived experience and integrating that into practice, also bridging the gap between research and practical application. As providers, as, frontlines professionals, where do we go to get the newest research, to get the newest information on what, synthetic opioids are impacting our work and our service? these are all things that are, they're vital right, in the evolution of harm reduction. Stigma continues to be an incredibly detrimental barrier to harm reduction efforts And I'm going to actually jump down to, Katerina and ask you also from a lens of education, also from the perspective of needing to bridge that gap, how do we continue to move this work forward? Speaker A: Yeah, thank you. so there's several different things that we can do to continue to move harm reduction in this work forward. And first and foremost is to really need to work together to reduce stigma surrounding harm reduction and around people who use drugs. Stigma continues to be an incredibly, detrimental barrier to this work, as well as to people who are seeking out help. so reducing stigma is the biggest and first step that we can all take into addressing that issue and getting this work to move forward next, it's really important that we recognize a harm reduction, as I kind of mentioned when I was first talking, and as we've talked about throughout the webinar today, is that harm reduction is its own unique part of the community of care when working with people who use drugs. And it has many diverse partnerships as a part of it, including this public safety. a lot of times people try to say that harm reduction is just sort of the stepping stone into treatment and recovery, but harm reduction really is its own thing, and it's important that we recognize it as such. next is to really partner with traditional and non traditional agencies to reach people who use drugs where they're at and create, instead of sort of this one stop shop, which isn't always possible for a lot of different communities and is not always a safe place for the people who are using drugs, to really create. What we like to say is a no wrong door approach in a community where no matter where someone reaches out for help, that they're able to get a warm handoff and connected to the services that they are looking for. So for example, a partner that we've worked with in the past is signs of hope down in, southern Nevada. So even if someone is a victim survivor of sexual violence, they're able to say, hey, I need help for my substance use. And we've built a warm connection between us and them so that they're able to get that help, same thing as they come to us. We know how to refer out and just continuing to build on those partnerships and those collaborations, in order to get to that point. And sort of, as I've mentioned a lot today, is that this work cannot be done in silos. So it's really important to connect with community groups and join events hosted by organizations, people and coalitions who don't have, ah, sort of a financial interest in, and are sort of just there to support the work, and recognize harm reduction as its own unique part of the continuum of care. So for example, here in the south we have the Southern Nevada Opioid Advisory Council, also known as the SNOWAC. and in the north there's organizations such as the Northern Nevada Harm Reduction alliance. And so if you wanted to join something like the snowac or learn more, you're able to visit snowac.org, which is snoac.org. and I'm sure all of my friends on the call today are happy to also connect you with the Northern Nevada Harm Reduction alliance. So if they have a website or a place to direct you to, I'm sure they're happy to drop that in the chat. I don't want to misspeak on behalf of my friends in the north. and then finally, you know, we really live in a society that encourages us and primes us to approach issues like substance use with this deficit mindset that there are just too little resources, that there's not enough, and that we need to fight with tooth and nail to get it and we have to fight each other, which really isn't helpful for our community and for the people that we serve. and a lot of times that causes us to be on the defense or if we don't share or collaborate, because what if it takes away from us? What if we lose what little bit we have? And in reality, though, there is more than enough for all of us to thrive and we can do so much more together than divided. So I really just encourage folks on this call, to really shift their thinking, to approach this work with a non competitive perspective and just recognize the entire continuum of care as important, from primary prevention to harm reduction to treatment and recovery, as they are all critical and necessary parts to responding to the substance use and overdose epidemic in our communities. Bianca McCall: Yeah. No. Thank you so much, Katarina. All great resources. I'm noticing a consensus. I'm noticing a theme, m. Of, meeting people where they are, of honoring lived experience and, centering around people who use drugs. What advice are we giving to people with relational experience regarding substance use and it kind of brings me into the next question, that I'd like to pose to a couple of our panelists, if I can. to both Katerina and to Bethany too, is what advice, what suggestions are we giving to people who use drugs and or to people with, relational, experience. Right. Relational lived experience, with risky substance use, risky opioid use. what suggestions are we giving to parents, to families, people who've experienced a loss due to drug overdose, and who want to get involved in harm reduction advocacy for speaking to the community and saying, hey, we wanna create space, to involve you, to include you. M what are we saying to them? How are we eliciting that involvement? And, I'll take it back to Katerina. and then Bethany would also love to hear your thoughts on this. And then we're also gonna hear from Donald here soon. Thanks. Speaker A: Yeah, thank you. when it comes to talking to people with relational experience, we do get folks who reach out to us a lot of times at the southern Nevada health district and through SnoWAC, wanting to know how we can do more. And I think the really big important thing is there's something, almost, it's said that to be a little bit beyond trauma informed care, but it's healing centered engagement that people need to feel connected and address the work to make it feel like they're making a difference in what is impacted their heart. and you see this in many different, movements where people who have those lived experiences are usually the biggest advocates in that space. So what we like to do is one, while there's not like a ton of volunteer opportunities with the southern Nevada Health District, since we also are, part of the backbone agencies that help with the Snow act, we connect them with other agencies who are reaching out to us and saying, hey, we have this volunteer opportunity, or we have this, chance to, we have this chance for someone to get involved and we connect them. But we also, here at the Snow act, know when there's something going on policy related or funding related in case they want to start their own programs or anything. And we get that information out and we disseminate that to the community. and so that way we encourage them to get on these listservs, be a part of these different areas. So that way they're able to get that information rapidly and they're able to respond appropriately. so they're able to be like, hey, you know, I want to get involved. Great. Well you know, here's our, you know, we just had this ad hoc community update go out. There's this funding source that is available. You know, if you want to start a program, you know, here's how you apply. Or hey, you know the new policy legislative session is coming up. we, you know, at Snowak we're going to have this individual come and talk about some of the things that you may want to keep an eye on. you know, we're not advocating for this. We're just sharing some things that are going on in, you know, what's happening in the snow. You know, sharing in snow things that are happening in the policy and legislative world. So people just are aware of what's happening in their surroundings and in our state and so that way they're able to, if they so desire to, they know who to connect with and get involved in a deeper level. So that's just some of the stuff that we do here at the southern mental Health district because we work more on that community level of the socioecological model rather than in that direct area down at the individual relationship level. But at the end of the day, ultimately, you know, you're not alone in this and we want to be able to help and connect you to where you want to be. Bianca McCall: Well, thank you so much. And Bethany, what do you think about that? Bethany Wilkins: Yeah, I agree with that and I think those are great routes. There are great resources for parents on how to talk to teens about drug use And I think that the first part of your question around, how are we talking about staying safe and drug use and such? I used to do a lot of work with the schools district in Nevada County, California. within my public health contract, will go in and do education on overdose prevention and harm reduction. And there's really great resources for parents, right. If you're wanting to stay a little bit more informed on drug trends and what's going on and how to talk to your kids, there's resources like song for Charlie or safety. first, real drug teen education. There's these different aspects that you can inform yourself. Song for Charlie has really great, endless resources for. How do I talk to my kid about this? How do I talk to my teen? Like, evidence based practices, real information. So I think that leaning on those resources, are really helpful. Bethany says sometimes people need a pause before getting involved in harm reduction And, another thing that just comes to mind when we're talking about, people wanting to get involved in harm reduction that have experienced a loss, or maybe they haven't even experienced a loss and they have a loved one that's using drugs, and maybe that use is pretty chaotic and it's affecting them. I would say that one of the first conversations I have is just around the sensitivity of it. And, sometimes people, when they've experienced deep loss, want to ensure that no one else has to experience that. And the easiest way through that is abstinence and fully abstaining, which is a part of harm reduction. And really, it works for me. It worked for a long time in my recovery. And, I think people think harm reduction doesn't include abstinence, but it absolutely does. but just ensuring that we do have harm reduction spaces that don't have, people that are coming in with coercion towards abstinence being the goal. Bianca McCall: Right. Bethany Wilkins: Because we want to make spaces for people along their continuum of drug use, really having those conversations with people and checking in. And just what do you want to do? What do you want to be involved with, with this harm reduction group? you know, is this. Is this too fresh? You know, sometimes we need a little bit more time before we can get directly involved in the world, in the work. Can we provide you peer support? Can we, you know, have some more conversations around? This is feeling grief looks like a lot of ways. And, sometimes we want to get right into the action and it can be really triggering and hard. So, yeah, I think that those are a couple of caveats. Just when I think about people that want to get involved, that have freshly lost, you know, lost someone. And there's beautiful ways to get involved that aren't direct service. Right. There's policy and advocacy, there's developing educational materials, there's boothing. There's, you know, you don't have to necessarily be in the street doing outreach. but you can still be involved in a way that feels really impactful and is impactful and meaningful to the. To the movement as a whole. So that just kind of rings in my head in this moment is, being able to pause and check in with the person and make sure that they're okay. And that they're entering a space that's going to allow them to, get the most out of it with not to the detriment of our participants feeling coerced towards anything. Bianca McCall: Yeah. And just such an interesting concept, right. Bethany taking a pause. That, that kind of really hit me at my core, right. Because especially when we're doing work, when we're serving our communities, we're doing just that, right. We're doing. And we're constantly going and we're forced to constantly pivot and just. And try to try to fix, try to heal, you know. These are all actions that we have been conditioned to do and to make it brief and to make it a tense to make To cause an impact, right. But very rarely are we pausing, And being in the moment, right. And really it's when we take a pause is when we can absorb and understand. Right. And receive. Right. In those moments. And so just such a profound, statement and thought, right. Is, Sometimes I think the answer for a lot of us is to take a pause and to be. And to reassess, right. I mean, there's assessment involved, but there's also this reassess and there's. There's taking an inventory, right. Of An inventory of strengths and resources, right. And that's where we begin to shift from trauma informed to healing centered. Right. When we're taking a look at what strengths, do we possess, as a community, as a continuum of care, what strengths does the person and the communities that we're serving, what strengths are possessed therein and what strengths, are going to help, you know, bridge that gap and get us closer to a better understanding. Right. And so, I love that. Taking a pause. I know I've been saying a lot about some things that have been discussed today, things that are resonating, things that are takeaways. so add that to the list. Taking a pause. Being, existing, understanding. I love it. Jamie: What strategies have your group implemented to raise awareness about harm reduction Donald, I want to go to you, and ask if you have any lasting thoughts on the question of what suggestions, what advice? What's the communication like with people who are. With lived experiences who are in this, Who want to be more involved in harm reduction advocacy. And I'd also like to leave space for you to talk about, what's been successful in your work. What are some successful strategies and campaigns that your group has implemented to raise awareness about harm reduction and elicit that involvement from the community? Donald Griffin: our high school students, will be taken throughout the community. To fill up the Narcan boxes, we let them share their experience, strength, and hope on a platform that when it's coming from the youth, your kids, your children, the ones that seem like they're a stranger because they drifted so far off. When you hear them actually speaking, I think that opens up a lot of doors. the narcan boxes that wake, up. Nevada has been spearheading for us. Ah, has been successful. We get a lot of people. We can't actually get the hospitals to comment on it because you have, the HIPAA law. But a lot of the people who come out the hospital tell us that, hey, you saved us. We find letters in our Narcan boxes saying, you saved our lives. I like that. That pause moment when we reflected with our clients. Because I have what I call, mental relapses, where I see somebody and I have a relapse, or I get bored in the house I prayed for when I was up under that $6 million bridge, ready to jump off of it. When I get bored for the family that I missed out on, when I get bored for all the things I pray for, I have to play that tape back. And then, God, tell me I can. I can. I can put you back in the shelter. I can put you back when you're facing prison time. I'm able to go and participate with the police officers that I had a grudge with. So the success stories are, more impactful. When we share in our media the things that we're doing. I believe everything that we do and we show, especially with our students graduating, is very impactful. So, yeah. Bianca McCall: Gosh, thank you so much for the work that you do. with your organizations, for all of you, for the work that's being done, the education, the outreach, the activity and the act of listening to be able to include your communities, it does not go unnoticed. This was an incredible honor to have this conversation with you all today about the work that you're doing and the work that's still, in need to be done. And so at this time, I'd like to go back to Jamie and see if we've got questions. Donald, what are your thoughts on Narcan boxes in the parks Speaker E: and with that said, we did just get one question in the comment. It says, what are your thoughts on Narcan boxes in the parks? Bianca McCall: Narragan boxes in the parks. And, Donald, I know that you just got done talking about, the installation of Narcan boxes. do you want to take that question? And then Katarina, Bethany, if you have, thoughts on Narcan boxes in the parks as well? You're welcome to answer that, but, Donald, I'm going to pitch that to you first. Donald Griffin: So Narcan boxes in the parks for us will be, a plus. They would be a great plus. that's from our counterpart. That's from our sister partner. That's the question from Kathy. She's with wake up, Nevada. So, we're pushing that to get the Narcan boxes in the park. We've been getting a little pushback from that. some want them in there, some don't. However, there's children and youth that are not in school that are at the parks that may benefit from this. so I think that's a green light for us, that we would try to push that, on the county. That let us allow us to place some Narcan boxes in certain areas of the parks. Bianca McCall: And then Katarina, Bethany, do you have any thoughts on Narcan boxes in the parks? Speaker A: Yeah, I mean, at, the health district, we've definitely done some work with nalox boxes. I can't confirm I am m not the lead on my program. but I, know that we think that that is a great idea to have nalox boxes around so that people can easily access naloxone when they need it. again, this is a perfectly safe medication where anyone can use it from. You can use it on a baby to a dog, to a full grown adult. It is completely safe. You can't overdose on it. So there's not really a harm in having it there, but it could save a life. Like, that is an actual human life there. And so I'd rather have naloxone boxes in the park, and have people who are able to access that and use it when they need it, rather than, having someone, unfortunately, pass away from an overdose, in the area. So, I think the locked boxes are evidence based and are a very, are a wonderful tool to help keeping people alive. Bianca McCall: Absolutely. It's all about increasing access. Thank you so much for that. Bethany, anything to add on that? Bethany Wilkins: Yeah, I actually, when I was just visiting Reno, a while ago and considering moving here, I was in the park and I saw the black Wall Street Narcan box, and I was like, oh, awesome. This exists here. This is a community that cares about. It's. It's neighbors. Like, I was so stoked. I emailed y'all. I was like, this is so cool. you know, I think that having accessible locations like that are so crucial. Someone, if they know that it's there and they are, you know, downtown and maybe someone they're with is overdosing. Like, at the least they could run. Hopefully the bar somewhere nearby has it, too. But they can go, okay, run to the park and get it right. And it's also a place for, you know, people like teens and such, that. That are maybe hanging out there instead of being in school or after school or whatever. that's a non stigmatizing way for them to discreetly just go get Narcan and keep it on them as a first aid tool. Right. So, I think they're great. I'm so stoked that they exist here, and really want to help push more of them however I can with, the northern Nevada harm reduction alliance. Bianca McCall: And Jamie, I see some additional comments and questions coming up in the chat. I didn't know, if any of those can be addressed before we go to final thoughts and comments from our panelists. Speaker E: Yeah, there was one additional comment, related to the Narcan boxes. Someone had suggested Narcan boxes at UNR, and I just wanted to comment that there was an initiative that came out this semester where all students are given a training opportunity to take our overdose education and harm reduction class. And if they complete that class, they do have an opportunity to get Narcan from the knowledge Center and the student health Center. So that is one initiative trying to help students on campus. another question that came in was, how would I get this evidence? Bianca McCall: Well, I know Katarina was talking about how these are evidence based practices for harm reduction. And so I'm wondering if, Kathy is referring to how do we again, bridge that gap between the research, the evidence, practical application for our service members, in the community? and that in itself is a great question. We've been having, conversations on the nose platform, for quite some time now, on how we can bridge that gap and how we can connect, people with these evidence based practices. The NOCE platform itself is one. One, way. And then also when we talk about peer reviewed information, that is true evidence. Evidence isn't just things that we could find online, right, things that we can google, but rather, things that have been reviewed, by peers, by physicians, by psychiatrists, by medical practitioners, that have done research and that have proven the effectiveness of certain interventions and treatment. So I, would recommend to anybody on the line to be connected with peer review, programming organizations and sites, so that you can be connected to the evidence. And then, Katarina, since you were talking about, evidence based practices, I wonder if there's, some additional, insights that you can give into others that are wondering, where do we go to find this stuff out and to actually be connected with the evidence. Speaker A: Yeah. So when we are talking about public health responses and what's evidence based and what's not evidence based, usually, a big part of what we do is, deep dives into the research that is out there. As people who work in a public health entity, we usually do. Whenever you call a health educator out, like myself or like my supervisors, or my coworkers, we have done hours of research that go into our presentation, our discussions, what we're able to present to you, and we see what would come out of the CDC. So I would highly encourage you to get connected to your local, your local public health entity and see if you could even sit down for what we call public health detailing, usually reserved for medical professionals. But if you were to say, hey, I just need to talk to someone about what the evidence is, and I want to hear more about what these best practices are, that's a really great, ah, way to do it. I'll also draw, a study that was done by or initial sort of pilot study that was done in, Rhode island, in case you've not seen, where I personally am a big fan of prevent overdose, Rhode island, they are a really great harm reduction agency that we look to sometimes, to see some of the great stuff that's coming out there. So, they are the ones who kind of piloted, this sort of initial discussion between agencies where they installed nalox boxes and what does that look like for their community? And there's a lot of information if you just look up nalox boxes on Google and sort through it, and then just kind of always check your sources. Obviously, people can put anything they want online, so just double checking that is a reputable source. who is it coming from? Verify the sources that happen below it. So if they're saying, like, this is where we got it from, double check where that's from and make sure that individual doesn't have any sort of payments. there is a lot of misinformation still out there. So double checking those sources and I honestly, your public health agencies are usually really great resources. NoS is a really great resource. Obviously, you're all here, so you're connected with them and cassette who are able to get you to the right person and do that sort of technical assistance work in case you don't know who to talk to. And they're able to discuss more and get you connected to the right people because they are an excellent resource as well as your local public health, public health entity. Bianca McCall: But final thoughts from our panelists. Thank you again so much for, the incredible insights, for the information, for you being vulnerable and authentic and sharing your own stories and lived experiences. Final thoughts from panelists on harm reduction: Don't give up I'd like to give you all a moment to give your final thoughts on today's listening session. We'll start with you, Donald. Donald Griffin: Final thoughts are don't give up. Don't give up. For those that are still out there struggling. I always say, Feed the hungry, pray for the ones that are sick and addicted. That's just my final thoughts. Bianca McCall: Thank you so much, Donald. And we'll go to you, Bethany, next. Bethany Wilkins: Yeah, I think what Donald said, really, focusing on that, I think, just so much of this work is, internal and within, you know, our own hearts and our own judgments and being able to kind of zoom out and see people for who they are as whole people. Not just the drugs they're using or the decisions they've made, but just trying to love and support people without judgment. if we can do that, then we're probably on the right. On the right track in some way, so. Bianca McCall: Absolutely. Thank you. Bethany and Katarina, final thoughts? Speaker A: final thoughts. I definitely echo what everyone has said on the panel today, but also get connected. this work can't happen alone. It takes people. It takes people who are passionate, just like everyone here on this webinar today. and so get connected, whether it's in the north or in the south, wherever it is that you are, get education, whether it's through CASAT. I know we also shared that the health district has a training website as well that has a lot of training resources on it. so in case you want alternate, trainings. I know sometimes, like, you all have a harm reduction training. We all have a harm reduction training. So get as many different, diverse voices and conversations and don't be afraid to have those conversations. I always. You know, I kind of. Sometimes I can get, a little down when I hear. No. A lot of. But if there's anything I've learned in the past year that even sometimes your most outspoken, critics with very loving, open, honest conversations, that are, vulnerable, like, really approaching even these stigmatizing conversations with harm reduction, knowing that it's, you're meeting someone where they're at, and you're not leaving them there. You're taking them with you. is really important so that we can continue to move this work forward and making a difference so that we can save lives. Bianca McCall: Gosh, thank you so much. And I'd like to offer some final thoughts that I actually pulled from Maya Angelou's work And I'd like to offer some final thoughts that I actually pulled from, maya Angelou's work, for what she said life taught her. And these are, it starts off from the words that inspired her, by Terence, a roman playwright and poet. but Terence says, because, ah, I'm a human being. Nothing human can be alien to me. And if you can internalize at least a portion of that, you will never be able to say of a criminal act, oh, I couldn't do that, no matter how heinous of a crime. And if a human being did it, you have to say, I have all the components that are in her or in him or in them. And I intend to use my energies constructively, as opposed to destructively. Now, if you can do that about the negative, just think about what you can do about the positive. If a human being dreams a great dream, dares to love somebody, if a human being dares to be a Martin Luther king or a Mahatma Gandhi or a Mother Teresa or Malcolm X, if a human being dares to be bigger than the condition in which she or he or them was born, it means so can you. And so you can try to stretch, stretch and stretch yourself. And so my final thought in closing is my wish for all of you. And these are also the words of Maya Angelou. My wish for all of you is that you continue, continue to be who and how you are, to astonish a mean world with your acts of kindness. That is, harm reduction. This podcast is brought to you by the Nevada Opioid center of Excellence Thank you for listening to the NOCE Dose the Opioid Epidemic Unplugged. We hope that you found this episode compelling and informative, and we ask that you please share this episode with your friends and your colleagues. And if you want to learn more, please visit our website at nvopu opioid coe.org. the NOCE 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. Now, 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 Director's office through the Fund for Resilient Nevada Speaker A: CASAT Podcast Network. Bianca McCall: M. Speaker A: This podcast has been brought to you by the CASAT Podcast Network, located within the Center for the Application of Substance Abuse Technologies, a. Bianca McCall: Part of the School of Public Health. Speaker A: At the University of Nevada, Reno. For more podcasts, information and resources, visit cassatt.org dot.