Bianca McCall: CASAT Podcast Network. 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 Nose Dose, brought to you by the Nevada Opioid center of Excellence at nvopioidcoe.org and I am your host with the notes, Bianca D. McCall, going behind the front lines with paraprofessionals and community members alike who support the opioid response programming in Nevada State. And we're gathered here today to debrief after the latest and the greatest no. Sponsored listening session with today's special guest, Eric Schoen. And today we're joined by Eric Schoen, a powerhouse in health and human services with over 30 years of experience mentoring and teaching and leading the next generation of professionals. And as CEO of Community Chest for nearly three decades, Eric has spearheaded innovative integrated care in rural and frontier communities. And his passion for building capacity in underserved areas has earned him statewide recognition, including the prestigious Administrator of the year award in 2023 and beyond. Leading Eric co authored Essentials of Chemical Dependency Counseling and has been shaping minds for over 10 years as a professor at the University of Nevada, Reno. NOCE Dose. Get ready for an insightful conversation with a true change maker in human services. Eric. Eric. Eric. Eric. So the year was 2024 when we last engaged in the conversation about the uses of medications for opioid use disorder and their critical role in improving treatment outcomes for people who use drugs, communities, and specifically people engaged in the high risk use of opioids, including those in pain management treatment. The first things first is I want to ask you, Eric, how have you been since the listening session?

Eric Schoen: how have I been? Well, we've survived the holidays, which is no small feat, as you know.

Bianca McCall: Absolutely.

Eric Schoen: Things can come up and so, I'm actually glad to be through. it's nice to be back to, a new year and new beginnings and see, what 2025 can bring us.

Bianca McCall: Absolutely. You know, and I don't know if you've heard, of this, the frequency illusion where you notice something more frequently after you've recently learned about it. Right. Or talked about it. And, for Our listeners. I'll give you an example. A friend of mine, told me about a particular car model, the Rivian or the Rivian. And I never heard of them before. Right. But as soon as she shared that with me, I started seeing the car everywhere on the road. Right. That's frequency illusion. And so to that point Eric, has anything related to the listening session kind of resurfaced for you or maybe appearing more frequently for you as you, you engage into 2025 a ah, year of service in 2025.

Eric Schoen: For me, I think if anything came through our conversation, for me it was just trying to I think get the message out how much infrastructure we still have to build here in rural Nevada. That you know, when I started off, when I got my master's in 93, I think I was like many students, kind of a purist of, you know, we're going to practice this to the, the nth degree of professionalism and aspirationally based counseling. And those things are still guiding stars for me. But then you get into reality and you get into a shortage of a workforce, which is something we've really kind of been on the wrong end of here in rural Nevada. All the things that the textbooks say we should have, we don't have. And we pretty much have to figure out how to create health and healing and well being and thriving, I think through activating the natural curative factors of pro social contact between neighbors, between family members, between teachers and students, between everybody in the community and then add on top of that what we can so that everybody has a chance when they need them to be connected to the resources and the people who will help them through those difficult times.

Bianca McCall: Gosh, so, so many, so many great things in what you said. The first thing that, that really resonated with me is you talk about your guiding stars. Right? And, and I think that this will really speak to our audience who may be already engaged in continuing education or learning. Right. To advance in their careers and how they decipher between the practical application from the things that they've learned and how do they decipher between what they see in textbooks versus what they're gonna see in real life and how that's even unique to a unique experience in rural, rural communities. Right. And so, so back to the guiding stars. Just for you and your own experience. What's motivated you to continue to do this work or to be in this particular lane in this work.

Eric Schoen: I will give you my best answer I just wrote an email to my staff to this very point for 20, 25, that most of them know me as the old guy in the office, and they've never known the agency without me. And when I first started, believe it or not, I was, you know, in my 20s and I was full of, we can make changes and, you know, really impact people's lives for the better. And I knew even back then that, this will likely take generations, because how could it not? You know, Nevada has been a State for 150 years, 175 years, something like that. So it's taking decades to get to this point. It's going to take us some time to get out of this. And yet 30 years later, now that I've been in doing this in Nevada for 30 years, I had hoped we would have moved the needle a little bit more tangibly than still being ranked 51st or 50th on all the indices, that we don't want to be ranked so low in mental health, access to early child education, you name it. The things that really support people to do well in their lives were that we're really low in. And it's really, on a personal level, easy to get a little discouraged by that. So I look for inspiration in different places, believe it or not. And this is a little bit of a long answer. I apologize. But I came across an article on climate change in New Orleans and how they are pretty, pretty much across the region acknowledging and embracing that New Orleans nature may one day overtake New Orleans, but it hasn't yet. And they have kind of this, this, I don't know if it's fatalistic attitude, but I think of it very optimistically. They say for now we live. For now we live. And to me that is as much a call to action as anything. This work to make a difference in some, in one person's life, in one family's life and one school's life and one communities, you know, overall makeup. For now we live. For now we can make a difference. And that's enough of a reason.

Bianca McCall: Yeah, I love that. For now we live. For now we can make a difference. And especially with your example, being centered on New Orleans and during this time, you know, post, tragedy, of occurring in New Orleans, that, that's, that's a really strong statement. For now we live. and having a conversation with you, Eric, there's never a shortage of these profound, statements. Right? And this profound forward thinking. you also talked about, in your first response, you Talk about this need for pro social activities and things like that. And I imagine that you mean, among the community, right? The community, and possibly people who use drugs communities, people that are engaged in these systems and the treatment systems. but also you talked about writing this email to staff and to the resources that are made up of this infrastructure, this foundation. And I would imagine that there needs to be, there's a call to action of sorts for our resources and for our staff to engage and to be comfortable engaging in these pro social activities. so that there's a bit of modeling, so that there's a bit of reflection of there is hope right on all sides of this coin. And so can you speak a little bit more towards your ideas of the pro social activities? I know during the listening session you talked about having kind of these gyms. So let's talk about the pro social activities.

Eric Schoen: Well, so for me where that, where the idea of the need for pro social contact really jumped to the top, I think of the needs list happened, shortly after Covid. So Covid happened. We all knew we were feeling a little, well, a lot disconnected, not like ourselves. And we were all generally feeling probably more anxiety and depression than we would normally feel because it's. That's kind of emblematic of not being connected socially in the ways that we need to be. And concurrently I was helping with the quad county here. There's four counties, four rural counties that work together on it was our health improvement plan. And one of the top needs that came up was identified, as pro social contact that there was. A third of the respondents felt disconnected, severely disconnected, did not have near enough connection with any, any positive people, whether neighbors or family members or clubs or, or or church or anything that would sort of give them that kind of positive pro social contact. And any that was perfectly bookended by the shoot. The top health officer in the US Who Surgeon General who put out a report identifying being disconnected. The lack of pro social contact as one of the top health risk factors that many people are facing. In fact it was. I think he tried. And I don't know where this comes from, but the effect of being chronically disconnected is equivalent to smoking almost a pack of cigarettes a day in terms of the negative health effects. So both of those things for me really cemented like oh my gosh, you know, our work maybe is not as complicated as we think it is. I mean, I think we kind of get enamored with complicated theories or practices that we need to put into place. And really I kind of think of myself at this time like an old school basketball coach where you're saying, fundamentals, fundamentals, fundamentals. We got a dribble, we got to, you know, we gotta, we gotta run our drills. And I feel like that's much the same thing that we need to do, not only in rural Nevada, because I think same thing's true in Reno where I live. And anywhere is really helping to. Helping people to care for each other, using language where it's okay to care for one another, coming up with models for caring, systems maybe instead of a. Everything right now seems to be a medical model. If we could create, and I think I talked about this during the podcast, the earlier one that we did with everybody. If we could create a really robust health and wellness model where you could have something like a mental health gym where people could stop and know they would get pro social contact, no judgment, no diagnosing, but people who would be there willing to listen, who would have be trained up on a few different skills and connection to resources, but a place where people would be positively affirmed for being proactive about that. Just like when we see our neighbor's car at the gym, we're like, oh, hey, Larry's at the gym. Good for him. If we saw, you know, Larry's car over at the mental health gym, you know, he's at the mental health gym. Good for him. If we could somehow turn that conversation around, I think we could see some really interesting results and innovative positive benefits from all of that.

Bianca McCall: Absolutely. Well, and I got to tell you, Eric, you're speaking my language. As soon as you talked about old school basketball coach, I was locked in. Right. You, talked about fundamentals and something that, from my athletic experience, I know this, that fundamentals are sustainable. Right. So when you talk about, the last thing, fundamentals and quick story. Because I'm a storyteller, Eric, and I got to tell you a story. So the last time that I was, playing some rec. Pull pick up basketball, at the, at the gym, I, you know, I was feeling kind of that betrayal between my body and my mind. My mind thought that I could do all these things and my body was just not, not there. Right. And, and I went through this kind of grieving process feeling like, you know, how could you do this to me? Body, you know, and, and and I remember one of my teammates came up to me and, and said, you've got great fundamentals. And at the time I was offended, Eric. I was offended because I thought that's what I say to somebody who's old and washed up. but that's a key component here. When we talk about what's lasting, what's sustainable is those fundamentals. That's like riding a bike. When they say it's like the muscle memory of riding a bike, those things never go away. And so, I think it's brilliant to include that in. And what you're talking about is kind of simplifying it a little bit. And what we consider to be evidence based. There's evidence in just doing kind of the fundamentals. and when you talk about the connection, and really kind of what you're talking about, it strikes me as a conversation around maybe more of an existential health, right? I mean, I know we look at these things as mental health, behavioral health, but when we look at the existential pieces, right? Life, meaning, purpose, motivation, freedom, you know, the things that really are stars in our decision making, in our behavior and in our mental capacities. you know, when we talk about these pro. Social activities that to me that's. Let's get into the conversation about the existential a bit, is it not?

Eric Schoen: yeah, I could totally see going there and I, in fact I really resonate with the existential, existential side of things. So it makes a lot of sense to me. But what I, what I'm not talking about, which I, I completely believe in, is having medication assisted treatment. That's absolutely vital. Right. I believe in therapies that utilize, you know, evidence based practices for helping people affect change and, and, and, and manage their addictions in a positive way. I'm not. Those are to me higher order things and those are important. But, but I would argue that what I'm talking about is like the foundation of the house. It's the foundation and the frame of the house. I can't get to the rest of this and have it be as effective as it possibly could be if the foundation and the frame aren't solid. So my, my, it's long, it's probably longer term. And I think people go, oh, I really like the idea, but man, that's a lot of work. I don't know if I want to do that. I'd rather just kind of change the window treatment on this and we'll worry about the foundation later. But sure, we can do that. We've been doing that for 30 years. I would argue, I think we really kind of need to rethink this and we need to then align the payment systems that go along with it. Of course. Where does the money come from? That's another big question. And I know that's also a difficult one to have. But if we can align the funding with the intent and what we are trying to do, I think it's possible. We just have to say, yes, we want to do that.

Bianca McCall: Sure, sure. And the money question, it is a big question. And I'm going to ask that question, but not before. So you're talking about this foundation for the house. And in the listening session you also brought this up. You, said it feels like, at times we're building a house with 100 hammers. Right. and so will you talk a little bit more about that, and how, you also mentioned how we need to mobilize segments of each community and have that be culturally based and things like that. And so how do we migrate away from, kind of that traditional medical model, the Hundred Hammers? A lot of people doing, things independently and possibly connected to this lack of engagement in pro social activities. Right. Because when you're not connected, as a community, then you don't know what's going on next door or right across the street and you don't know what resources, you have in your inventory, environmentally and possibly even internally. Right. So let's talk about how do we build this house? How do we migrate away from the Hundred hammer model? And what does this gym look like then?

Eric Schoen: You know, great, great questions. And I think my, I either misspoke or my metaphor. So, in the previous, webinar. What, what I was, in artfully, trying to suggest is that the way we've approached therapy so far is we have 100 architects and one worker. If the architects are the, the mental health therapists, the master's level mental health therapists, which are expensive and, and far between, and above. so we, we've been kind of doing this backwards. If you look at how houses are built, it's one architect who's helping to guide the dozens of workers who are swinging the hammers and making the house, you know, making a nice house and building the, the structure. That's what I would argue we want to pivot to. We want to. For a long time, the mental health professions really sort of pushed their. Themselves as the answers. It was a medical model. This goes all the way back to Freud and those guys who started this off, that only physicians could be a part of this new emerging field of Psychological study, but it remained there, unfortunately. And so you had to be a physician to practice and to be recognized. And that has kind of. That was needed for legitimacy, I think, but it also tainted, the profession of people who maybe may not be physicians. And it became professionalized in ways that were both helpful and harmful. So in my mind, being familiar with research that shows when people are allowed to include cultural elements and have their families be a part of their therapy, and it's not so professionalized. In fact, countries who don't always use all of our westernized approaches have better outcomes, mental health outcomes, because family members who may be symptomatic are included in the, in the support structure and they're given that support. that's what I'm trying to suggest, I think is possible here. But we have to be able to imagine it differently. I have never seen a mental health gym. I mean, you ask what that would look like, I don't know. I just imagine, you know, if it were me, I would like some. So for somebody else, it's gonna be some different projection, but for me, it's gonna be some old grizzled guy who, if I'm having a hard time, I can stop in and say, hey, Frank, I just need to talk. Can we grab, you know, can, can we pour, you know, this ever present cup. Pot of coffee? Can we pour some of that horrible coffee and then just have a conversation in this very com space without feeling like I'm going to be judged or, or threatened to be removed and taken somewhere. That somebody is just going to relate to me as a human. I think that's what most people want. I think that affirmation. When I was doing the mental health counseling Prior to being CEO here, I found, that I think 70% of my clients didn't need my advanced degree. It wasn't my diagnostic acumen, it wasn't my clinical expertise. It was me being in the room with them, being willing to have a conversation and bear witness to the journey that they were on, the pain they were experiencing and saying, yep, I can relate to them. I completely understand that. So all those things that you're talking about, this finding meaning and feeling like I'm validated and I'm worthwhile, I think that is part of the work of addictions. It's why a lot of people end up using in the first place, because they feel empty. They don't have a sense of meaning or purpose. And so if we can create that in more organic ways and create more frequent opportunities to hopefully Engage in that maybe we could actually make some progress, Some pretty. Pretty interesting progress.

Bianca McCall: I love that. I love that. I love how you really, brought into the conversation like the workforce, workforce culture and the culture of. Of psychology and, of health and wellness and how, we prioritize having the licensed folks and things like that. But when we talk about Frontline specifically and who has the most frequent engagement with people in the community, the skill set is a little bit different. when you see a therapist or you see a doctor once a month or even less than that, you know, the front lines, the daily interactions, the skill sets required to nurture a healthy relationship, a positive relationship with community, is really about just having those courageous conversations, you know, and those culturally responsive conversations. And, and. And I'm. I'm a huge, you know, anybody that knows me knows that I'm a huge proponent of cultural responsiveness. You know, it needs to be culturally and linguistically, you know, appropriate. And I want to talk about rural culture and for a moment, because there are certainly, there's certainly a uniqueness to rural Nevada culture. Right? And when we talk about rural Nevada, that's not even just one group or population. You're talking about rural counties and frontier counties, that look and live very differently across the map. And so can you help us, paint a picture of the uniqueness of rural Nevada?

Eric Schoen: Yeah, I think I can, and I hope I can do it without. So I don't know I'm going to date myself here, but there used to be a show on TV called the Donny and Marie Osmond show, and they used to do a bit Donnie and Marie, where, I'm a little bit country, I'm a little bit rock and roll. That's how I feel. I feel like I have one foot in Reno because I live in Reno, my family lives in Reno. Know I teach at UNR, but I also have 30 years of working in rural Nevada, and that goes back to my childhood. I also had a bifurcated childhood. and I am really appreciative of what both of those sides of my life give me. I think both urban and rural areas have a lot to offer, and we have some treasures in all of those areas, in terms of what it means to be a Nevadan, what, you know, all the sort of the. The proud, prideful things of what it means to be in Nevada. I think most of the listeners are probably comfortable or familiar with how neighborhoods are different if they're in a big city. Like I call Reno and even Carson and, Las Vegas, big cities, neighborhoods can be very distinct and very different. And if you ask somebody to talk about what the differences are, some of them are really subtle. You can't even really kind of name what it is. It's just, you know, when you drive across the street, it's got a very different feel, it's got a different vibe. People are doing this and this, and over here they're more like this and this. And you can't necessarily articulate that. So I'm saying that as a way for giving myself an out, because I don't know that I'm going to be able completely define it for you. What I can say is that nobody can really understand rural Nevada if they haven't spent time in rural Nevada, which is what I think. I think the mistake that a lot of our folks who live in urban Nevada, they kind of look at it as this, this other place that they may. And they have judgments, but they haven't really spent time. The only one. Let me tell you a story in. We have a community in East. In the East. Well, east of Sparks, in Store county, called Lockwood. And if you blink, you'll miss it. It's right on i80. And it's, you know, the, the residents there are very, very proud. a lot of them lived on fixed incomes. Not all of them, but it's, it's sort of a, ah, tough and tumble, but very resilient place. They have a school down there as well, and also senior center. And when I was the primary main counselor, slash social worker, slash addictions counselor here at Community Chest, I started, going down once a week to start providing case management and supportive services. And I would end up at the senior center every single time. And for the first three months, all I did was drink coffee until my eyeballs turned brown. And the first month and a half, the seniors looked at me like, who the heck is this young kid? Who, who is he? Why is he here? But I wasn't going anywhere. I just sat and I had conversations to the degree that they would interact with me. And finally, after about two and a half, three months, they're like, he's not going anywhere. Maybe we should give him some referrals. And the ice was broken. From that point forward, it was a matter of like, okay, I think we have some commonalities and some similarities, but it's. It. That kind of trust has to be earned. I don't know how many. How many. I don't know if it's taught that, hey, you should wait for three months, keep going and drinking coffee till you can't drink anymore for three months, and eventually something's going to happen. But there was no other way through the door except through the door. And that's true of a lot of the rural Nevada, communities is what we have found with Community Chest is we need to respect where the communities have come from. We need to respect, for, for better or for worse. There are some really great strengths in all communities and there's often some drawbacks, but we need to respect the history and what the, the people who live there have tried to do and how they've tried to do that, understand their mindset. And then once we have a good sense of that, I think then we can be a really effective partner for bringing our resources if they want them, they don't always want them, but if they want resources or help them develop the resources that they want, we can be much more effective because otherwise it comes across as us telling them, it can be perceived as us telling them what they should be doing and it can come across as us judging them. And that's the last thing that I want to do. So there's also, not only are there these nuances in rural communities based on histories, because all their histories are a little bit different, but also place based because all that geography informs the identity of these people. But then you also have, how do you work with that? How do you honor that? How do you, make room for that? rather than, again, this idea that I'm coming from Reno, so I know better, you should just listen to what I say and take that as gospel advice.

Bianca McCall: Right, right. And to your point, rather than, hey, I'm bringing my strengths from an urban area, from Areno, I'm bringing my strengths and resources to the rules. there's that nuance of how do we empower and uplift the strengths that exist in the rules. Right?

Eric Schoen: Very much so, yeah.

Bianca McCall: And so and to me, you know, that's getting into language of more healing centered. You know, you go from traditional, treatment of, you know, let's diagnose what's wrong with this area, what's wrong, you know, what problems are exist in these rural areas, to trauma informed to what happened and to your point of let's look at the history and then to healing centered of, well, what are your strengths? Let's empower, and mobilize the champions within your community. Right. And the strengths within the rural communities. And I agree, wholeheartedly that the conversation, the language needs to shift a bit, you know, to be able to achieve that and certainly spending time, I love that. And that's true for any community. Right. cultural. This whole idea of cultural competence, you know, is a lifelong journey, which may not ever be achieved. Right. Because no matter how much time that you are, you know, emerged in a culture or in a community, it doesn't mean that you are ever able to truly understand, the walk in their shoes. But it's that sensitivity and the humility and the willingness to engage in these conversations and learn about the history and learn about the strengths. it's that willingness that fosters the humility to be able to at least bridge the gaps a little bit and increase the flow, of resources and connectivity and connectedness throughout our rules. So thank you so much for that. as promised, I've got to ask about the money because that's a question that we all have. Who's going to pay for this? and you mentioned something, during the listening session about there being a divide between what's effective in treatment. Right. And treatment focus, versus what's cost effective. Right. And what's more aligned with the medical model. Right. And so, can you, can you talk about, about that a little bit more and help us understand how we might bridge the gap between treatment effective and cost effective?

Eric Schoen: Well, I think that for me the low hanging fruit in terms of building capacity, because I think they have such strong activation potential for all of the things that we're trying to talk about are our peers and community health workers. So our paraprofessionals, if you will. And the reason I think that is our experience has been that there are a lot of community members that want to make a really positive difference in their communities. But the idea of going the traditional academic route is more than they want to do. It's just kind of unfathomable and unrelatable. But being able to be a volunteer, start off as a volunteer and then have some training that goes along with that and then utilize their lived experience in a way that's beneficial for others. And to be guided along and be part of a community of other people that are doing that, to me that's cost effective and that's treatment effective. It's both of those things. And I think we get far more bang for our buck. That workforce I believe is more sustainable because people are still in the communities that they love. they have an investment in, they're already culturally fluent in those communities. So we don't have to try to get somebody up to speed who through the old important mental health professional model, which was not sustainable, was a lot more expensive for the cost of a, master's level or greater person compared to a cost of a paraprofessional. All of that being said, I am not saying we do away with counselors. We still need counselors, we still need psychologists, we still need psychiatrists. I'm not letting anybody off the hook. I'm not saying we should replace those with community health workers and peers because they're cheaper. No, what I am saying is that we should have a strong base of those paraprofessionals who are. Then there's an overlay of these other professionals who can provide now those other services and medication assisted treatment. the motivational interviewing in the context of the counseling interventions that they're doing, that is what I'm hoping we can get to in terms of the cost. There's a cost to not doing anything, which is 30 years of lost lives and still being 51st out of 51. I would argue, I mean that's a cost. I can't magically create the money. I think it's trying to get to a point where this vision is compelling enough that enough people say yes, how do we do that? How do we, how do we take the first step and then the next step? And for me, some of that's already happening. With the acknowledgement that peers have such value and the acknowledgment that community health workers have such value. I am already seeing, some room being made for. It's not, it's not just for professionals here. You know, communities can own this. They can, they can have some sense of their destiny and some sense of self determination and through that have more responsibility and more of a sense of being able to self determination, being able to really drive those changes themselves. I think that's one of the, one of the disservices we did when we professionalized mental health care is we said, oh, families, you don't have a role here. People, your natural healing, curative factors as a human being, they don't matter so much as the professional judgment. And we harmed a lot of people. So I think we're reclaiming that. I think we're making strides. and again, I think it's going to take some time. I mean it's decades for getting here. I think it'll take some time. That being said, a lot of change can happen in a short amount of time if we just decide we want to.

Bianca McCall: Yeah, yeah. And I couldn't agree with you more in terms of I think as a, as a, as a workforce empowering and uplifting, lived experience, you know, and not you know, in the grander scheme of things with the hierarchy of professional experience versus lived experience, but more so creating an, I guess an emphasis on the integration of lived experience and professional experience. I think in turn going back to what you and I enjoy as existential psychology, right, Is that that's what gives us meaning and purpose. Right? If we can if we can align or find meaning and purpose in our lived experiences and have that be supported in the healthcare, behavioral healthcare workforce, then I think we're meeting a, ah, few needs here in the communities, in terms of providing that purpose, that meaning, as well as really carving out space I think in the workforce and in the continuum of care for positions that rely on their lived experience. As you mentioned, peers and CHWs, as well. so we had a couple of questions, that I just want to bounce to you, in using the basketball language, still stuck on that fundamentals. we had a couple of questions that came out of the listening session. I know one person asked about more and this might relate to your, your gym, your gym point. But one person asked about more holistic approaches when we, even when we are talking about you know, medically assisted treatments and we are talking about medications for opioid use disorder, how we can integrate not only lived experience but, but other holistic interventions. This one question was specific to nutrition, and other ways to manage our physical health. Didn't know if you had any thoughts about that. And we also had some questions about technology and how that links to rules specifically and the role of technology and what we know about advanced technologies and the uses of AI and things like that, generative AI, and, and how that affects the workforce and so even to your points of developing peers and CHWs, how technology, what the role of technology is in all of that and so. Didn't know. I know that's a, that's a mouthful. Technology alone is its own podcast segment. But, but what are your thoughts on, on technology? What are your thoughts on some holistic approaches with regards to nutrition and gut health and things like that and how to integrate that into some of the concepts that you shared with us today?

Eric Schoen: Well, so I love that you Landed on nutrition. We'll take those in order. there is an agency, so I'll just talk about one agency in rural Nevada that I'm very familiar with, Healthy Communities Coalition out of Dayton, Nevada. They serve primarily Lyon county, but one of their, their sort of keystone programs is community and school based gardens. And they have done a lot around developing healthy food ecosystems for connecting people, to physical health, social health, mental health. They use their food distribution points as access points for all of those different resources, all those different, yeah, solutions. they have volunteers who help staff all of that so they can be of service to their, to everybody. And then everybody has a chance to be a part and learn about organic farming or clean farming and then share that produce and, and even sell it down the road or share it down the road as well. And it's gone a long way to creating a sense of community and a sense of identity and a sense of connection not only to each other, but to the land, to the environment. that's one example of, I think some really innovative programming that's not terribly expensive compared to what things could be. You know, like if you're talking about cancer treatment, you're talking about really just kind of an organic, grassroots based effort. but that's one way I think of addressing the whole person, in a very naturalistic kind of a setting. and then when somebody has an identified mental health or addictions need, they make sure to connect them to those resources or to appear. They utilize peers and community health workers as well. so I think there's, we're mostly kind of limited by, I think our imagination of, of, of what we've seen a clinic be in the past. So that's the way it has to be. When I first started in the mid-90s in Portland, Oregon, that was a very vibrant time for mental health, services in that they had just decommissioned all of their state hospitals and community based resources were where it was at. And so the clinic that I worked at had occupational therapy, gardening therapy, supported employment, supported living, acupuncture, a day treatment program. And this was for people who had schizophrenia and all the disorders that we're taught to be afraid of. And I realized that we don't have to be afraid of those. These are people who are just kind of trying to figure it out. And when they're wrapped in support and they're wrapped in love, many of them are able to have really good, good lives, good quality lives and be able to live independently. So I was fortunate enough to See that? And I don't know that a lot of clinicians these days have had that benefit, but if we can imagine what it could look like, I think we could include it. We can include these more organic elements. As far as technology goes, it's interesting you bring that up because one of the ways that I try to keep my skills sharp, I'm getting more towards the end of my career than I am at the beginning is I participate in monthly supervision meetings with other supervisors so we can stay abreast of what's happening in the field. And we were talking about this very, it feels like a binary choice of, virtual or non virtual. You know, should interns be not allowed to do virtual counseling and only in face to face counseling so they learn the basics? It sounds a little old school, right? But just learn the basics because that's the way you have full context. You can see somebody, their bodies or their, towels, if you will. But then recognizing that a lot of the, up and coming counselors now are digital natives, it's a very different, different, different world. And during COVID we didn't have a choice. The only way we could provide counseling was by digitally. And that was better than nothing. So where we kind of left it, and I think this is true, but who knows, is that we want them to be. It's important to be fluent in both. It's important to be fluent in both. How to, to work with people who are sitting across from you in a room as well as across from you on a screen. And those are slightly different skill sets. There's some things that go along with that. But for some people in rural Nevada, they may be an hour and a half, two hours before they can get to an office. So it may be more time, effective for them to do a virtual based session. Maybe come in once a month to do a face to face session or once every two months. but if you take that away, some people may never be able to receive services. Maybe they're mostly homebound and it's really difficult for them to leave the homes. that's true for a lot of seniors. So I think there's room for all of that. I don't think either side of that is inherently, bad. And I don't think one necessarily wins out over the other. They both have their strengths and they both have their drawbacks. Sure, sure.

Bianca McCall: Well, and I think going back to, you know, the gym example, I'm hearing arms, I'm hearing legs, I'm hearing cardio I'm hearing, you know, the weights, and I'm hearing that through. Here's some, you know, hybrid, platforms, you know, with as far as use, cases for technology. Here's nutrition and integration of some physical health stuff. Here's you know you've got peers, you've got chws, and really looking at kind of all those domains of wellness and how we can best support people, not only in pro social activity, but also how do we empower people to be healthy and safe while being independent. Right. Because we also know that as soon as they leave our offices, as soon as they leave the agencies, as soon as they return back to their natural environments, they're still living, they're still accruing lived experience. And so how do we empower people to do that independently, and have that, that sense of self efficacy, as well as. Here's how you connect, you know, here's how we, we can go in between. So I love everything that you shared today. Thank you so much. I want to end with asking, you or, and asking from you, your, your contact information. I want to know how professionals, and community members alike in the opioid treatment spaces connect with you and, and what can they call you for specifically, what can you help them out with?

Eric Schoen: I'm not sure about that last part, but if anybody's interested in connecting, I, think the easiest way is just to reach out in my work email, which is the easy part is Eric. Eric. That's my first name at this is the harder part because it's a run on sentence, but it's Community Chest Nevada all in one word, all spelled out dot net. That's the easiest way.

Bianca McCall: All right. And thank you so much. And I know you said you're not sure about why the heck we'd be reaching out to you, but do you, do you mentioned supervision and things like that? Do you do mentorship and that sort of thing for community members?

Eric Schoen: Yeah. So I used to do supervision and I used to do counseling. I mean I love. Those are my passions. this job of running an agency took more than I thought it would and I had to let those things go. I do still teach at unr and I am in the process of revising that textbook that you talked about earlier. So that should hopefully come out an updated version in a year or two. and you know, mostly, I think if it's mostly as a mentor, you know, informally, if people want to bounce off, bounce ideas off me, I'M I'm. That's a lot of fun for me. And also, involved sort of legislatively, try to keep my eye on, on what's happening. Having been a board member for 12 years and understanding that, world a little bit, try to keep abreast of that as well.

Bianca McCall: Well, thank you so much. I will certainly be reaching out to you because I feel like, there's some twin flaming going on. Existential. And of course, you had me with basketball. so I will certainly be reaching out and I, and I encourage our, our audience and our listeners, to do the same, to pick your brain, your brilliant brain. it sounds like there's some, there's some consulting opportunities, there's some mentorship. And so, I'm excited to be able to have you as a resource and leverage you as a resource in our communities of the future, the next generations of paraprofessionals, and licensed folks alike.

Eric Schoen: Well, you're too kind. This has been a lot of fun. I've really enjoyed all of this time that we've got to spend together. And to me, this is really important. I can't imagine more important work than what we're trying to do, seriously. And I don't mean to sort of puff up our own chest. I mean, this is change. This is life change work. We haven't figured it out yet. We've been trying to figure it out for hundreds of years. We still haven't figured it out. So we need everybody on board to bring their talents and their ingenuity and help us out.

Bianca McCall: Absolutely. The importance is in the conversation that, that we're having, continuing to have these conversations. So that's why I love the, the, the no platform, the listening sessions, the podcast. This, is exactly what we're trying to do, is encourage these courageous conversations. So with that, thank you so much, Eric, for joining us today. That will be all for the no podcast today. Thank you for listening to the nose. 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@nvopioidcoe.org the Nostos 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, NOSE 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 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 casat.org.