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 NOCE Dose brought to you by the Nevada Opioid center of excellence at www.nvopioidcoe.org. I'm your host with the NOCE, Bianca D. McCall, going behind the front lines with the community stakeholders who are holding up to support the opioid response programming in the great silver state of Nevada. Now we are here to debrief after the latest. No. Sponsored listening session, the first of a two part series series examining the opioid use disorder impact on special populations. And our guest today is known to shine a light on a group that is rarely talked about out loud and in recovery spaces and that is high achieving performers, especially those in their youth and in sports. So today's guest is Ryan Mills, a former professional BMX writer whose story story rides the edge of pain and perseverance and powerful transformation. Once soaring through the air and shredding skate parks. Right. Ryan's career was sidelined by serious injury that led to prescription opioids and eventually a decade long battle with heroin addiction. But his crash wasn't the end of his story. Ryan fought his way back through persistence and programming, got clean and reclaimed not just his life but, but his love for bmx. And now he's pouring into a new heat with higher purpose. He's turned his story into a source of strength for others. Ryan now works with Nevada Division of Public and Behavioral Health and continues to be a voice for recovery, for resilience and for redemption. Now let's drop into this main event. Ryan, how are you feeling today? How have you been since, since the listening session?

Ryan Mills: I've been good. it was a, a good time actually. I had a, a lot of fun answering the questions and listening to the other people involved, what they had to say. It was very interesting. yeah, haven't really thought too much more about it afterwards. But yeah, I was just getting ready for this little podcast.

Bianca McCall: Yeah, I mean it's, it's just back to work, right? Back to business as usual. and that's pretty consistent for those of you who are listening, who are not perhaps, retired professional athletes, like, like you and I, Ryan. Right. that's, that's kind of how we're, we're groomed or we're molded as people, as competitors. It's, it's. You go out for a heat, right? You go out for competition, and then as soon as it's done, it's, it's kind of like onto the next, preparing for the next. You know, you kind of have that short term memory. Am I right on that?

Ryan Mills: 100%.

Bianca McCall: Yeah. Yeah. And I have to say, as a retired athlete myself, what you said during the listening session about upstream prevention, it really stuck with me. Now, you drew such a clear line between injury prevention and opioid use prevention, especially for young performers and athletes. We don't talk about that enough. How the pressure to perform, to push through the pain, to over train. Right. it could lead to real harm. And so, often these injuries that sideline our young people, they don't just take them off the field, off the track, or out of the final, they can push them down a path towards substance use, a dangerous relationship with substances, in fact, especially when pain management isn't handled holistically, as you mentioned during the listening session. So that connection between performance culture and opioid risk, it needs more attention. And I really appreciated how you brought that into the light. And I'd love to take a deeper dive into a few of the things that you shared during the listening session. You mentioned how hard it was to rebuild identity and purpose after your criminal record. And so my question is, what. What helped you move from surviving the injury and that fall from grace to thriving? Right. And what do you think recovery programs could do better to support the emotional rebuilding process?

Ryan Mills: That is a lot. yeah. I think what helped me kind of gain my identity back was, was stepping back on my bike back then, getting, just seeing if I could do it again. And it was kind of one of my goals when I was sitting in jail of like, what I'm going to do, that was one of the things that kept popping up in my mind, like, you need to get back on your bike. And it was the best decision I ever made, even though it was also the reason I ended up on heroin. So, but jumping back on the bike, being loud about sobriety, and having the BMX community understand that and accept me as that, and then kind of getting, some light shown down on that in the whole BMX community, like worldwide, it was Definitely brought me back to finding, myself. but my sport's a little different than other sports. it's, not a team sport, so it's a little bit different. And the pressures that you get are the ones that you only put on yourself. So, I understand in the team sports you have a little more pressure to do well, and, you want to kind of look past the injuries and you want to go back out there and help the team win. But you got to also remember that it's just a game. everyone's gonna be fine if, if you lose a game. so you gotta kind of weigh the options of do you want to risk hurting yourself more or risk losing a game?

Bianca McCall: Yeah, no, I love, I love, some of the things that you. You bring up. Right? the difference between team sports and individual sports, where the. The competition is really against yourself, right? And the pressure that you're. You're putting on yourselves, and especially about our young people that are performers in sport and the amount of pressures, that are placed on them externally and then internally, the. The amount of pressure that's put on themselves. and I, and I don't want to lose anybody that's listening that. That again, may not relate to the sports aspects, because when we talk about performance, really all of us are performers. We're performing in, whether it's sports or academics, right? In school, we're performing in the workforce. And still the same principles apply, right, Ryan? Like where, if your job is you're on a team, on a committee, in a coalition, and you're playing a particular role, then there's still those same concepts of, hey, there's pressures to perform, there's pressures to, no matter what you're going through, maybe in your personal life, so to come to work, to perform, especially when you are working in recovery, like a lot of our listeners, are, professionals or community stakeholders in the recovery space. And so some of these same principles apply. And like I said, I don't want anybody to feel disconnected from this conversation, because that desire to have a quick bounce back, to have a quick cure to whatever challenges that we're facing and a quick return to be able to perform, for whatever our motivations are, that's something that exists for all of us. Right? and as you were sharing your story during the listening session, you described, even more of what are those pressures? What do I have to face in terms of my identity and reshaping and things like that, and understanding that the system itself has such, such an impact on that reshaping on that rebuilding process. And there's gotta be some mutual accountability in that. Right? because we as professionals, as supporters in the recovery space, we have such a high influence and impact on people in their recovery journeys. And so you described specifically how going through the legal process, being mandated to certain programming through drug court and how being even a minute late to appointments and things like that landed you in jail and how that level of rigidity, it doesn't reflect real life or real recovery, you know, things that really happen, you know, during, during those recovery journeys. So if you were sitting with someone designing a diversion model for young people today, what would you say to them about balancing accountability with compassion?

Ryan Mills: yeah, I mean I think there needs to be, I think I've said that in the session was more leniency. there's obviously we're trying to structure the people that are early in recovery and get them back on something to where the real world is like also on that same thing where it's like get to work on time, you're going to get in trouble if you don't. And, but it's not going to jail. It's not a such a huge punishment. And to make you feel deflated, trying to go through these programs, it's hard enough to even go through the program, on its own. It makes you kind of, you feel a little worthless at points and you feel like you're never going to get it and you feel like it's impossible to even make it a year through this program and how long it's going to take and but in hindsight it's very short. You just, you need probably more time to, to get the proper amount of training, life training back and how to get back into the real world after you've been through. Well, the level that I was, was homeless and addicted to drugs for many, many years. So I had completely had to relearn everything in life. I didn't even know how to do laundry. So it was just like the very little things. And then with work, same thing. I'm, I'm like trying to catch up on all the new apps and all, everything And Lucky and I have co workers like I do and they, and I let them know my past so they are aware of like anytime I could be in trouble, they help me so I don't go off the deep end. So yeah, I think that's probably leniency would be the answer.

Bianca McCall: Leniency Yeah, I heard, I heard leniency and more time, which, you know, some people might be like more time. What are you talking about? But I, but I love the connection between more time with more compassion. It actually, kind of pours into people and teaches them how to be human again. Because, like, you're mentioning, you're learning to be human and to treat yourself with humanity and compassion all over again, down to basic living skills like doing the laundry and things. And so. And during the listening session, you made that powerful point about how dehumanizing, the system is. Right. With the dehumanizing experience that you had in the first 48 hours in jail. And so you talk about perhaps more time with that compassion and to help, to help relearn how to be compassionate and treat yourself with humanity and be treated with humanity. and then you also talked about kind of that, having that thought of, how am I going to make it through this year? how am I going to make it through this year? Seems like it's such a profound question, in those first 48 hours. Right? So what, in your, in your opinion, if we flip the model from the dehumanizing experience in the first 48. Right. What would be the first 48 hours of real care? What would that look like, especially, again, for a young person, for a person that's a high performer, whether it be sports, academics, workforce in their community and their families. What if we, you know, caught that person at the same crossroads in that first 48 hours? What would you want them to feel and to see and to hear first?

Ryan Mills: I think the. Maybe putting people around, people with more time in recovery first, instead of throwing them all in with a bunch of people in the brand new beginning of it, thrown into, you know, mandated sober living or whatever. Everyone in their first 30 days, everyone's dropping like flies out of the system. Like, maybe having people a couple months in that have already been through the stuff that they've been through, to show them the love that you can get from this and the compassion you can get from this, and more of a mentor ship of, people. Because it seems, impossible when you're sitting there with a bunch of other people thinking it seems impossible. So if you had someone there that can show you the way and show you the light, and you are open to the idea of it working, then the first 48 hours could be pretty easy. that's if we're talking the first 48 hours after withdrawal has kind of gone through, because that's the only thing you can think about when you're in the first 48, actual first 48 hours is how to find a new source of drugs.

Bianca McCall: such an important point. the first 48 are we looking at after detox and what those first 48, hours actually look like? and then you mentioned, which I love the, the ideal of mentorship and peer support, engagement right away in that first 48, being able to, to see, you know, and what I think of Ryan is, is, you know, the, the Christmas story of, of the Christmas past. You know, you've got the, the three ghosts and things like that. That is like kind of this is your life. I, I, I kind of got that visual, you know, when we're talking about integrating lived experience and peer support right away because there's this, there's this vision that appears, right, that this could be your life in recovery. Right. And, and how important and how significant of a role that, that they would play initially. you know, and, and, and for a lot of people who don't know about peer support, because you also mentioned, during the listening session that you are a certified peer recovery support specialist. You went through that programming. I'd love to give another opportunity to give a shout out to, Nose and to Cassat for our peer recovery support specialist, ah, certification. but with you going through that process, and how you see that, how you see peers currently being utilized in the system, what changes need to happen there?

Ryan Mills: it's, it's fairly interesting going through that certification, because you kind of get a chance to see the other side of it after recovery of like the people who were helping me, and what they must have gone through as well, to become a peer support, I do think they could be used a lot more and maybe like have a lot more space for them and a lot more different programs of where you have to hire two, three, four peer supports, to take on the overwhelming amount of people that are going through this. you get stretched too thin. You see a lot of people, relapse and you kind of lose hope a little bit on this side. it's hard to see people that you thought were gonna make it, not make it or even die. so there's a lot of that and it's a pretty big struggle to work that that way. but I just lost my train of thought. But yeah, I think, it's, it's.

Bianca McCall: A difficult thing yeah, no, and I can imagine. And you even bring up, you know, an important point there too is what is it like, what is your experience like as a peer support? seeing somebody else struggle in a very real way in a way that, that might even activate some memories of, and some feelings, right, that, that you experience during your first 48 or during your time in recovery. what is that experience like for you? And how do you, how do you protect against a reoccurrence or a relapse, as you put it, even for yourself being still involved, in the spaces, right, that ah, where, where addiction, where, where you might. May have had a past history and dangerous relationship with, With. With substances.

Ryan Mills: It can, it can be very triggering. I know in the first year, or two, it was a lot of triggers that I had to live through. And that's something you kind of learn how to deal with a little bit as you're going through recovery is your triggers. That's one of the main points you talk about in drug court, in the counseling sessions. and you learn to kind of sit with them, go through them, and then they become not a trigger after. you kind of build an immunity to them, get stronger. but yeah, it is challenging. You can, and you can be triggered again anytime and it comes out of nowhere. for me, I would, if I needed a break, I would just take a break. I would tell my boss, hey, I'm triggered right now. I don't want to be a part of this meeting anymore. I don't want to do this anymore. Get me away from this, this section. I can't do it right now. Maybe I'll come back to it later, which I often did. I didn't spend a whole lot of time as a peer support. I got moved fairly quickly and moved up in the chain. but it was definitely an interesting few months, doing that stuff.

Bianca McCall: Yeah. And now that you've moved up, do you see any type of, reassurance or of change that's on the wave where we could help our peer supports not have to sit through that alone as they face kind of those triggers, those activations, those challenges? I think that that's the, That's a key point, right? Is that. Do we have enough support for our support that are. That are in the space?

Ryan Mills: Yeah. Ah, I think a good idea would be to have some sort of monthly group of. Where people can unload, maybe, you know, a large group or like several small groups of just People that know each other, trust each other, can unload almost like an AA meeting, I guess you could say, but for the space.

Bianca McCall: Yeah, Yeah, I love that. I love that. Ryan, tell us a little bit more about the work that you're doing today and the agencies that you work with and how you've been able to again, maintain recovery as a lifestyle for yourself through intentional actions and a mindset, through what have been arguably the most challenging times in recent human history.

Ryan Mills: Yeah, I'm now out of the opioid space about two years now. now I'm working as a health resource analyst. Three. but I'm about to be promoted to a health program manager, which, is kind of cool to keep moving on up. I'm working with ARPA funds, which is basically leftover, Covid funds that, the are being used as grants to beef, up the health care system in Nevada. giving out, grants for scholarships, certificates, community health worker, scholarships, lactation consultants, doulas, just where there's like, a lot of need in Nevada. We're trying to beef that up, and over the next year and a half, we'll be continuing to do that. So. But on the opioid side, I still use my social media as a platform for it, and I talk to a lot of people. I just got a text message today about how you, how do you do after you get injured, how you not take a pill? It's so painful. Like, well, it actually stops you from healing faster. It makes it a longer healing process. And it, and I told him pain is temporary. Addiction is a lifetime. So it's easy to say no to take ibuprofen. That actually kind of takes the pain away. yeah, so I just use my Instagram and Facebook's platforms to talk to people. And I have a little community of people. I text every day. We text our sober days and just, keep each other accountable.

Bianca McCall: So I love that, I love the texting of the sober days. and I also, I love the concept of, you know, we need to initiate more conversations around holistic pain management, you know, and your story, the reason why, I mean, it just resonates with me so much. Again from my experience as an athlete, you know, I, I, I tell the story all the time about, when I, I sustained an injury, you know, ahead of, of being able to select any college or university that I, that I wanted to go to, I sustained an injury. And I remember, that fall from grace, that loss of identity, you know, that, that my worst nightmare of I'm never going to be accepted, if I can't perform, never going to be loved and adored if I can't perform. And I recall the surgeon, I had to repair my acl, my mcl, my meniscus. And the surgeon says here, Bianca, here's a black button. You don't need permission to be out of pain. And those words were just so profound to. Then I was 17 years old, Ryan, at the time. And I just remember, again, that the. That culture around performance is that, we want pain to be not just temporary, we want to be able to cure it right away, almost immediately. Right? And so giving permission to not be in pain for an extended period of time, that sounded like all of my hopes and dreams were being fulfilled in that moment. but not being able to wrap my mind around the, the fact that I was introducing into my body for the first time some serious stuff, right? Some. I'm not going to curse on the podcast, but, you know, serious drugs that would change, you know, my internal makeup and how I handled, stress and anxiety and depression and all the things it, would change that way for the rest of my life. And so I, I'm such a huge proponent and, admirer of your message to. Let's have some conversations about how do we, manage pain more holistically. Right. And how do we complement, pain management with a strong support system that we could hold each other accountable while also sharing in those courageous conversations. Confronting pain when with compassion.

Ryan Mills: I got two for you right now. So two years ago, I had tendonitis in both elbows so bad I could. I couldn't ride anymore. I was, I was like, it's, it's over, it's over. There goes my. My therapy, my BMX therapy. It's gone. so I got in the gym, where a lot of people would maybe have relapsed and gotten. It was a lot of pain. But I watched a year worth of YouTube videos of how to alleviate pain from tendonitis, and it was all gym work. So I got a gym membership and worked it out, and now I have no tendonitis. It's a year and a half later I'm riding bikes. It's. So there's a holistic way to do it. And then next week I'm getting. I decided to go on a health kick and get everything fixed. I need to get fixed. So I had this deviated septum, and it's been bad, hard to breathe. when I'M sleeping. And it's just been like a, a pain for a long time since nine years ago. so I'm getting that fixed next, Wednesday and today the pharmacist called me, in my town, my Boulder City small town. They, they all, everyone knows I'm sober. So the pharmacist called me and said, hey, they prescribed you Norcos. Is this right? I said, no, no, no, no. Hit them back up and have them give me ibuprofen 800. I'm only going to take it for two or three days and then that's it. I don't need to get on the Norcos again. Come on. And I've also had wrist surgery, I've had a broken hip. All just ibuprofen and working out to fix it.

Bianca McCall: So, well, first of all, congratulations. I don't want to miss the opportunity to congratulate you on your promotion in the profession in the professional, space. Right. But also your promotion in, your self care, space. Right. Because that's something a lot of us, again, it's not talked about, how difficult it is to then care for yourself, love yourself, nurture yourself, fix some of the things, right? Pay attention to your, your physical health, your mental health. Shout out to, June being, men's mental health. Right. Month. And so, for me, this is, this is a huge celebration for you, Ryan, that you've promoted, you've been promoted to actually caring, loving, pouring into yourself, right? So this is amazing. This is amazing stuff. Thank you so much for sharing.

Ryan Mills: And that's another thing is you don't really realize, it takes a couple years after getting off of opioids to feel okay. It, I mean, you feel, you feel maybe 70% okay the first year or two, but took me quite a few years to get to the right weight again, get to eating right, get to like tons of stuff you have to work on. And it's a slow burn and it's a step by step, but I feel better than I do now at 40 years old than I did at 25.

Bianca McCall: So that's awesome. That's awesome. And thank you for also bringing a voice to. Yeah, it's a slow burn, it's a slow process, right? that takes years. There are no quick fixes, there's no quick fixes in recovery. And so, it's so important to be able to have platforms and share in these conversations, with your unique lived experiences. and so I want to know, how can professionals in the prevention in the diversion spaces, how can community stakeholders, in the recovery spaces, how can they connect with you? And then can you also let us know, like, why is it so important to integrate lived experiences like yours into, the recovery journeys at any, at any space or any stage?

Ryan Mills: yeah. The importance of having people that have been there with lived experience is number one, I think. people don't want to listen to people who are just there out of a textbook. I heard that many, many, many times in drug court and counseling. Tons of people just, I'm, not listening to you. What do you know? but they listen to people that have experience. I go to Westcare here in Vegas and do talks, all the time with the newcomers and they're always just like, that was like, way better than the other people that came here. And we're just like talking and listening to their stories and trying to give them help and advice and what their next steps are. And it seems to be a lot more important than what the high paid PhDs are getting. Yeah, and if you want to connect with me, you can do it through Instagram or Facebook. it's, it's Ryan Mills is the, the Instagram, and just Ryan Mills on Facebook. So I love it. R Y A N M I L.

Bianca McCall: L S I love it. I love it. And Ryan, I also love what you said about everybody in town knows that I'm sober. I, I kind of saw that on a T shirt. Like, everybody in town knows I'm sober. Right. and so it's Ryan Mills or at Ryan Mills on Facebook.

Ryan Mills: Yeah, that's it.

Bianca McCall: Yeah. Awesome. Awesome. Thank you so much. And, and, and Ryan, you know, as we kind of come to a close with the podcast, I always like giving our guests an opportunity, to, ah, speak to the ones or perhaps the just one that's out there that your message really resonates with. So speaking to that one person out there who you hope hears this conversation and not just listens to it, but hears the conversation that we had today. What do you want to say? What do you want to resonate with that one person who needed to hear from you today?

Ryan Mills: I, I always just do that you can do it thing. It's, it's. There's hope, there's all that stuff. But just today, the guy reaching out to me, I, I'll read the text, actually. I told him, damn, dude, you got this. Worth it. In the long run, this part of it will be a small blip of memory soon enough. And he's just. I appreciate that. that's over. Him not taking painkillers for the first time on an injury and trying to get off Xanax at the same time. So it's. You have to tell that to everybody. Is you. It'll be over soon. This hurt. This, like, nasty feeling or feeling. I don't even remember mine in that. It was nine years ago. And it's just. I was running from that, afraid of that feeling for so long and not wanting to go through that for years when I could have just gotten it over with and it would have been a memory. And I, regret not doing it sooner. That's probably the only regret I have in life. So.

Bianca McCall: Make it a memory.

Ryan Mills: Make it a memory.

Bianca McCall: I love that. Make it a memory. You can do it. The famous words of Ryan Mills. You can do it. But I love that, extensive piece. Make it a memory.

Ryan Mills: Yeah.

Bianca McCall: Ryan, Ryan, Ryan. Thank you so much for joining us today, for sharing your journey with such honesty and heart, your perspective as an athlete, as a survivor, and now a public health professional. It brings so much depth to the conversation around recovery, and we're grateful for the work that you're doing and the lives that you continue to impact, including my own, sir. Thank you.

Ryan Mills: I really appreciate you guys having me on here, so.

Bianca McCall: No, absolutely. And I'd love to. I'd love to even have you back and, and check in, and. And to be able to. To share with, with our communities. You can do it. Let's make it a memory. In addition to those, any last words of wisdom, a, ah, projection of your reflection that you would like to share with us.

Ryan Mills: I just want. I don't know, I just want everyone to, to get out of this era of fentanyl and opioids and drug use. And we're in some crazy times right now politically, and I just want it all to just even out. Let's get on the other side of all this and become, humans again, please.

Bianca McCall: For sure. For sure. Well, my friend, in the fight, you know, we. That's what we're here for. And, we will continue our commitment, to moving us beyond this era. And, And I appreciate you again. thank you so much for, for being a part and leading from the front in this movement. So with that being said, that wraps up this episode of the no Stage Dose. And if today's conversation gave you something to think about like it did me, it gave you something to feel or something to act on. Go ahead and subscribe. Leave us a review. Share this episode with someone who needs to hear it. Until next time, stay grounded, stay human, and be well. Thank you for listening to the NOCE 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 www.nvopioidcoe.org. the NOCE Dose Podcast is brought to you by the Nevada Opioid center of Excellence. 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 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 www.casat.org.