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. All right, welcome to the Nostos brought to you by the Nevada Opioid Center of Excellence at NV Opioid coe.org.

I'm your host with the NOCE, Bianca D McCall going ahead and, and, and hit that subscribe like or comment button right now to disrupt the algorithm and bring more attention and insights to these important conversations. The Nostos we launched with a mission to celebrate the Nevada strong and communities in this great silver state, saying no to silence and fighting the good fight to prevent the tragedies experienced by our loved ones, our families, our friends and communities impacted by the opioid epidemic. And today, we are tackling the digital frontier. In our recent listening session, we brought together 4 absolute Titans to map out the intersection of high tech innovation and the deeply personal landscape of recovery.

And we talked about automated empathy, about GPS, Geo fencing, virtual reality tech and interventions, and the ethical nuances of training these algorithms on lived experience data. But we only scratched the surface. So today we're going to go behind the scenes, through the screens, if you will, for an exclusive one-on-one recording session with each of our panelists to ask the tough, unfiltered follow up questions that came out of that main session. So grab your coffee in Nevada, your tea, your matcha.

Let's get into the deeper dive. And our special guest for today is Sam Demello, the founder and CEO of Evive. Sam, thank you so much for joining me today. How are you holding up?

And and since the listening session, tell us how is your life's story been developing? Thank you so much for having me on. Being on the listening session was great. I would say the biggest change in my life in the last couple weeks is that the sun came out in Massachusetts.

We got about 10 weeks a year that we got to hold on to, you know, squeeze the most out of. So I've been on the beach as much as I possibly can. Oh, that's beautiful, the sun coming out in Massachusetts. Now I'm a, I'm a basketball fan.

You know, it's no secret to to those that have listened that have followed that, that know me well. I'm a huge basketball fan and I happen to know the state of Massachusetts and in Boston specifically, y'all got a, a pretty good team. And so, even if the the the sun's not in the sky, that the sun's out, you know, most seasons, and I know this season fell a little bit short, came up a little bit short of of that, that championship run. But but thank you so much for for joining.

You know, usually, and, and I was telling you this before, you know, usually we we like doing an introduction. You know, I'm a big introduction gal, especially, you know, playing basketball. I'm I'm used to coming out the tunnel high fives, you know, and six one from Santa Rosa, CA right. So introductions are important, you know, and in my world.

But but today I want to do something a little bit different. I want to give you some time and space to tell your story because the first time that we met, I I was blown away, Sam, I was blown away. And it's an experience that I want our listeners to be gifted with and inspired by just the same. So.

So Sam, you know, tell us, how do we how do we get here? Yeah, the. $1,000,000 question OK, so who am I professionally? I've been working in the technology sector for last 16 years or so.

I'm originally from the Bay Area. I started, you know, in consumer tech in Silicon Valley, joining like Series B startups and helping them scale. I did that for about a decade and I loved it. I thought it was really cool the way the technology could empower people to do more.

I worked with a lot of small business owners. I worked at companies that helped small business owners make websites and sell more things, and I generally felt really good about the work that I was doing. And then in 2020, I moved to Boston, MA with my fiance and I took a job at a digital therapeutic company called Achille Interactive, which was something completely different for me and something pretty different in terms of technology. They made a mobile video game that was approved by the FDA and prescribed by doctors to treat ADHD in kids.

And my level of fulfillment just went through the roof. You know, What do you mean? You can use technology that video game companies use to take money from people and instead use it to support them and help with their behavioral health and their overall well-being. I, I became hooked.

I, I became a huge proponent for digital therapeutics and I, I really threw myself into the industry, probably more applicable to NOCE. And our talk is personally, I'm in recovery from a gambling addiction and I've now been in recovery for about 6 years. And it's always funny for me to come on a podcast and talk about it because for most of my life, that was like the biggest, deepest, darkest, most shameful secret of my life, nobody knew. And I think that's one of the things about gambling addiction is it can be really easy to hide from other people.

And I would argue even yourself, you know, we've normalized gambling. It is everywhere. You turn on the TVA, sports game, a casino, God forbid your social media feed and it is just gambling everywhere. But the conversation around gambling problems or struggles is not something that we have very often today.

And I, I think it's an important one. My history with gambling, unfortunately, is not particularly unique. You know, I have a very cookie cutter story for men my age. I will be 40 next year.

I, I don't know if I'm going to take Flack for this. I guess that makes me coming into middle age. I certainly feel like it. I started gambling when I was 12.

I started by playing poker at a neighbor's house. And for me, growing up, I was kind of an uncoordinated kid. A lot of my friends were really into sports. I was never particularly competitive on the sports field.

But when I sat down at the poker table, it was just this just kind of sacred place for me, right? I was always good at strategy. I was always good at cards, and it became my entry point into being one of the guys, you know, into masculinity. And I played early and I played with neighbors and older folks and not for a lot of money.

And then when I was 15 or 16, amateur poker player named Chris Moneymaker won the World Series of Poker. And it kicked off what we now call the poker boom. And all of a sudden all my friends got into it. And then I got really serious about it because now I was doing something for the first time that I was good at that my friends thought was cool, right?

And that was huge for me. And I played poker through high school. I played poker in college. I went to UC Santa Barbara, which is one of the most beautiful campuses in the entire world.

And I spent most of my time in a smoky casino card room about 45 minutes away, you know, instead of my classes. And I graduated from college, and I moved to Sao Paulo, Brazil. And I did not speak very good Portuguese. And again, poker was a lifeline for me.

It was the way that I made friends. It was universal. It got me integrated into, you know, groups of people. And for all of this time, you know, 12 to 23, I think that there were massive warning signs that I was going to have a problem with gambling.

I couldn't set a limit on the money that I was spending. I was just lucky. I didn't have very much money. I was a young broke student, and I couldn't set a limit on the time that I was spending thinking about or playing poker.

But the way that I looked at it is I graduated, I got my degree. I brought it back to my mom. I gave it to her. I was like, here you go.

You know, I did the thing. It wasn't, it wasn't keeping me from other things, right? It was just a hobby and everything really changed for me when I got introduced to online gambling. That was at about age 23.

I moved back from Brazil. I was looking to reconnect with my friends. I went to a bar to watch a Golden State Warriors game. Part of the reason I have a hard time rooting for the Celtics is that I grew up a Warrior.

Friend night. Night, night, night. And I I distinctly remember the first time I placed a bet. I had a friend show me what I know now is an offshore sports book.

It was called Bovada. I put $5 on the Golden State Warriors to win, and all of a sudden I was 12 years old again. I had a reason to belong. I had something to talk to my friends about.

I was part of the circle. And I think a lot of times we talk about sports gambling becoming this like evolution of fandom, especially with young men, right? For me, I, I wasn't a fan and that's actually why it worked for me. You know, I didn't want to spend my time in the bar watching sports games, but all of a sudden I could gamble on them.

And that gave me a reason to be there, right? And it probably took 30 days for me to go from that $5 bet in a bar socially to a $200 bet on like, Ugandan women's volleyball at 2:00 in the morning on my phone. And that was it. You know, all of the barriers that had existed between me and my ability to gamble disappeared instantaneously, right?

I could use a credit card so I didn't have to go back to the ATM, and I didn't ever hit my ATM limit. My friends didn't see what I was doing on my phone. If I went to a casino to play cards with my poker playing friends, they would have said, what are you doing sitting in front of a slot machine? Man, that's a suckers game.

But nobody could see what I was doing on my phone. And probably the biggest thing, I didn't have to drive 45 minutes to get there, right? It was in my pocket 24 hours a day. So I started my journey with sports gambling and my career with technology took off and I started making more money than I had ever made.

And I started gambling more than I had ever gambled. And it just got worse and worse and worse. And at first I didn't really understand what was happening because I, I had no language for gambling addiction. I didn't know you could be addicted to it.

My parents sat me down when I was 16 and they were like sex, drugs, don't do those things. Here's a poker table. Go to the basement. What's the worst that's going to happen, right?

It, it, it wasn't even on my radar as a problem, but I started to lose and I started to chase and I started to lose more. And then I started to feel embarrassed. And then it got to a point where my paycheck was coming and my paycheck was already going out the door. And as I lost more and more control of my gambling and it took up more and more of my life, it just made me feel ashamed and isolated.

And I didn't want to talk to anybody about it, and I didn't want anybody to know. And it created this dissonance for me where externally to my friends and my family, I looked successful. I was getting promotions. I was, you know, doing things that I could control as a way to try and, you know, fix my gambling.

Like, I started running. I started running marathons. I started working out. And everybody would come up to me and be like, man, congratulations, you're doing so well.

We're so proud of you. And I would just think, oh, twist the knife, right? I am a fraud. I, if they knew what I was experiencing, they would not say these nice things about me.

And it was that way for years of my life, right from 23 to probably about age 30. And then when I got to be 30, I started looking around and I saw my friends buying houses, getting married and having kids. And I just kind of took a step back and looked at my life. And I said, OK, I don't have any more money than I had when I was 23, even though I've been working my tail off for seven years.

I've no savings, I've no real relationships. And more than anything, I I hate myself when I look in the mirror. I just do not like the person that's looking back at me. I'm going to stop.

I got to stop gambling. It's causing me a problem. Like I'm done and I couldn't. I tried and failed to quit just cold Turkey probably 50 or 60 times.

And I thought that it was a problem of willpower. And it was funny for me because I am someone with a lot of willpower. I've done a lot of things in my life that people say, oh, man, you can't do that. It's like, yeah, OK, cool, watch me, right?

But I I couldn't do this. And so eventually, after this cycle of trying and failing and slipping and feeling terrible about it, I said I need to find some professional support. And I opened up Psychology Today and I found a counselor who specialized in gambling addiction. And I walked into their office and I said, hey, I, I have a problem.

I, I gamble too much. And they said, cool, tell me about your traumatic childhood. And that just wasn't me. You know, I, I'm a very stereotypical cisgendered white dude, middle class, well educated.

I grew up in a place where people had a hard time and I was very aware of my privilege and I just thought, man, this is a problem for people with real problems. I am being a baby. And they sent me to Gamblers Anonymous and I was the youngest person in the room by 30 years. And I was talking about my cell phone and these guys were talking about the horse track in the 1980s.

And I felt very unseen. And I forced myself to do those things for about 6 months 'cause they were the only things that I could find to do. And eventually I just got to the point where I said OK. Like I am an addict.

I am paying this therapist $100.00 an hour and leaving her office after lying to her and gambling on my phone in the elevator on the way out. Like clearly I have a problem but I can't fix it and these things aren't working for me. I must be uniquely broken and I just have to manage this addiction for the rest of my life. And that kicked off probably the worst 18 months of my entire life.

I started drinking more. I started using other drugs. I stopped sleeping. I became even more socially isolated.

I started struggling at work. I, I could not keep it together. And eventually I got very, very lucky in that my fiance, who I proposed to, gave me an ultimatum. She said, I, I, I agreed to marry you.

But something is going on. I don't know what it is, but 90% of the time you're great and 10% of the time you're this totally different person. You need to tell me what's happening or we're not going to get married. And that for me was rock bottom, right?

I, I very deeply recognized if I choose gambling over the future that I want and this person that I love, life is not worth living. So I'm going to quit and I'm going to do it for her. And if I fail to do it, that's going to be the end of the road for me. And I'm I'm going to end things.

And I got lucky. I had a very supportive fiance. When I opened up to her, the first person in my life that I'd opened up to, she said, OK, I don't know anything about this, but people figure this out and and we're going to figure this out. And I'm here to support you.

And that changed everything for me. You know, it broke the isolation. She started feeding me information about the neuroscience of gambling. I started to understand when I gambled, I was putting drugs into my brain.

That changed my perspective and the way that I operated in the world. And I think it separated my addiction as my identity from, you know, my addiction as something that I was dealing with, right, that I really was or could be the person that I wanted to be. It was just buried under this addiction. And I had to deal with that instead of just being this like morally bankrupt, broken person.

And I stopped gambling. You know, I, I put in a bunch of different barriers. I gave up financial control. I did a lot of work and my life got immeasurably better.

And for a long time, I didn't expect to do anything with my experience. I I didn't want to do anything with my experience. I didn't want to be a figurehead or an example. I sure as heck didn't want to be on a podcast talking about it.

But I I made a a fateful mistake in March of 2023 after being laid off from my job and having my wife be laid off from her job and knowing that I needed to do something to strengthen my recovery. At that point, I ended up sharing my story on Reddit anonymously. All of the things that I experienced and what I did to keep myself sober. And that post ended up going viral.

And all of these people started reaching out to me and saying, man, your experience is so resonant with me and I struggled with the same things. And what do I do? Could I talk to you? Would you be my recovery coach?

Which I just laughed at? You know, I, I wasn't certified in anything at that point, but it was this moment of clarity where I went, oh, I'm not alone. I'm not uniquely broken. Like this experience that I had is shared by tons of people and we need to show up for them and we need to do something so that they don't end up where I did.

And that was really what I've been doing for the last 3 1/2 years with Evive is continuing to, you know, peel back the layers of the onion around gambling addiction in the United States and trying to show up and help other people. I love it, I love it. And we're going to, we're going to get to to talk about Evive here, you know, throughout throughout today's conversation. But but Sam, I and and I know that those that are listening are, are, are feeling the the same ways that I did.

You know, the first time that we met and I heard this story, you know, I instantly became a a huge fan, number one, top five fan of of you as a storyteller. I know that you say that it's it's not an uncommon experience for men and for men your age, but but just in the ways that that you realize kind of finding a purpose, right, meaning and and purpose and then and launching evive. And, and creating that resource for so many across the, across the country, it's remarkable. It's, it's incredible.

And I'm so grateful that that you shared it. And, and you know what, what's interesting when you, when you talk about problem gambling, it's, it's such a unique space, right? Because compared to other dependencies and addictions, opioids, alcohol, substances, psychological pain, you know, the, the, there are consequences to your physical body. You know, there's a physical representation of that dangerous relationship.

And there's a clear pathway to diagnosing those problems with those issues. But when the, when we see the bigger problems as lack of finances or lack of social belonging, lack of purpose, lack of control, gambling or, or taking a risk to improve those circumstances, that tends to get swept under the rug, right? And, and, and so the underlying complexity is the comorbidity with financial problems, isolation, existential crises, dangerous relationships with alcohol and substances and significantly escalating those risks for overdose and, and for suicide. So, so Sam, you know, during the listening session in a little bit here, you've talked about how the 90% of problem gamblers who never reach out for help, they suffer in absolute silence and secrecy.

So now that Evive has active state contracts across the country, like I mentioned, what does, what does some of the data, some of the anonymized data tell us about when and how these hidden users are interacting with your platform And, and what are some of the green flags that show a digital tool is successfully breaking through those those experiences of denial before they hit a financial ruin? Yeah, totally. So I'm going to start a little earlier and just like I think it's important to lay out what exists today to understand what we're what we're trying to build as as an alternative fright or or an amplification. So today if you struggle with gambling, most likely you were never going to reach out to any kind of state funded system.

And it's not because they don't exist, it's because we are not marketing them and the channels for engaging people are not very resonant. With it being 2026, there is no federal funding for gambling addiction or resource or support. This is compared to billions of dollars that we put into substance use disorder. So what this means is that there is no federal body that overseas gambling support in the country.

There is no kind of universal safety net. Every state has its own system and they all exist in silos. They do what they do in their state. So if you live in Massachusetts, where I live, we happen to have the most money per capita of any state in the country.

There's about $40 million in a public health trust fund that funds things like treatment services and peer support and in person residential treatment. For example, if you live in Texas, they have $0.00. There are three certified gambling counselors in the entire state of Texas and two of them are married to each other and live in the same house, right? There's not a lot of reach.

So your access to support first relies very much on who you are and, and where you live, right? And God forbid you don't speak English, right? Otherwise it's even more challenging. The second thing is the main entry point into the support system is A1800 phone number.

It is a helpline. It was 1800 Gambler and then recently it was rebranded to 1800 My Resets. And you've probably seen an ad at the end of a DraftKings or FanDuel commercial. Do you have a gambling problem?

Call this phone number. Well, there's a couple challenges with this one. Most people in general do not want to pick up a phone to get support for anything. Like, I don't know, Bianca, when was the last time you willingly called customer support for a product?

Never willingly, no. Never willingly. And two, there is so much shame and stigma and, you know, just general confusion when you're experiencing A gambling addiction, it's a very big request to ask somebody to pick up the phone and say, hey, I have a gambling problem or I am a problem gambler. Help me, right.

And So what ends up happening is that across the country we engage less than about 1% of the target population that needs help. They don't call the helpline. Maybe they do an online search, but it's very hard for them to find things. So when I looked at this, I said, man, isn't that a great use of technology?

Couldn't we make the entry points to the system anonymous and stigma free and personalized for the person that needs help? So that instead of them calling a helpline and maybe receiving APDF with 100 different resources in their state that they then have to go through, we could make a personalized recommendation based on what we know about them and give them something that really fits their life? So we started Evive about 3 years ago and it really started as a mobile application. And one of the things that was really important was that we didn't want a member to have to identify as anything to use Evive.

They didn't have to identify as a problem gambler or an addict or someone with a gambling problem. It's part of the reason that we called this thing Evive and not stop gambling today, right? If you downloaded it and it was on your phone, nobody would know that it you know what it was. So when we first launched, there was a pathway for people that wanted to stop gambling and they wanted abstinence.

And a lot of people do. That is the recovery community that that is the choice that I have personally made. And we help those people. We help them build recovery capital.

We educate them. We do daily journaling activities rooted in cognitive behavioral therapy. We help them understand what's happening in their life. We connect them with a community of other people that are on the same mission.

We facilitate peer support groups. Think of it as digital peer support in your pocket 24 hours a day that is personalized to you. But very quickly in looking at the data, we recognized most people that choose abstinence. They're doing that after eight years of getting to rock bottom, just like I did, right?

When I was 27 and I was gambling and I knew that it was causing me problems. I wouldn't even consider abstinence. It was my entire social life. It was everything I did with my friends.

It was the subject of every group text message with my buddies forever, right? Abstinence was terrifying. And with the gambling problem, you know, unlike other substances, every gambler has a fantasy that they're going to win the jackpot and all of the pain and suffering and financial harm that they've experienced over the last decade is just going to magically disappear, right? So to choose abstinence and say I never want to gamble again, it's a pretty big bridge to get someone to cross, right?

You have to really see the other side of it to to make that decision. So we adapted the product and we launched A pathway that we call Manage My Gambling. And this is really modelled off the sober curious movements. You don't need to be a problem gambler.

You don't need to be an addict. You don't need to do a a Screener and, you know, test yourself. We don't need to analyze you. All you have to do is say, I don't like the way that gambling is showing up in my life.

You don't even need to stop, right? You're spending too much time, you're spending too much money. Your girlfriend doesn't like it. Great.

We will help you learn more about gambling. If you can find a way that gambling fits into your life and you can do it without problems. Good for you man. I will support you.

I am not anti gambling. I am anti gambling problems, right? And this is what we found. All of a sudden we started marketing.

The product is something that anybody could use. That was gambling. And we started getting people to engage with it. And what do you know, a subset of those people moved themselves to abstinence.

We didn't have to tell them to stop gambling, right? All we had to do was say what is your goal? My goal is to control your gambling. Cool, this is how you're doing in controlling your gambling.

Does that feel right to you? No. OK, cool. Why don't you try to stop, see what it feels like, Do a sober October.

What do you know? They're finding that abstinence isn't so scary. And then in looking at the data and talking to people and engaging with the community, we learned. And by the way, this is all vetted out in the data.

I'm just in my own personal discovery as a non researcher. What do you know? The person placed in the bed, well, they have a ripple effect of harm that they're causing to their families, to their friends, to their parents, to their spouses, to their partners, to their friends, right? So we launched A pathway for what is clinically called affected others.

I hate that term. Nobody wants to be othered, right? So I will call them family and friends. But if you're with someone who's struggling with gambling, it's very difficult to a figure out how to help them.

You might not know what gambling is. We especially see this with parents, right? Yeah, I know gambling. You go and play blackjack.

Wait, what? What do you mean that my kid is playing a video game and gambling on loot boxes? What do you mean that he's gambling on a live traffic feed of how many red cars are going to cross this intersection in the next 30 seconds? I I wish I was joking.

These are very popular gambling activities today. And so it starts by educating the family system on what they can do to support, you know, their loved one and then gives them support as well because, you know, they're also affected by this and, and they, they need help. So this is really how Eva Eva has evolved. And our goal is anybody who gambles, anyone who is impacted by gambling, whether you want to stop doing it all together, you want to cut back and reduce it, you want to prevent harm before it starts.

If you want a better relationship with gambling, you show up and, and we help you. And one of the things that was really important to me was that it's completely free. I, I never wanted to charge people who needed help. I, I think in general, I, I don't like doing that.

And especially in this population, if you're struggling with gambling, most likely it's affected your finances and, you know, seeing finance as a barrier to entry. We know that gambling disproportionately affects the most vulnerable, you know, parts of our communities. I wanted to show up for them. So the way that our business model works is that we sell the platform to a state public health department, and they subsidized the cost of the platform.

It becomes customized for the state. So any resource that you would get from calling the 1800 Gambler phone number is immediately available at your fingertips. You don't have to talk to anybody, and you can still go through and find counselors and peer support and financial assistance and all of those things. And because we have this digital ecosystem, we can pull this really interesting data and give it to the States and help them design better systems, right?

Who is showing up in need of help? Often times it's different than what you would expect. What resources do they need to engage with what communities are out there that are being totally underserved and and need more support? These are the kinds of insights that we can, you know, help give to the system.

And so Evive in the first year was really an application company and then in the second year we kind of became a technology company. And now in this third year, we're really becoming consultants, right? We're really helping to improve the system at large, and it's one of the things that, you know, you mentioned a little bit earlier, bringing lived experience to the conversation, I think in this field is so incredibly important, right? I'm not just advocating on behalf of my own personal experience, but of this community of 10,000 people that have their own experience with gambling, right?

How do we take these folks who've lived it and walked through the fire and take their feedback and their messaging and, and their brilliant ideas and get that to the people that are writing public service announcements, right? Get that to the people that are designing programs. I, I firmly believe that communities need to advocate for themselves. And one of the things that I'm really passionate about with Evive is, is putting lived experience at the center of the conversation, right?

We we need to be in the room. Yeah, no, gosh, absolutely. And and you know, as you're as you're talking Sam, I'm, I'm, I'm thinking about gambling in, in sports and, and how much are shared, you know, how much run parallel between gambling and sports. And, and for me being a, you know, retired athlete, I'm just seeing all of these, all these parallels, right.

Gambling and sports share this envelopment of, of superstition and, and ritual. There's preparation to, to go out and compete, whether it's us V them home VOA or US versus the house. You know, we're, we're preparing for that, that competition just the same. And, and something else that, that we share is that you can't tell an athlete that they're injured.

You know, we, we may be hurt, you know, but, but when we're hurt, you, you make adjustments, you rest, ice, compress, elevate, you push through from being hurt. And with gambling, it's the same thing, right? You can't talk about being hurt. You can't talk about the losses.

You may be down momentarily, but but you make adjustments and, and you keep going. And so as I'm, as I'm looking at this, we, we almost have to, I think, you know, two things that resonate. One, lived experience is paramount, you know, and, and how do we intervene with a, with a cultural responsiveness that speaks the language right? For, for, for athletes.

I want to talk to other athletes, you know, that have, that have been through the trenches that, that know that level of, of competition, that know that level of preparation. I believe that, that I understood, right. I, I'm, I'm less likely to be existentially isolated if I know that you know, what it's taken to, to get here. Same thing with, with gambling, right?

The lived experience is paramount. And then also something that you said was deferring and referring to, to the numbers, right? And so in the data. So let's talk numbers and, and you said that we're reaching less than 1% of a problem gamblers.

And, and in another way that 1% has has shown up in this conversation during the listening session. I believe that you said that your work is, is, is really about getting 1% better each day day, right. And, and, and the data it shows that up to 10% of patients experiencing opioid use disorder are also dealing with severe comorbid problem gambling and it's the highest suicide risk category. So when a person is, is standing in that high acuity cross section of both opioid use and gambling addiction, you know, what does, what does a 1% shift really look like or what does it look like practically?

And, and how do you, how do you gamify these micro steps towards safety when someone's in an active crisis? Yeah, totally. All great questions. So I think starting with Co occurring conditions, right, If I start with my own personal experience, it was about at age 30 after I had tried counselling and I had tried Gamblers Anonymous where I recognized that I was a addicted to gambling, but I could not seem to fix it.

And that's when I started to self medicate, right? I started to drink more than I had ever drank before. I started to use cocaine first recreationally and then you know, more than that. And it was these activities that ultimately had the kind of physical symptoms that got me found out, right?

I, I stopped sleeping. I started struggling at work. This is eventually what made my fiance say, hey, man, what the heck is going on now? At that time, if you would have came to me and said we need to address your drinking or we need to address your, you know, cocaine, but didn't talk to me about gambling, I don't think that I would have actually gotten better, right?

They were coping strategies, unhealthy ones that I was using to cover my primary issue. And we hear this all the time from people in our community. I was in and out of rehab three times and they asked me if I was suicidal or if I did other drugs, but they never asked me if I gambled. And so I addressed the drug use.

I went back, I kept gambling, it got darker and I went back to drugs, right. So if we're going to look at someone's mental health or their experience with substances, we need to include gambling on that list. And a lot of times when I talk to substance use disorder counselors or community health workers, or, you know, a great example is counselors on college campuses, I say, hey, are you guys hearing about gambling? Nope, we don't hear about it at all.

Do you ask the questions? No, I go cool, you should. And then inevitably they come back to me three or four months later and they go, Oh my God. We started asking about gambling and it's showing up everywhere.

Wait. One of my favorite stories is this college counsellor was like, man, I had a kid come in. He got into a fist fight with his roommate and he was drunk and we sent him to alcohol counselling and I went back and I talked to him and what do you know, he'd lost $10,000 on the Bruins game that night and came back and was drinking his sorrows away and got into a fight. It was right there, right?

So you're right, the date is very consistent. People that struggle with other things often times struggle with gambling. And we currently have a project in Nevada called Grasp, where we've built a custom version of the Evive app that addresses opioid use and amphetamine use disorder, in addition to gambling to both help people that may be struggling in the moment when they're trying to get off of other substances. And gambling could hurt the foundation of their recovery, but also to prevent people from addiction switching, right?

If you've ever gone outside of a medically assisted treatment facility, you've probably seen a lot of people standing outside smoking cigarettes and scratching lottery tickets, right? It's a very easy thing to to fall into, right? So I think on the substance you side, we need to be asking the question and on the gambling side, we need to be asking the other questions, right. You don't want to give up gambling and start drinking your, your sorrows away in terms of how do we show up with this 1% better mentality?

You know Evive does not ascribe to any particular dogma or solution, right? Like it is not a 12 step program. It is not a SMART Recovery program. I personally don't have skin in the game right?

Like I, I don't care what you do to get better. The goal of Evive is to make our members aware of all of the different options that are available to them and help them chart the path that works for them individually. Because if you have 100 people in a room that need help with gambling, there are 100 different things that they can do. And sure, they fall into categories, but getting into recovery is about finding your own system, right?

And I will steal blatantly from one of my colleagues and best friends, Christina Cook, who runs the Broke Girl Society, which is the largest women's focused gambling support group in the world. She says recovery from gambling addiction for me is about building a life that I don't want to escape from. And I would say this is how we frame it to most of our members, right? They come in with this desire of I don't want to do X, right?

How do we take that and move that to because I do want to do Y, right? And I want to be this person. So we help them understand what their value systems are and the impact that gambling is having and what it's taking away from them. And then we try to help them facilitate new things that build the life that they want to live.

Whether that's other activities that take the space that gambling used to take, whether that's, you know, deeper self knowledge and better coping skills so that they can manage stress. Whether that's helping them with communication and, you know, kind of coalescing their support system so that they can have a better relationship with their family. I think it's about turning people from this act of avoidance into this act of growth and helping them, you know, live this life on their terms. Yeah.

Oh, I love it. I love it. And you said it's grasp, GRASP, grasp exposing addiction switching and, and, and, and I love that. And we need to be asking the questions to expose more of what's happening under our Nevada nose, right?

And, and bringing these issues to light and dispelling some of these myths that we may still be holding on to, that may be kind of holding us captive with these dangerous relationships with not only substances, but, but also, you know, these activities, these behaviors that, that we may be kind of engaging in to, to self, soothe self to, to address, you know, other issues that are going on in, in our lives. And so, and, and Speaking of myths, Sam, to close out the, the listening session, you wanted to put a specific myth to, to rest and, and, and let's get, you know, let's get straight to it. When we talk about technology and when we talk about, you know, applications and app alone, it can't save someone, right? And, and so I'd like for you to, to kind of tell us in these, in these, you know, final moments for today is what, what's the hardest truth about the limitations of digital health tech that the industry keeps trying to kind of gloss over with a smooth user interface, you know, like the the bells and whistles, but something that, you know, perhaps Evive, you know, this is the space that that, that it fills the, the void that it fills for those that are into the digital health tech.

So, so, So what are some of the what are some of the limitations that that you're addressing with evive that the industry as a whole is is kind of, you know, glossing over with, Hey, this is cool, you know, this is cool technology, cool new technology. Yeah, I think so. One of my biggest challenges in selling Evive to states is that they said, OK, you're just going to replace us with an app, right? Or counselors, you're just going to replace us with an app.

And every day I have someone that says here's a chatbot, right? It's trained on everything about gambling addiction. We'll have people talk to it, man. It'll be super effective.

Again, like any good artist, I'm just going to steal and I, I will tell you something that Doctor Tim Fong, who is on our scientific Advisory Board, said on an interview the other day. We asked him what is the thing that people get wrong about gambling addiction. And he said they think of it as a, as a brain disease when in reality gambling addiction is a condition of loneliness. And I, that really stuck with me right?

The shame and the isolation and the financial consequences and all of these things, it just leads people to become extremely isolated. And I was personally isolated from everybody. I was in the room, but I wasn't in the room, right? I, I looked like I was there.

And it was community and other people that understood my experience that was really the antidote to that isolation and enabled my recovery. So I think that one of the things that we get wrong and one of the things that Evive is trying to correct here is technology is an incredible tool. And it's an incredible tool for engaging people. And that is why Evive exists as a mobile app because it can reach into these spaces and it can come and talk to you wherever you are.

If you have your phone and you open up Evive it is there and it is a safe space and nobody needs to know what is going on. But once we engage you, it's not enough to just put you in front of some lessons, right? It's not enough to just give you a chat bot that's going to answer your questions. You probably know the answers, you know, Is gambling good for me?

No, man, it's not. You should stop. OK, like now, what do I do? Right?

It's about the community. It's about using technology to meet people where they are, whether that's a sports book or their living room or into a population that does not speak the language or reach out from outside of their community to get help. It is about infiltrating these spaces, showing up with support, and then bringing them into this community. Whether that community is a couple people in their lives that they get the courage and get armed with the words to talk about their struggles.

Whether it's engaging them with the evive community where they are sharing stories and showing up in in meetings. Whether it's connecting them with a peer specialist or a counselor or a clinician or a financial counselor. It like my main message is you are not alone. Technology can be used to bring you into this community and welcome to the secret club that none of us ever wanted to be part of.

Nobody has to be here, man, but it's way better if if we're all in it together. Yeah. Oh, I love that. I love that.

Reaching out. How, how does one reach out and how does one get connected or download the the Evive app? How does one get connected with you if they want to continue this conversation, Yeah. 100% so you can go to our website, www.getgeteviveevive.com.

You can access the community from the web. Everything is totally free. We have educational content and resources there. You can type Evive into your iPhone or your Android or your tablet or whatever you're using, and you can download the mobile application.

If you want to talk to me, I would love to talk to you. You can send me an e-mail at sam@getevive.com or come into the community and chat with me. And if anyone listening here is a counselor or a community health worker or a preventionist, you know, just going back to asking the question, Bianca, it can be scary to ask the question, right? If you're a primary care provider and you ask someone if they have a gambling problem and they say yes, well, you have to do something about it, right?

It can be a little tricky. So if you have people in your world that are struggling with gambling or maybe send them to us, it does not matter if we have a contract in your state or not. Evive is completely free. There is no subscription.

It will be completely free forever in the United States, around the world. This is about democratizing access to support for everybody who needs it. Oh, I love it. And you know, I, I couldn't let this hour of power go by without being a little disruptive.

And, and a lot of the, the, what I'm seeing is, you know, it's hard for us to ask questions when we ourselves are, are, are hurting, you know, and I, and I always say in, in every single platform that I'm on is, is hurt people, hurt people and hurt people that don't know that they're hurt, hurt people at a higher rate, right. And, and for a lot of us, it's identifying and defining problem gambling, you know, is, is really the first step for ourselves so that we can become safe spaces for, for other people that, that are also experiencing problem gambling. So Sam, thank you so much to our phenomenal guest. Sam, thank you for your insights.

Thank you for your vulnerability. And and if I'm not the number one fan, like I said, of your storytelling, I've got to be top five. But thank you so much for for joining us today. Also to our incredible listeners who have stayed with us in the space, who have challenged us and supported the nostos through all three seasons, thank you.

You are the reason that we say no to silence. You are the reason that we are Nevada strong. Make sure you visit envy Opioid CODCOE dot org. I'll say it one more time, Envy Opioid coe.org to access all of the program references, data, resources, toolkits from today's session as well as the listening session.

Keep supporting each other in Nevada. Keep closing the gap, Nevada, and as always, keep fighting that good fight. I'm your host with the NOCE, Bianca De McCall. Thank you for listening.

Take great care and be well. 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 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. And whether you are a chair, 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 DHHS Director's Office through the Fund for a Resilient Nevada.

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.