Since 2019, Ria has been on the leadership team of the North Carolina Survivors Union's Narcofeminism Storyshare Project, an internationally recognized initiative that uses storytelling to document the drug war's failures and promote healing and policy reform. She has shaped the project's reproductive harm reduction curriculum, which connects personal narrative to systemic change.In 2024, she co-authored "Narrative Disruption: Evolving Narcofeminism Storyshare" in the Journal of Contemporary Drug Policy. Working to further build a global movement, Narcofeminism Storyshare has gained international attention. Including in Australia  and Manchester, England, where she has presented and where organizations have been trained in the Narcofeminism story share approach. 

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Ria is emeritus co-founder of the Academy of Perinatal Harm Reduction and co-author of "Pregnancy and Substance Use: A Harm Reduction Toolkit", the first of its kind, intended for pregnant and parenting people who use drugs, their families, and those who care for them in clinic or in community. She has trained nearly 100 doulas and community birth workers nationally in harm reduction approaches to pregnancy and birth. From 2022 to 2025, she contributed her expertise to the University of Texas's STAT ECHO series, which educated clinicians and service providers across the state of Texas.

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Currently, Ria sits on the American Society of Addiction Medicine's Medications for Opioid Use Disorder (MOUD) guideline recommendations board and Portland's Joint Office of Homelessness Supportive Housing Services Advisory Board, among others. She also serves on the board of the Everly Project, a grassroots mutual aid organization providing harm reduction supplies and street-based services in Portland, where she lives with her daughter. In 2025, Ria was a recipient of Legal Action Center's Edward J. Davis Community Service Award for her work championing against Medicaid cuts. 

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She grounds her advocacy in the balance of evidence and lived experience. Ria strives to ensure her community understands that when systems fail, survival alone can be one of the most powerful acts of resistance.