TEDxMidAtlantic
Michael Botticelli: Addiction is a disease. We should treat it like one
迈克尔·波提切利: 瘾是一种疾病，我们应该像治疗疾病一样治疗它
Filmed:
Readability: 4
1,620,936 views
在美国，只有九分之一的人得到了他们需要的，治疗上瘾和药物滥的疗程。前国家医药政策负责人，迈克尔·波提切利希望结束这种疾病，并以友善、同情和公正来对待有瘾的人。在这个引人思考的演讲中，他鼓励百万在康复治疗中的美国人说出他们的故事，并抵抗药物滥用等疾病。
Michael Botticelli - Drug policy expert
As Director of National Drug Control Policy, Michael Botticelli led the Obama Administration’s drug policy efforts to diminish the consequences of substance use through evidence-based prevention, treatment and recovery support services. Full bio
As Director of National Drug Control Policy, Michael Botticelli led the Obama Administration’s drug policy efforts to diminish the consequences of substance use through evidence-based prevention, treatment and recovery support services. Full bio
Double-click the English transcript below to play the video.
00:13
Twenty-eight years ago,
I was a broken man.
I was a broken man.
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28年前，我的人生陷入低谷，
00:16
And you probably wouldn't be able
to tell that if you met me.
to tell that if you met me.
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如果你遇见我，你可能看不出来。
00:20
I had a good job at a well-respected
academic institution.
academic institution.
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我在一个德高望重的
学校有一份很好的工作。
学校有一份很好的工作。
00:24
I dressed well, of course.
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当然，我穿着得体。
00:27
But my insides were rotting away.
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但是我的内心却在被侵蚀。
00:30
You see, I grew up in a family
riddled with addiction,
riddled with addiction,
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我在一个充满上瘾的家庭长大，
00:34
and as a kid, I also struggled
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当我还是一个孩子的时候，
00:36
with coming to terms
with my own sexuality.
with my own sexuality.
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我对自己的性取向也很疑惑。
00:38
And even though I couldn't name it then,
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虽然那个时候我无法直说，
00:41
growing up as a gay kid
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作为一个同性恋小孩长大，
00:43
just compounded my issues
of isolation and insecurities.
of isolation and insecurities.
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让我有了自我封闭和缺乏自信的问题。
00:48
But drinking took all of that away.
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但是喝酒把这一切都带走了。
00:52
Like many, I drank at an early age.
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像很多人一样，我很小就开始喝酒。
00:56
I continued to drink
my way through college.
my way through college.
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我喝着酒上完了大学。
00:59
And when I finally did come out
in the early 1980s,
in the early 1980s,
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当我在80年代初终于出柜时，
01:02
about the only places
to meet other gay people,
to meet other gay people,
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唯一一个地方，我能够见到其他同性恋，
01:05
to socialize,
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来社交，
01:07
to be yourself, were gay bars.
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来展现真我，就是同性恋酒吧。
01:10
And what do you do in gay bars?
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然而你在同性恋酒吧里做的事情是什么？
01:12
You drink.
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喝酒。
01:14
And I did --
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而且我喝了，
01:15
a lot.
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很多。
01:17
My story is not unique.
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我的故事并不时独一无二。
01:19
Like millions of Americans,
my disease progressed undiagnosed.
my disease progressed undiagnosed.
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像上百万美国人，
我的疾病无法被诊断。
我的疾病无法被诊断。
01:24
It took me to people
and places and things
and places and things
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它让我选择我永远不会选择的
01:26
that I never would have chosen.
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人、地方和事情。
01:29
It wasn't until
an intersection with the law
an intersection with the law
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直到我由此触犯了法律
01:32
gave me an "opportunity" to get care,
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我有了一个“康复治疗”的“机会”，
01:35
that I began my journey of recovery.
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然后我开始了改过自新的旅程。
01:39
My journey of recovery
has been filled with love and with joy,
has been filled with love and with joy,
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我改过自新的旅程充满了爱和快乐，
01:43
but it hasn't been without pain.
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但是也有痛苦。
01:45
Like many of you, I've lost too many
friends and family to this disease.
friends and family to this disease.
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像你们中的很多人，我因为这个疾病
失去了太多的朋友和家人。
失去了太多的朋友和家人。
01:49
I've heard too many
heartbreaking stories
heartbreaking stories
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我听说了太多令人伤心的故事，
01:51
of people who've lost
loved ones to addiction.
loved ones to addiction.
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关于人们因为上瘾失去了喜欢的人。
01:54
And I've also lost
countless friends to HIV and AIDS.
countless friends to HIV and AIDS.
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我也因为艾滋病失去了无数朋友。
01:59
Our current opioid epidemic
and the AIDS epidemic
and the AIDS epidemic
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现在不断增长的鸦片类药品的使用和艾滋病的传播
02:02
tragically have much in common.
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不幸的有很多相同点。
02:06
Right now, we are in the midst of one
of the greatest health crises of our time.
of the greatest health crises of our time.
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现在，我们处在历史上
最严重的医疗保健危机中。
最严重的医疗保健危机中。
02:11
During 2014 alone, 28,000 people
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单单在2014年，两万八千人
02:15
died of drug overdoses associated
with prescription drugs and heroin.
with prescription drugs and heroin.
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死于因为处方药和海洛因
的过度使用。
的过度使用。
02:22
During the 1980s, scores of people
were dying from HIV and AIDS.
were dying from HIV and AIDS.
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在20世纪80年代，很多人死于艾滋病。
02:27
Public officials ignored it.
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政府无视了这个问题。
02:30
Some wouldn't even utter the words.
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有些甚至无法说出那个词。
02:33
They didn't want treatment.
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他们不想接受治疗。
02:36
And tragically, there are many parallels
with our current epidemic.
with our current epidemic.
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不幸的是，这和我们
现在的（同性恋）意识的风潮有很多相同之处。
现在的（同性恋）意识的风潮有很多相同之处。
02:40
Some called it the gay plague.
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有些人称之为同性恋瘟疫。
02:43
They called for quarantines.
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他们呼吁隔离。
02:46
They wanted to separate
the innocent victims from the rest of us.
the innocent victims from the rest of us.
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他们想要将无辜
的”受害者“（非同性恋）和我们隔离。
的”受害者“（非同性恋）和我们隔离。
02:52
I was afraid we were losing this battle
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我很担心我们会在这场战争中失败，
02:54
because people were
blaming us for being sick.
blaming us for being sick.
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因为人们都在责怪生病的我们。
02:58
Public policy was being held hostage
by stigma and fear,
by stigma and fear,
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公众政策被恐惧和不安绑架，
03:03
and also held hostage
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被绑架的还有
03:05
were compassion, care,
research, recovery and treatment.
research, recovery and treatment.
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同情、关心、医疗研究、恢复和治疗。
03:11
But we changed all that.
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但是我们改变了这一切。
03:14
Because out of the pain of those deaths,
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因为那些逝者造成的伤痛，
03:17
we saw a social and political movement.
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我们开启了一个社会和政治的运动，
03:20
AIDS galvanized us into action;
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艾滋病促使我们行动，
03:24
to stand up, to speak up and to act out.
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让我们站出来，大声表达自己的意愿，并付诸行动
03:30
And it also galvanized
the LGBT movement.
the LGBT movement.
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这也促使了LGBT运动。
03:34
We knew we were
in a battle for our lives
in a battle for our lives
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我们知道我们在为我们的生活而斗争，
03:36
because silence equaled death,
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因为沉默意味着死亡，
03:38
but we changed,
and we made things happen.
and we made things happen.
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但是我们改变了，我们使事情成真。
03:42
And right now, we have the potential
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现在，我们有希望
03:45
to see the end of HIV/AIDS
in our lifetime.
in our lifetime.
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在我们人生中看到艾滋病的结束。
03:50
These changes came in no small part
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这些改变由很大程度上
03:53
by the courageous, yet simple decision
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靠通过勇敢却简单的决定，
03:57
for people to come out
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让人们走出家门，
03:59
to their neighbors,
to their friends, to their families
to their friends, to their families
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到他们的社区，他们的朋友，他们的家人，
04:05
and to their coworkers.
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和他们的同事那里。
04:08
Years ago, I was a volunteer
for the Names Project.
for the Names Project.
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几年前，我是“名字计划”的一个志愿者，
04:12
This was an effort started
by Cleve Jones in San Francisco
by Cleve Jones in San Francisco
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这个组织由克里夫·琼斯在旧金山成立，
04:15
to show that people who died of AIDS
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为了展示死于艾滋病的人的名字，
04:17
had names
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04:19
and faces and families
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脸庞和家庭
04:23
and people who loved them.
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以及爱他们的人。
04:27
I still recall unfolding
the AIDS memorial quilt
the AIDS memorial quilt
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我依旧记得展开艾滋病纪念被子
04:32
on the National Mall
on a brilliant day in October, 1988.
on a brilliant day in October, 1988.
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在1988年10月的一天的国家广场。
04:43
So fast forward to 2015.
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快进到2015，
04:46
The Supreme Court's decision to strike
down the ban on same-sex marriage.
down the ban on same-sex marriage.
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最高法院决定取消同性婚姻的禁令。
04:51
My husband, Dave, and I walk over
to the steps of the Supreme Court
to the steps of the Supreme Court
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我的丈夫，戴夫和我
走到最高法院的楼梯，
走到最高法院的楼梯，
04:54
to celebrate that decision
with so many other people,
with so many other people,
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和其他人一起庆祝这个决定，
04:57
and I couldn't help but think
how far we came around LGBT rights
how far we came around LGBT rights
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我不禁思考我们在
LGBT维权上走了这么远，
LGBT维权上走了这么远，
05:03
and yet how far we needed to go
around issues of addiction.
around issues of addiction.
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但是我们在成瘾问题上还需要走多远。
05:10
When I was nominated
by President Obama
by President Obama
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当我被奥巴马总统提名为
05:12
to be his Director of Drug Policy,
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他的医药政策负责人时，
05:14
I was very open about my recovery
and about the fact that I was a gay man.
and about the fact that I was a gay man.
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我对我改过自新和同性恋非常开放。
05:18
And at no point during
my confirmation process --
my confirmation process --
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在我接受审核的过程中，
05:21
at least that I know of --
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我并没有注意到
05:22
did the fact that I was a gay man
come to bear on my candidacy
come to bear on my candidacy
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作为同性恋影响到我的候选
05:26
or my fitness to do this job.
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和我能否胜任这份工作。
05:29
But my addiction did.
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不过真正的阻碍是我的瘾
05:32
At one point, a congressional staffer
said that there was no way
said that there was no way
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一次，一个国会工作人员说，
05:36
that I was going to be confirmed
by the United States Senate
by the United States Senate
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我的任职不可能会被参议院通过，
05:39
because of my past,
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因为我的一些过去历史，
05:40
despite the fact that I had been
in recovery for over 20 years,
in recovery for over 20 years,
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尽管我在20年来改过自新，
05:44
and despite the fact
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尽管这份工作
05:45
that this job takes a little bit
of knowledge around addiction.
of knowledge around addiction.
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和有关的瘾的知识没有什么关系。
05:48
(Laughter)
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（笑声）
05:51
So, you know, this is the stigma
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所以这个就是
05:54
that people with
substance use disorders
substance use disorders
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有对物品上瘾的人
05:56
face every single day,
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每天面对的，
05:58
and you know, I have to tell you
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而且我不得不说，
06:00
it's still why I'm more comfortable
coming out as a gay man
coming out as a gay man
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这也是为什么我更愿意承认我是同性恋，
06:03
than I am as a person
with a history of addiction.
with a history of addiction.
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相比于承认我有药瘾的历史。
06:07
Nearly every family in America
is affected by addiction.
is affected by addiction.
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几乎美国的每一个家庭都被瘾影响。
06:11
Yet, unfortunately, too often,
it's not talked about openly and honestly.
it's not talked about openly and honestly.
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但是不幸的是，
这并不经常被公开和诚实地讨论。
这并不经常被公开和诚实地讨论。
06:18
It's whispered about.
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这只被私底下谈论。
06:19
It's met with derision and scorn.
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这受到鄙视和嘲讽。
06:23
We hear these stories,
time and time again, on TV, online,
time and time again, on TV, online,
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我们听说这些故事，一次又一次，
在电视上，在网络上，
在电视上，在网络上，
06:28
we hear it from public officials,
and we hear it from family and friends.
and we hear it from family and friends.
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从政府和家人朋友中听说。
06:33
And those of us with an addiction,
we hear those voices,
we hear those voices,
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但是有上瘾的人听到了这些事情，
06:37
and somehow we believe that we are
less deserving of care and treatment.
less deserving of care and treatment.
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不知怎么的认为我们不值得关心和治疗。
06:43
Today in the United States,
only one in nine people
only one in nine people
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现在在美国，只有九分之一的人
06:46
get care and treatment for their disorder.
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接受针对他们上瘾的治疗和照顾。
06:49
One in nine.
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九分之一。
06:50
Think about that.
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好好想想。
06:52
Generally, people with other diseases
get care and treatment.
get care and treatment.
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大体上来说，有其他
疾病的人们接受治疗和照顾。
疾病的人们接受治疗和照顾。
06:55
If you have cancer, you get treatment,
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如果你有癌症，你接受治疗。
06:57
if you have diabetes, you get treatment.
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如果你有糖尿病，你接受治疗。
06:59
If you have a heart attack,
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如有你心脏病突发，
07:01
you get emergency services,
and you get referred to care.
and you get referred to care.
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你接受急救，然后接受康复治疗。
07:05
But somehow people with addiction
have to wait for treatment
have to wait for treatment
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但是不知道为什么
上瘾的人需要等待治疗，
上瘾的人需要等待治疗，
07:08
or often can't get when they need it.
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或者在需要的时候接受不到。
07:11
And left untreated, addiction
has significant, dire consequences.
has significant, dire consequences.
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没有治疗，瘾会造成很严重的后果。
07:16
And for many people
that means death or incarceration.
that means death or incarceration.
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对于很多人，这意味着死亡或者入狱。
07:21
We've been down that road before.
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我们都曾经历过这些。
07:23
For too long our country felt
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这么久以来，我们的国家认为
07:24
like we could arrest our way
out of this problem.
out of this problem.
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我们能够通过逮捕来解决问题。
07:27
But we know that we can't.
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但我们知道这不行。
07:30
Decades of scientific research has shown
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几代科学家的研究表明
07:33
that this is a medical issue --
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这个健康问题
07:35
that this is a chronic medical condition
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是一个长期的疾病，
07:37
that people inherit
and that people develop.
and that people develop.
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人们生来就有或者后天养成的。
07:42
So the Obama administration
has taken a different tack on drug policy.
has taken a different tack on drug policy.
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所以奥巴马政府改变了毒品政策。
07:46
We've developed and implemented
a comprehensive plan
a comprehensive plan
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我们创造并实施了一个全面的计划，
07:49
to expand prevention services,
treatment services,
treatment services,
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扩大预防措施、治疗、
07:52
early intervention and recovery support.
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早期干预和恢复治疗。
07:56
We've pushed criminal justice reform.
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我们加快了法律上的改革。
07:59
We've knocked down barriers
to give people second chances.
to give people second chances.
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我们消除了人们得到第二次机会的障碍。
08:02
We see public health and public safety
officials working hand in hand
officials working hand in hand
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我们看见了公共健康和安全部门
08:06
at the community level.
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在社区内团结协作。
08:08
We see police chiefs across the country
guiding people to treatment
guiding people to treatment
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我们看见全国的警察引导人们接受治疗，
08:11
instead of jail and incarceration.
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而不是直接把他们逮捕和收监。
08:14
We see law enforcement
and other first responders
and other first responders
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我们看见执法者和工作人员
08:17
reversing overdoses with naloxone
to give people a second chance for care.
to give people a second chance for care.
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把毒品改成纳洛酮，给人们第二次机会。
08:23
The Affordable Care Act
is the biggest expansion
is the biggest expansion
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平价医疗法案是这个世纪
08:26
of substance use disorder
treatment in a generation,
treatment in a generation,
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对上瘾治疗的最大进步，
08:29
and it also calls for the integration
of treatment services within primary care.
of treatment services within primary care.
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这份法案倡导把康复治疗
整合到基础医疗保障中。
整合到基础医疗保障中。
08:36
But fundamentally,
all of this work is not enough.
all of this work is not enough.
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但是总而来说，这些并不够，
08:40
Unless we change the way
that we view people with addiction
that we view people with addiction
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除非我们改变美国
人们对有上瘾的人的观念。
08:44
in the United States.
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08:47
Years ago when I finally
understood that I had a problem
understood that I had a problem
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几年前，当我终于意识到我有问题，
08:51
and I knew that I needed help,
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我知道我需要帮助的时候，
08:53
I was too afraid to ask for it.
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我因为害怕而不敢请求帮助。
08:56
I felt that people would think
I was stupid, that I was weak-willed,
I was stupid, that I was weak-willed,
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我担心人们会觉得我很傻、意志脆弱，
09:01
that I was morally flawed.
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觉得我道德有缺陷。
09:05
But I talk about my recovery
because I want to make change.
because I want to make change.
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但是因为我希望改变，
所以我会谈论我的康复治疗。
所以我会谈论我的康复治疗。
09:10
I want us to see that we need to be open
and candid about who we are
and candid about who we are
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我想让人们知道，
我们需要真诚开放的对待我们是谁，
我们需要真诚开放的对待我们是谁，
09:16
and what we can do.
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和我们能做什么。
09:18
I am public about my own recovery
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我公开我的康复治疗，
09:20
not to be self-congratulatory.
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不是为了炫耀，
09:23
I am open about my own recovery
to change public opinion,
to change public opinion,
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我公开我的康复治疗
是为了改变公众的意见，
是为了改变公众的意见，
09:27
to change public policy
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为了改变政策，
09:29
and to change the course of this epidemic
and empower the millions of Americans
and empower the millions of Americans
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和改变这个疾病的现象，
并使百万受其折磨的美国人有能力
09:33
who struggle with this journey
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09:35
to be open and candid
about who they are.
about who they are.
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开放真诚的对待他们是谁。
09:38
People are more than their disease.
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疾病代表不了一个人。
09:41
And all of us have the opportunity
to change public opinion
to change public opinion
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每一个人都有机会改变公众的观念
09:45
and to change public policy.
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和政策。
09:48
All of us know someone
who has an addiction,
who has an addiction,
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每一个人都认识某些上瘾的人，
09:51
and all of us can do our part
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而且每一个人都可以为改变美国
09:53
to change how we view people
with addiction in the United States.
with addiction in the United States.
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人们对上瘾的人的观念做出一份贡献。
09:58
So when you see
someone with an addiction,
someone with an addiction,
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如果你看到有上瘾的人，
10:00
don't think of a drunk or a junkie
or an addict or an abuser --
or an addict or an abuser --
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不要只看到一个酒鬼、
瘾君子或者滥用者，
瘾君子或者滥用者，
10:07
see a person;
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要看到一个人类，
10:10
offer them help;
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向他们提供帮助，
10:11
give them kindness and compassion.
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给他们友善和同情。
10:14
And together, we can be part
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团结一致，我们可以
10:16
of a growing movement
in the United States
in the United States
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成为一个美国正冉冉升起的一个运动的一部分，
10:18
to change how we view
people with addiction.
people with addiction.
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来改变我们看待有瘾的人的观念。
10:21
Together we can change public policy.
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团结一致，我们能够改变政策。
10:24
We can ensure that people
get care when they need it,
get care when they need it,
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我们可以保证
让人们得到他们需要的治疗，
让人们得到他们需要的治疗，
10:28
just like any other disease.
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就像其他疾病一样。
10:31
We can be part of a growing,
unstoppable movement
unstoppable movement
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我们可以成为一个
不断进步的美国运动的一部分，
不断进步的美国运动的一部分，
10:34
to have millions of Americans
enter recovery,
enter recovery,
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让百万美国人的得到康复治疗，
10:37
and put an end to this epidemic.
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并结束这个不好的风潮。
10:39
Thank you very much.
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谢谢。
10:41
(Applause)
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（鼓掌）
ABOUT THE SPEAKER
Michael Botticelli - Drug policy expertAs Director of National Drug Control Policy, Michael Botticelli led the Obama Administration’s drug policy efforts to diminish the consequences of substance use through evidence-based prevention, treatment and recovery support services.
Why you should listen
Michael Botticelli was sworn in as Director of National Drug Control Policy at the White House on February 11, 2015, after being unanimously confirmed by the Senate. He joined the White House Office of National Drug Control Policy (ONDCP) as Deputy Director in November 2012 and later served as Acting Director. He is currently the Executive Director of the Grayken Center for Addiction Medicine at Boston Medical Center and also a Distinguished Policy Scholar at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
As Director of National Drug Control Policy, Botticelli led the Obama Administration's drug policy efforts, which are based on a balanced public health and public safety approach. The Administration advanced historic drug policy reforms and innovations in prevention, criminal justice, treatment and recovery.
In response to the national opioid epidemic, Botticelli coordinated actions across the Federal government to reduce prescription drug abuse, heroin use and related overdoses. These include supporting community-based prevention efforts; educating prescribers and the public about preventing prescription drug abuse; expanding use of the life-saving overdose-reversal drug naloxone by law enforcement and other first responders; and increasing access to medication-assisted treatment and recovery support services to help individuals sustain their recovery from opioid use disorders.
Botticelli has more than two decades of experience supporting Americans affected by substance use disorders. Prior to joining ONDCP, he served as Director of the Bureau of Substance Abuse Services at the Massachusetts Department of Public Health, where he successfully expanded innovative and nationally recognized prevention, intervention, treatment and recovery services for the Commonwealth of Massachusetts. He also forged strong partnerships with local, state and Federal law enforcement agencies; state and local health and human service agencies; and stakeholder groups to guide and implement evidence-based programs.
Botticelli has served in a variety of leadership roles for the National Association of State Alcohol and Drug Abuse Directors. He was a member of the Advisory Committee for the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Prevention and the National Action Alliance for Suicide Prevention. He has also co-authored many peer-reviewed articles that have significantly contributed to the field.
Born in Upstate New York, Botticelli holds a Bachelor of Arts degree from Siena College and a Master of Education degree from St. Lawrence University. He is also in long-term recovery from a substance use disorder, celebrating more than 28 years of recovery.
Michael Botticelli | Speaker | TED.com