Addiction is a disease. We should treat it like one | Michael Botticelli

220,890 views ・ 2017-04-21

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Twenty-eight years ago, I was a broken man.
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And you probably wouldn't be able to tell that if you met me.
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I had a good job at a well-respected academic institution.
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I dressed well, of course.
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But my insides were rotting away.
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You see, I grew up in a family riddled with addiction,
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and as a kid, I also struggled
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with coming to terms with my own sexuality.
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And even though I couldn't name it then,
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growing up as a gay kid
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just compounded my issues of isolation and insecurities.
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But drinking took all of that away.
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Like many, I drank at an early age.
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I continued to drink my way through college.
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And when I finally did come out in the early 1980s,
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about the only places to meet other gay people,
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to socialize,
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to be yourself, were gay bars.
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And what do you do in gay bars?
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You drink.
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And I did --
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a lot.
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My story is not unique.
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Like millions of Americans, my disease progressed undiagnosed.
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It took me to people and places and things
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that I never would have chosen.
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It wasn't until an intersection with the law
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gave me an "opportunity" to get care,
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that I began my journey of recovery.
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My journey of recovery has been filled with love and with joy,
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but it hasn't been without pain.
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Like many of you, I've lost too many friends and family to this disease.
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I've heard too many heartbreaking stories
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of people who've lost loved ones to addiction.
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And I've also lost countless friends to HIV and AIDS.
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Our current opioid epidemic and the AIDS epidemic
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tragically have much in common.
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Right now, we are in the midst of one of the greatest health crises of our time.
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During 2014 alone, 28,000 people
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died of drug overdoses associated with prescription drugs and heroin.
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During the 1980s, scores of people were dying from HIV and AIDS.
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Public officials ignored it.
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Some wouldn't even utter the words.
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They didn't want treatment.
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And tragically, there are many parallels with our current epidemic.
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Some called it the gay plague.
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They called for quarantines.
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They wanted to separate the innocent victims from the rest of us.
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I was afraid we were losing this battle
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because people were blaming us for being sick.
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Public policy was being held hostage by stigma and fear,
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and also held hostage
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were compassion, care, research, recovery and treatment.
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But we changed all that.
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Because out of the pain of those deaths,
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we saw a social and political movement.
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AIDS galvanized us into action;
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to stand up, to speak up and to act out.
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And it also galvanized the LGBT movement.
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We knew we were in a battle for our lives
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because silence equaled death,
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but we changed, and we made things happen.
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And right now, we have the potential
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to see the end of HIV/AIDS in our lifetime.
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These changes came in no small part
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by the courageous, yet simple decision
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for people to come out
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to their neighbors, to their friends, to their families
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and to their coworkers.
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Years ago, I was a volunteer for the Names Project.
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This was an effort started by Cleve Jones in San Francisco
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to show that people who died of AIDS
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had names
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and faces and families
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and people who loved them.
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I still recall unfolding the AIDS memorial quilt
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on the National Mall on a brilliant day in October, 1988.
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So fast forward to 2015.
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The Supreme Court's decision to strike down the ban on same-sex marriage.
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My husband, Dave, and I walk over to the steps of the Supreme Court
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to celebrate that decision with so many other people,
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and I couldn't help but think how far we came around LGBT rights
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and yet how far we needed to go around issues of addiction.
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When I was nominated by President Obama
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to be his Director of Drug Policy,
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I was very open about my recovery and about the fact that I was a gay man.
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And at no point during my confirmation process --
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at least that I know of --
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did the fact that I was a gay man come to bear on my candidacy
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or my fitness to do this job.
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But my addiction did.
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At one point, a congressional staffer said that there was no way
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that I was going to be confirmed by the United States Senate
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because of my past,
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despite the fact that I had been in recovery for over 20 years,
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and despite the fact
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that this job takes a little bit of knowledge around addiction.
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(Laughter)
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So, you know, this is the stigma
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that people with substance use disorders
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face every single day,
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and you know, I have to tell you
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it's still why I'm more comfortable coming out as a gay man
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than I am as a person with a history of addiction.
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Nearly every family in America is affected by addiction.
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Yet, unfortunately, too often, it's not talked about openly and honestly.
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It's whispered about.
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It's met with derision and scorn.
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We hear these stories, time and time again, on TV, online,
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we hear it from public officials, and we hear it from family and friends.
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And those of us with an addiction, we hear those voices,
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and somehow we believe that we are less deserving of care and treatment.
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Today in the United States, only one in nine people
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get care and treatment for their disorder.
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One in nine.
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Think about that.
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Generally, people with other diseases get care and treatment.
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If you have cancer, you get treatment,
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if you have diabetes, you get treatment.
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If you have a heart attack,
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you get emergency services, and you get referred to care.
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But somehow people with addiction have to wait for treatment
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or often can't get when they need it.
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And left untreated, addiction has significant, dire consequences.
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And for many people that means death or incarceration.
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We've been down that road before.
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For too long our country felt
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like we could arrest our way out of this problem.
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But we know that we can't.
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Decades of scientific research has shown
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that this is a medical issue --
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that this is a chronic medical condition
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that people inherit and that people develop.
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So the Obama administration has taken a different tack on drug policy.
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We've developed and implemented a comprehensive plan
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to expand prevention services, treatment services,
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early intervention and recovery support.
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We've pushed criminal justice reform.
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We've knocked down barriers to give people second chances.
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We see public health and public safety officials working hand in hand
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at the community level.
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We see police chiefs across the country guiding people to treatment
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instead of jail and incarceration.
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We see law enforcement and other first responders
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reversing overdoses with naloxone to give people a second chance for care.
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The Affordable Care Act is the biggest expansion
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of substance use disorder treatment in a generation,
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and it also calls for the integration of treatment services within primary care.
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But fundamentally, all of this work is not enough.
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Unless we change the way that we view people with addiction
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in the United States.
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Years ago when I finally understood that I had a problem
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and I knew that I needed help,
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I was too afraid to ask for it.
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I felt that people would think I was stupid, that I was weak-willed,
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that I was morally flawed.
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But I talk about my recovery because I want to make change.
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I want us to see that we need to be open and candid about who we are
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and what we can do.
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I am public about my own recovery
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not to be self-congratulatory.
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I am open about my own recovery to change public opinion,
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to change public policy
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and to change the course of this epidemic and empower the millions of Americans
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who struggle with this journey
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to be open and candid about who they are.
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People are more than their disease.
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And all of us have the opportunity to change public opinion
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and to change public policy.
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All of us know someone who has an addiction,
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and all of us can do our part
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to change how we view people with addiction in the United States.
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So when you see someone with an addiction,
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don't think of a drunk or a junkie or an addict or an abuser --
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see a person;
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offer them help;
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give them kindness and compassion.
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And together, we can be part
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of a growing movement in the United States
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to change how we view people with addiction.
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Together we can change public policy.
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We can ensure that people get care when they need it,
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just like any other disease.
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We can be part of a growing, unstoppable movement
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to have millions of Americans enter recovery,
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and put an end to this epidemic.
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Thank you very much.
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(Applause)
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