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

翻译人员: Conway Ye 校对人员: Peter Coolman

Twenty-eight years ago, I was a broken man.

28年前，我的人生陷入低谷，

And you probably wouldn't be able to tell that if you met me.

如果你遇见我，你可能看不出来。

I had a good job at a well-respected academic institution.

我在一个德高望重的 学校有一份很好的工作。

I dressed well, of course.

当然，我穿着得体。

But my insides were rotting away.

但是我的内心却在被侵蚀。

You see, I grew up in a family riddled with addiction,

我在一个充满上瘾的家庭长大，

and as a kid, I also struggled

当我还是一个孩子的时候，

with coming to terms with my own sexuality.

我对自己的性取向也很疑惑。

And even though I couldn't name it then,

虽然那个时候我无法直说，

growing up as a gay kid

作为一个同性恋小孩长大，

just compounded my issues of isolation and insecurities.

让我有了自我封闭和缺乏自信的问题。

But drinking took all of that away.

但是喝酒把这一切都带走了。

Like many, I drank at an early age.

像很多人一样，我很小就开始喝酒。

I continued to drink my way through college.

我喝着酒上完了大学。

And when I finally did come out in the early 1980s,

当我在80年代初终于出柜时，

about the only places to meet other gay people,

唯一一个地方，我能够见到其他同性恋，

to socialize,

来社交，

to be yourself, were gay bars.

来展现真我，就是同性恋酒吧。

And what do you do in gay bars?

然而你在同性恋酒吧里做的事情是什么？

You drink.

喝酒。

And I did --

而且我喝了，

a lot.

很多。

My story is not unique.

我的故事并不时独一无二。

Like millions of Americans, my disease progressed undiagnosed.

像上百万美国人， 我的疾病无法被诊断。

It took me to people and places and things

它让我选择我永远不会选择的

that I never would have chosen.

人、地方和事情。

It wasn't until an intersection with the law

直到我由此触犯了法律

gave me an "opportunity" to get care,

我有了一个“康复治疗”的“机会”，

that I began my journey of recovery.

然后我开始了改过自新的旅程。

My journey of recovery has been filled with love and with joy,

我改过自新的旅程充满了爱和快乐，

but it hasn't been without pain.

但是也有痛苦。

Like many of you, I've lost too many friends and family to this disease.

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。

I've heard too many heartbreaking stories

我听说了太多令人伤心的故事，

of people who've lost loved ones to addiction.

关于人们因为上瘾失去了喜欢的人。

And I've also lost countless friends to HIV and AIDS.

我也因为艾滋病失去了无数朋友。

Our current opioid epidemic and the AIDS epidemic

现在不断增长的鸦片类药品的使用和艾滋病的传播

tragically have much in common.

不幸的有很多相同点。

Right now, we are in the midst of one of the greatest health crises of our time.

现在，我们处在历史上 最严重的医疗保健危机中。

During 2014 alone, 28,000 people

单单在2014年，两万八千人

died of drug overdoses associated with prescription drugs and heroin.

死于因为处方药和海洛因 的过度使用。

During the 1980s, scores of people were dying from HIV and AIDS.

在20世纪80年代，很多人死于艾滋病。

Public officials ignored it.

政府无视了这个问题。

Some wouldn't even utter the words.

有些甚至无法说出那个词。

They didn't want treatment.

他们不想接受治疗。

And tragically, there are many parallels with our current epidemic.

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。

Some called it the gay plague.

有些人称之为同性恋瘟疫。

They called for quarantines.

他们呼吁隔离。

They wanted to separate the innocent victims from the rest of us.

他们想要将无辜 的”受害者“（非同性恋）和我们隔离。

I was afraid we were losing this battle

我很担心我们会在这场战争中失败，

because people were blaming us for being sick.

因为人们都在责怪生病的我们。

Public policy was being held hostage by stigma and fear,

公众政策被恐惧和不安绑架，

and also held hostage

被绑架的还有

were compassion, care, research, recovery and treatment.

同情、关心、医疗研究、恢复和治疗。

But we changed all that.

但是我们改变了这一切。

Because out of the pain of those deaths,

因为那些逝者造成的伤痛，

we saw a social and political movement.

我们开启了一个社会和政治的运动，

AIDS galvanized us into action;

艾滋病促使我们行动，

to stand up, to speak up and to act out.

让我们站出来，大声表达自己的意愿，并付诸行动

And it also galvanized the LGBT movement.

这也促使了LGBT运动。

We knew we were in a battle for our lives

我们知道我们在为我们的生活而斗争，

because silence equaled death,

因为沉默意味着死亡，

but we changed, and we made things happen.

但是我们改变了，我们使事情成真。

And right now, we have the potential

现在，我们有希望

to see the end of HIV/AIDS in our lifetime.

在我们人生中看到艾滋病的结束。

These changes came in no small part

这些改变由很大程度上

by the courageous, yet simple decision

靠通过勇敢却简单的决定，

for people to come out

让人们走出家门，

to their neighbors, to their friends, to their families

到他们的社区，他们的朋友，他们的家人，

and to their coworkers.

和他们的同事那里。

Years ago, I was a volunteer for the Names Project.

几年前，我是“名字计划”的一个志愿者，

This was an effort started by Cleve Jones in San Francisco

这个组织由克里夫·琼斯在旧金山成立，

to show that people who died of AIDS

为了展示死于艾滋病的人的名字，

had names

and faces and families

脸庞和家庭

and people who loved them.

以及爱他们的人。

I still recall unfolding the AIDS memorial quilt

我依旧记得展开艾滋病纪念被子

on the National Mall on a brilliant day in October, 1988.

在1988年10月的一天的国家广场。

So fast forward to 2015.

快进到2015，

The Supreme Court's decision to strike down the ban on same-sex marriage.

最高法院决定取消同性婚姻的禁令。

My husband, Dave, and I walk over to the steps of the Supreme Court

我的丈夫，戴夫和我 走到最高法院的楼梯，

to celebrate that decision with so many other people,

和其他人一起庆祝这个决定，

and I couldn't help but think how far we came around LGBT rights

我不禁思考我们在 LGBT维权上走了这么远，

and yet how far we needed to go around issues of addiction.

但是我们在成瘾问题上还需要走多远。

When I was nominated by President Obama

当我被奥巴马总统提名为

to be his Director of Drug Policy,

他的医药政策负责人时，

I was very open about my recovery and about the fact that I was a gay man.

我对我改过自新和同性恋非常开放。

And at no point during my confirmation process --

在我接受审核的过程中，

at least that I know of --

我并没有注意到

did the fact that I was a gay man come to bear on my candidacy

作为同性恋影响到我的候选

or my fitness to do this job.

和我能否胜任这份工作。

But my addiction did.

不过真正的阻碍是我的瘾

At one point, a congressional staffer said that there was no way

一次，一个国会工作人员说，

that I was going to be confirmed by the United States Senate

我的任职不可能会被参议院通过，

because of my past,

因为我的一些过去历史，

despite the fact that I had been in recovery for over 20 years,

尽管我在20年来改过自新，

and despite the fact

尽管这份工作

that this job takes a little bit of knowledge around addiction.

和有关的瘾的知识没有什么关系。

(Laughter)

（笑声）

So, you know, this is the stigma

所以这个就是

that people with substance use disorders

有对物品上瘾的人

face every single day,

每天面对的，

and you know, I have to tell you

而且我不得不说，

it's still why I'm more comfortable coming out as a gay man

这也是为什么我更愿意承认我是同性恋，

than I am as a person with a history of addiction.

相比于承认我有药瘾的历史。

Nearly every family in America is affected by addiction.

几乎美国的每一个家庭都被瘾影响。

Yet, unfortunately, too often, it's not talked about openly and honestly.

但是不幸的是， 这并不经常被公开和诚实地讨论。

It's whispered about.

这只被私底下谈论。

It's met with derision and scorn.

这受到鄙视和嘲讽。

We hear these stories, time and time again, on TV, online,

我们听说这些故事，一次又一次， 在电视上，在网络上，

we hear it from public officials, and we hear it from family and friends.

从政府和家人朋友中听说。

And those of us with an addiction, we hear those voices,

但是有上瘾的人听到了这些事情，

and somehow we believe that we are less deserving of care and treatment.

不知怎么的认为我们不值得关心和治疗。

Today in the United States, only one in nine people

现在在美国，只有九分之一的人

get care and treatment for their disorder.

接受针对他们上瘾的治疗和照顾。

One in nine.

九分之一。

Think about that.

好好想想。

Generally, people with other diseases get care and treatment.

大体上来说，有其他 疾病的人们接受治疗和照顾。

If you have cancer, you get treatment,

如果你有癌症，你接受治疗。

if you have diabetes, you get treatment.

如果你有糖尿病，你接受治疗。

If you have a heart attack,

如有你心脏病突发，

you get emergency services, and you get referred to care.

你接受急救，然后接受康复治疗。

But somehow people with addiction have to wait for treatment

但是不知道为什么 上瘾的人需要等待治疗，

or often can't get when they need it.

或者在需要的时候接受不到。

And left untreated, addiction has significant, dire consequences.

没有治疗，瘾会造成很严重的后果。

And for many people that means death or incarceration.

对于很多人，这意味着死亡或者入狱。

We've been down that road before.

我们都曾经历过这些。

For too long our country felt

这么久以来，我们的国家认为

like we could arrest our way out of this problem.

我们能够通过逮捕来解决问题。

But we know that we can't.

但我们知道这不行。

Decades of scientific research has shown

几代科学家的研究表明

that this is a medical issue --

这个健康问题

that this is a chronic medical condition

是一个长期的疾病，

that people inherit and that people develop.

人们生来就有或者后天养成的。

So the Obama administration has taken a different tack on drug policy.

所以奥巴马政府改变了毒品政策。

We've developed and implemented a comprehensive plan

我们创造并实施了一个全面的计划，

to expand prevention services, treatment services,

扩大预防措施、治疗、

early intervention and recovery support.

早期干预和恢复治疗。

We've pushed criminal justice reform.

我们加快了法律上的改革。

We've knocked down barriers to give people second chances.

我们消除了人们得到第二次机会的障碍。

We see public health and public safety officials working hand in hand

我们看见了公共健康和安全部门

at the community level.

在社区内团结协作。

We see police chiefs across the country guiding people to treatment

我们看见全国的警察引导人们接受治疗，

instead of jail and incarceration.

而不是直接把他们逮捕和收监。

We see law enforcement and other first responders

我们看见执法者和工作人员

reversing overdoses with naloxone to give people a second chance for care.

把毒品改成纳洛酮，给人们第二次机会。

The Affordable Care Act is the biggest expansion

平价医疗法案是这个世纪

of substance use disorder treatment in a generation,

对上瘾治疗的最大进步，

and it also calls for the integration of treatment services within primary care.

这份法案倡导把康复治疗 整合到基础医疗保障中。

But fundamentally, all of this work is not enough.

但是总而来说，这些并不够，

Unless we change the way that we view people with addiction

除非我们改变美国

人们对有上瘾的人的观念。

in the United States.

Years ago when I finally understood that I had a problem

几年前，当我终于意识到我有问题，

and I knew that I needed help,

我知道我需要帮助的时候，

I was too afraid to ask for it.

我因为害怕而不敢请求帮助。

I felt that people would think I was stupid, that I was weak-willed,

我担心人们会觉得我很傻、意志脆弱，

that I was morally flawed.

觉得我道德有缺陷。

But I talk about my recovery because I want to make change.

但是因为我希望改变， 所以我会谈论我的康复治疗。

I want us to see that we need to be open and candid about who we are

我想让人们知道， 我们需要真诚开放的对待我们是谁，

and what we can do.

和我们能做什么。

I am public about my own recovery

我公开我的康复治疗，

not to be self-congratulatory.

不是为了炫耀，

I am open about my own recovery to change public opinion,

我公开我的康复治疗 是为了改变公众的意见，

to change public policy

为了改变政策，

and to change the course of this epidemic and empower the millions of Americans

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

who struggle with this journey

to be open and candid about who they are.

开放真诚的对待他们是谁。

People are more than their disease.

疾病代表不了一个人。

And all of us have the opportunity to change public opinion

每一个人都有机会改变公众的观念

and to change public policy.

和政策。

All of us know someone who has an addiction,

每一个人都认识某些上瘾的人，

and all of us can do our part

而且每一个人都可以为改变美国

to change how we view people with addiction in the United States.

人们对上瘾的人的观念做出一份贡献。

So when you see someone with an addiction,

如果你看到有上瘾的人，

don't think of a drunk or a junkie or an addict or an abuser --

不要只看到一个酒鬼、 瘾君子或者滥用者，

see a person;

要看到一个人类，

offer them help;

向他们提供帮助，

give them kindness and compassion.

给他们友善和同情。

And together, we can be part

团结一致，我们可以

of a growing movement in the United States

成为一个美国正冉冉升起的一个运动的一部分，

to change how we view people with addiction.

来改变我们看待有瘾的人的观念。

Together we can change public policy.

团结一致，我们能够改变政策。

We can ensure that people get care when they need it,

我们可以保证 让人们得到他们需要的治疗，

just like any other disease.

就像其他疾病一样。

We can be part of a growing, unstoppable movement

我们可以成为一个 不断进步的美国运动的一部分，

to have millions of Americans enter recovery,

让百万美国人的得到康复治疗，

and put an end to this epidemic.

并结束这个不好的风潮。

Thank you very much.

谢谢。

(Applause)

（鼓掌）