Only one in nine people in the United States gets the care and treatment they need for addiction and substance abuse. A former Director of National Drug Control Policy, Michael Botticelli is working to end this epidemic and treat people with addictions with kindness, compassion and fairness. In a personal, thoughtful talk, he encourages the millions of Americans in recovery today to make their voices heard and confront the stigma associated with substance use disorders.



タイトル Addiction is a disease. We should treat it like one
依存症は病気です。 それを一つのものとして扱うべきです
スピーカー マイケル・ボティチェリ
アップロード 2017/04/22

「依存症は病気です。 それを一つのものとして扱うべきです(Addiction is a disease. We should treat it like one)」の文字起こし

Twenty-eight years ago, I was a broken man.
And you probably wouldn’t be able to tell that if you met me.
I had a good job at a well-respected academic institution.
I dressed well, of course.
But my insides were rotting away.
You see, I grew up in a family riddled with addiction,
and as a kid, I also struggled
with coming to terms with my own sexuality.
And even though I couldn’t name it then,
growing up as a gay kid
just compounded my issues of isolation and insecurities.
But drinking took all of that away.

Like many, I drank at an early age.
I continued to drink my way through college.
And when I finally did come out in the early 1980s,
about the only places to meet other gay people,
to socialize,
to be yourself, were gay bars.
And what do you do in gay bars?
You drink.
And I did —
a lot.

My story is not unique.
Like millions of Americans, my disease progressed undiagnosed.
It took me to people and places and things
that I never would have chosen.
It wasn’t until an intersection with the law
gave me an “opportunity” to get care,
that I began my journey of recovery.

My journey of recovery has been filled with love and with joy,
but it hasn’t been without pain.
Like many of you, I’ve lost too many friends and family to this disease.
I’ve heard too many heartbreaking stories
of people who’ve lost loved ones to addiction.
And I’ve also lost countless friends to HIV and AIDS.

Our current opioid epidemic and the AIDS epidemic
tragically have much in common.
Right now, we are in the midst of one of the greatest health crises of our time.
During 2014 alone, 28,000 people
died of drug overdoses associated with prescription drugs and heroin.
During the 1980s, scores of people were dying from HIV and AIDS.
Public officials ignored it.
Some wouldn’t even utter the words.
They didn’t want treatment.
And tragically, there are many parallels with our current epidemic.

Some called it the gay plague.
They called for quarantines.
They wanted to separate the innocent victims from the rest of us.
I was afraid we were losing this battle
because people were blaming us for being sick.
Public policy was being held hostage by stigma and fear,
and also held hostage
were compassion, care, research, recovery and treatment.

But we changed all that.
Because out of the pain of those deaths,
we saw a social and political movement.
AIDS galvanized us into action;
to stand up, to speak up and to act out.
And it also galvanized the LGBT movement.
We knew we were in a battle for our lives
because silence equaled death,
but we changed, and we made things happen.
And right now, we have the potential
to see the end of HIV/AIDS in our lifetime.
These changes came in no small part
by the courageous, yet simple decision
for people to come out
to their neighbors, to their friends, to their families
and to their coworkers.

Years ago, I was a volunteer for the Names Project.
This was an effort started by Cleve Jones in San Francisco
to show that people who died of AIDS
had names
and faces and families
and people who loved them.
I still recall unfolding the AIDS memorial quilt
on the National Mall on a brilliant day in October, 1988.

So fast forward to 2015.
The Supreme Court’s decision to strike down the ban on same-sex marriage.
My husband, Dave, and I walk over to the steps of the Supreme Court
to celebrate that decision with so many other people,
and I couldn’t help but think how far we came around LGBT rights
and yet how far we needed to go around issues of addiction.

When I was nominated by President Obama
to be his Director of Drug Policy,
I was very open about my recovery and about the fact that I was a gay man.
And at no point during my confirmation process —
at least that I know of —
did the fact that I was a gay man come to bear on my candidacy
or my fitness to do this job.
But my addiction did.

At one point, a congressional staffer said that there was no way
that I was going to be confirmed by the United States Senate
because of my past,
despite the fact that I had been in recovery for over 20 years,
and despite the fact
that this job takes a little bit of knowledge around addiction.

So, you know, this is the stigma
that people with substance use disorders
face every single day,
and you know, I have to tell you
it’s still why I’m more comfortable coming out as a gay man
than I am as a person with a history of addiction.

Nearly every family in America is affected by addiction.
Yet, unfortunately, too often, it’s not talked about openly and honestly.
It’s whispered about.
It’s met with derision and scorn.
We hear these stories, time and time again, on TV, online,
we hear it from public officials, and we hear it from family and friends.
And those of us with an addiction, we hear those voices,
and somehow we believe that we are less deserving of care and treatment.

Today in the United States, only one in nine people
get care and treatment for their disorder.
One in nine.
Think about that.
Generally, people with other diseases get care and treatment.
If you have cancer, you get treatment,
if you have diabetes, you get treatment.
If you have a heart attack,
you get emergency services, and you get referred to care.
But somehow people with addiction have to wait for treatment
or often can’t get when they need it.

And left untreated, addiction has significant, dire consequences.
And for many people that means death or incarceration.
We’ve been down that road before.
For too long our country felt
like we could arrest our way out of this problem.
But we know that we can’t.
Decades of scientific research has shown
that this is a medical issue —
that this is a chronic medical condition
that people inherit and that people develop.

So the Obama administration has taken a different tack on drug policy.
We’ve developed and implemented a comprehensive plan
to expand prevention services, treatment services,
early intervention and recovery support.
We’ve pushed criminal justice reform.
We’ve knocked down barriers to give people second chances.
We see public health and public safety officials working hand in hand
at the community level.

We see police chiefs across the country guiding people to treatment
instead of jail and incarceration.
We see law enforcement and other first responders
reversing overdoses with naloxone to give people a second chance for care.
The Affordable Care Act is the biggest expansion
of substance use disorder treatment in a generation,
and it also calls for the integration of treatment services within primary care.

But fundamentally, all of this work is not enough.
Unless we change the way that we view people with addiction in the United States.
Years ago when I finally understood that I had a problem
and I knew that I needed help,
I was too afraid to ask for it.
I felt that people would think I was stupid, that I was weak-willed, that I was morally flawed.
But I talk about my recovery because I want to make change.
I want us to see that we need to be open and candid about who we are
and what we can do.
I am public about my own recovery
not to be self-congratulatory.
I am open about my own recovery to change public opinion,
to change public policy
and to change the course of this epidemic and empower the millions of Americans
who struggle with this journey
to be open and candid about who they are.

People are more than their disease.
And all of us have the opportunity to change public opinion
and to change public policy.
All of us know someone who has an addiction,
and all of us can do our part
to change how we view people with addiction in the United States.

So when you see someone with an addiction,
don’t think of a drunk or a junkie or an addict or an abuser —
see a person;
offer them help;
give them kindness and compassion.
And together, we can be part
of a growing movement in the United States
to change how we view people with addiction.

Together we can change public policy.
We can ensure that people get care when they need it,
just like any other disease.
We can be part of a growing, unstoppable movement
to have millions of Americans enter recovery,
and put an end to this epidemic.
Thank you very much.

「依存症は病気です。 それを一つのものとして扱うべきです(Addiction is a disease. We should treat it like one)」の和訳







これらの変化は、勇気を持ってカミングアウトし、隣人や友人、家族、そして同僚に自分を見せるというシンプルな決断から始まりました。私は数年前、Names Projectのボランティアをしていました。これはエイズで亡くなった人々が名前と顔を持ち、愛する人々がいることを示すものでした。