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Home » Addiction is a Disease. We Should Treat It Like One: Michael Botticelli (Full Transcript)

Addiction is a Disease. We Should Treat It Like One: Michael Botticelli (Full Transcript)

Michael Botticelli – Drug policy expert

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.

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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.

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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.

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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.

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