ABOUT THE SPEAKER
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.

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.

More profile about the speaker
Michael Botticelli | Speaker | TED.com
TEDxMidAtlantic

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

Filmed:
1,620,936 views

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.
- 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

Double-click the English transcript below to play the video.

00:13
Twenty-eight years ago,
I was a broken man.
0
1000
2840
00:16
And you probably wouldn't be able
to tell that if you met me.
1
4760
2880
00:20
I had a good job at a well-respected
academic institution.
2
8240
3880
00:24
I dressed well, of course.
3
12840
1280
00:27
But my insides were rotting away.
4
15760
1720
00:30
You see, I grew up in a family
riddled with addiction,
5
18640
2960
00:34
and as a kid, I also struggled
6
22640
1460
00:36
with coming to terms
with my own sexuality.
7
24124
2772
00:38
And even though I couldn't name it then,
8
26920
2336
00:41
growing up as a gay kid
9
29280
2016
00:43
just compounded my issues
of isolation and insecurities.
10
31320
3760
00:48
But drinking took all of that away.
11
36520
1690
00:52
Like many, I drank at an early age.
12
40840
3120
00:56
I continued to drink
my way through college.
13
44840
2200
00:59
And when I finally did come out
in the early 1980s,
14
47840
2816
01:02
about the only places
to meet other gay people,
15
50680
2816
01:05
to socialize,
16
53520
1200
01:07
to be yourself, were gay bars.
17
55520
1680
01:10
And what do you do in gay bars?
18
58360
1480
01:12
You drink.
19
60480
1576
01:14
And I did --
20
62080
1616
01:15
a lot.
21
63720
1200
01:17
My story is not unique.
22
65760
1360
01:19
Like millions of Americans,
my disease progressed undiagnosed.
23
67960
3680
01:24
It took me to people
and places and things
24
72400
1976
01:26
that I never would have chosen.
25
74400
1480
01:29
It wasn't until
an intersection with the law
26
77200
2816
01:32
gave me an "opportunity" to get care,
27
80040
3200
01:35
that I began my journey of recovery.
28
83880
1920
01:39
My journey of recovery
has been filled with love and with joy,
29
87000
4000
01:43
but it hasn't been without pain.
30
91960
1976
01:45
Like many of you, I've lost too many
friends and family to this disease.
31
93960
3976
01:49
I've heard too many
heartbreaking stories
32
97960
1936
01:51
of people who've lost
loved ones to addiction.
33
99920
2160
01:54
And I've also lost
countless friends to HIV and AIDS.
34
102760
3360
01:59
Our current opioid epidemic
and the AIDS epidemic
35
107160
3536
02:02
tragically have much in common.
36
110720
1760
02:06
Right now, we are in the midst of one
of the greatest health crises of our time.
37
114040
3840
02:11
During 2014 alone, 28,000 people
38
119280
4336
02:15
died of drug overdoses associated
with prescription drugs and heroin.
39
123640
4440
02:22
During the 1980s, scores of people
were dying from HIV and AIDS.
40
130160
4600
02:27
Public officials ignored it.
41
135800
1640
02:30
Some wouldn't even utter the words.
42
138520
1920
02:33
They didn't want treatment.
43
141800
1640
02:36
And tragically, there are many parallels
with our current epidemic.
44
144280
3280
02:40
Some called it the gay plague.
45
148720
1640
02:43
They called for quarantines.
46
151520
1560
02:46
They wanted to separate
the innocent victims from the rest of us.
47
154440
3120
02:52
I was afraid we were losing this battle
48
160120
2336
02:54
because people were
blaming us for being sick.
49
162480
2960
02:58
Public policy was being held hostage
by stigma and fear,
50
166800
3320
03:03
and also held hostage
51
171880
1256
03:05
were compassion, care,
research, recovery and treatment.
52
173160
5600
03:11
But we changed all that.
53
179640
1200
03:14
Because out of the pain of those deaths,
54
182480
2576
03:17
we saw a social and political movement.
55
185080
2720
03:20
AIDS galvanized us into action;
56
188800
3360
03:24
to stand up, to speak up and to act out.
57
192920
4240
03:30
And it also galvanized
the LGBT movement.
58
198200
2560
03:34
We knew we were
in a battle for our lives
59
202520
1936
03:36
because silence equaled death,
60
204480
1560
03:38
but we changed,
and we made things happen.
61
206960
3000
03:42
And right now, we have the potential
62
210760
2296
03:45
to see the end of HIV/AIDS
in our lifetime.
63
213080
3000
03:50
These changes came in no small part
64
218480
2816
03:53
by the courageous, yet simple decision
65
221320
3120
03:57
for people to come out
66
225160
1440
03:59
to their neighbors,
to their friends, to their families
67
227440
4920
04:05
and to their coworkers.
68
233480
1200
04:08
Years ago, I was a volunteer
for the Names Project.
69
236560
2840
04:12
This was an effort started
by Cleve Jones in San Francisco
70
240200
3376
04:15
to show that people who died of AIDS
71
243600
1976
04:17
had names
72
245600
1200
04:19
and faces and families
73
247560
2800
04:23
and people who loved them.
74
251320
1480
04:27
I still recall unfolding
the AIDS memorial quilt
75
255120
4839
04:32
on the National Mall
on a brilliant day in October, 1988.
76
260920
5560
04:43
So fast forward to 2015.
77
271440
1680
04:46
The Supreme Court's decision to strike
down the ban on same-sex marriage.
78
274480
4280
04:51
My husband, Dave, and I walk over
to the steps of the Supreme Court
79
279760
3176
04:54
to celebrate that decision
with so many other people,
80
282960
2936
04:57
and I couldn't help but think
how far we came around LGBT rights
81
285920
5376
05:03
and yet how far we needed to go
around issues of addiction.
82
291320
4800
05:10
When I was nominated
by President Obama
83
298120
1856
05:12
to be his Director of Drug Policy,
84
300000
2176
05:14
I was very open about my recovery
and about the fact that I was a gay man.
85
302200
3640
05:18
And at no point during
my confirmation process --
86
306720
2336
05:21
at least that I know of --
87
309080
1536
05:22
did the fact that I was a gay man
come to bear on my candidacy
88
310640
3976
05:26
or my fitness to do this job.
89
314640
1800
05:29
But my addiction did.
90
317760
1200
05:32
At one point, a congressional staffer
said that there was no way
91
320680
3456
05:36
that I was going to be confirmed
by the United States Senate
92
324160
2856
05:39
because of my past,
93
327040
1576
05:40
despite the fact that I had been
in recovery for over 20 years,
94
328640
3416
05:44
and despite the fact
95
332080
1216
05:45
that this job takes a little bit
of knowledge around addiction.
96
333320
2976
05:48
(Laughter)
97
336320
1480
05:51
So, you know, this is the stigma
98
339640
2936
05:54
that people with
substance use disorders
99
342600
2056
05:56
face every single day,
100
344680
1400
05:58
and you know, I have to tell you
101
346880
1576
06:00
it's still why I'm more comfortable
coming out as a gay man
102
348480
3456
06:03
than I am as a person
with a history of addiction.
103
351960
2520
06:07
Nearly every family in America
is affected by addiction.
104
355640
3400
06:11
Yet, unfortunately, too often,
it's not talked about openly and honestly.
105
359760
5520
06:18
It's whispered about.
106
366160
1656
06:19
It's met with derision and scorn.
107
367840
2360
06:23
We hear these stories,
time and time again, on TV, online,
108
371320
4640
06:28
we hear it from public officials,
and we hear it from family and friends.
109
376760
3440
06:33
And those of us with an addiction,
we hear those voices,
110
381720
2800
06:37
and somehow we believe that we are
less deserving of care and treatment.
111
385560
4120
06:43
Today in the United States,
only one in nine people
112
391040
3376
06:46
get care and treatment for their disorder.
113
394440
2536
06:49
One in nine.
114
397000
1576
06:50
Think about that.
115
398600
1200
06:52
Generally, people with other diseases
get care and treatment.
116
400600
3056
06:55
If you have cancer, you get treatment,
117
403680
1976
06:57
if you have diabetes, you get treatment.
118
405680
2016
06:59
If you have a heart attack,
119
407720
1336
07:01
you get emergency services,
and you get referred to care.
120
409080
2700
07:05
But somehow people with addiction
have to wait for treatment
121
413200
3216
07:08
or often can't get when they need it.
122
416440
2120
07:11
And left untreated, addiction
has significant, dire consequences.
123
419800
3960
07:16
And for many people
that means death or incarceration.
124
424360
3320
07:21
We've been down that road before.
125
429000
1587
07:23
For too long our country felt
126
431400
1416
07:24
like we could arrest our way
out of this problem.
127
432840
2320
07:27
But we know that we can't.
128
435880
1280
07:30
Decades of scientific research has shown
129
438680
2376
07:33
that this is a medical issue --
130
441080
2136
07:35
that this is a chronic medical condition
131
443240
2576
07:37
that people inherit
and that people develop.
132
445840
2880
07:42
So the Obama administration
has taken a different tack on drug policy.
133
450000
3400
07:46
We've developed and implemented
a comprehensive plan
134
454560
2936
07:49
to expand prevention services,
treatment services,
135
457520
3376
07:52
early intervention and recovery support.
136
460920
2640
07:56
We've pushed criminal justice reform.
137
464800
1785
07:59
We've knocked down barriers
to give people second chances.
138
467640
2720
08:02
We see public health and public safety
officials working hand in hand
139
470880
3416
08:06
at the community level.
140
474320
1200
08:08
We see police chiefs across the country
guiding people to treatment
141
476480
3176
08:11
instead of jail and incarceration.
142
479680
1640
08:14
We see law enforcement
and other first responders
143
482400
2896
08:17
reversing overdoses with naloxone
to give people a second chance for care.
144
485320
4840
08:23
The Affordable Care Act
is the biggest expansion
145
491640
2656
08:26
of substance use disorder
treatment in a generation,
146
494320
3256
08:29
and it also calls for the integration
of treatment services within primary care.
147
497600
4040
08:36
But fundamentally,
all of this work is not enough.
148
504280
4040
08:40
Unless we change the way
that we view people with addiction
149
508840
4016
08:44
in the United States.
150
512880
1200
08:47
Years ago when I finally
understood that I had a problem
151
515400
3576
08:51
and I knew that I needed help,
152
519000
2135
08:53
I was too afraid to ask for it.
153
521159
1640
08:56
I felt that people would think
I was stupid, that I was weak-willed,
154
524320
4200
09:01
that I was morally flawed.
155
529520
1730
09:05
But I talk about my recovery
because I want to make change.
156
533880
3520
09:10
I want us to see that we need to be open
and candid about who we are
157
538240
5936
09:16
and what we can do.
158
544200
1200
09:18
I am public about my own recovery
159
546320
2376
09:20
not to be self-congratulatory.
160
548720
1920
09:23
I am open about my own recovery
to change public opinion,
161
551440
3856
09:27
to change public policy
162
555320
1896
09:29
and to change the course of this epidemic
and empower the millions of Americans
163
557240
3896
09:33
who struggle with this journey
164
561160
1856
09:35
to be open and candid
about who they are.
165
563040
1960
09:38
People are more than their disease.
166
566640
2320
09:41
And all of us have the opportunity
to change public opinion
167
569880
3296
09:45
and to change public policy.
168
573200
1640
09:48
All of us know someone
who has an addiction,
169
576000
2280
09:51
and all of us can do our part
170
579280
1936
09:53
to change how we view people
with addiction in the United States.
171
581240
4160
09:58
So when you see
someone with an addiction,
172
586400
2416
10:00
don't think of a drunk or a junkie
or an addict or an abuser --
173
588840
5680
10:07
see a person;
174
595680
1200
10:10
offer them help;
175
598040
1496
10:11
give them kindness and compassion.
176
599560
1720
10:14
And together, we can be part
177
602360
2216
10:16
of a growing movement
in the United States
178
604600
2056
10:18
to change how we view
people with addiction.
179
606680
2080
10:21
Together we can change public policy.
180
609480
2120
10:24
We can ensure that people
get care when they need it,
181
612440
3896
10:28
just like any other disease.
182
616360
1680
10:31
We can be part of a growing,
unstoppable movement
183
619040
3696
10:34
to have millions of Americans
enter recovery,
184
622760
3016
10:37
and put an end to this epidemic.
185
625800
2096
10:39
Thank you very much.
186
627920
1216
10:41
(Applause)
187
629160
2376

▲Back to top

ABOUT THE SPEAKER
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.

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.

More profile about the speaker
Michael Botticelli | Speaker | TED.com