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

Michael Botticelli: A dependência química é uma doença. E deveria ser tratada como tal.

Filmed:
1,620,936 views

Apenas uma em nove pessoas nos Estados Unidos consegue a assistência e o tratamento necessários para tratar a adição e o abuso de substâncias. Ex-diretor do National Drug Control Policy, Michael Botticelli está trabalhando para pôr um fim nessa epidemia e conseguir que pessoas com dependência química sejam tratadas com bondade, compaixão e de forma justa. Numa palestra pessoal e ponderada, ele encoraja os milhões de norte-americanos em recuperação a fazerem suas vozes serem ouvidas e a confrontar o estigma associado a desordens do uso de substâncias.
- 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.
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Há 28 anos, eu era um homem acabado.
00:16
And you probably wouldn't be able
to tell that if you met me.
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E quem me conhecesse na época
provavelmente nem notaria.
00:20
I had a good job at a well-respected
academic institution.
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Eu tinha um bom emprego
numa respeitada instituição acadêmica.
00:24
I dressed well, of course.
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Eu me vestia bem, claro.
(Risos)
00:27
But my insides were rotting away.
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Mas, por dentro, estava desmoronando.
00:30
You see, I grew up in a family
riddled with addiction,
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Vejam bem, cresci numa família
minada por dependências químicas
00:34
and as a kid, I also struggled
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e, quando criança, lutava
00:36
with coming to terms
with my own sexuality.
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pra entrar num acordo
com minha sexualidade.
00:38
And even though I couldn't name it then,
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E, mesmo que à época
eu não soubesse explicar,
00:41
growing up as a gay kid
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crescer como um menino gay
00:43
just compounded my issues
of isolation and insecurities.
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só aumentou meus problemas
de isolamento e inseguranças.
00:48
But drinking took all of that away.
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Mas beber levava tudo isso embora.
00:52
Like many, I drank at an early age.
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Como muitos, quando jovem, eu bebia.
00:56
I continued to drink
my way through college.
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Bebi durante todo meu tempo de faculdade.
00:59
And when I finally did come out
in the early 1980s,
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E, quando finalmente me assumi,
no início da década de 1980,
01:02
about the only places
to meet other gay people,
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os únicos lugares
para conhecer outros gays,
01:05
to socialize,
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para socializar,
01:07
to be yourself, were gay bars.
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ser você mesmo, eram os bares gays.
01:10
And what do you do in gay bars?
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E o que se faz num bar gay?
01:12
You drink.
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A gente bebe.
01:14
And I did --
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E eu bebia...
01:15
a lot.
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e muito.
01:17
My story is not unique.
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Meu caso não era uma exceção.
01:19
Like millions of Americans,
my disease progressed undiagnosed.
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Como para milhões de norte-americanos,
minha doença avançava sem diagnóstico.
01:24
It took me to people
and places and things
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Ela me levou a lugares, pessoas e coisas
que eu jamais teria escolhido.
01:26
that I never would have chosen.
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01:29
It wasn't until
an intersection with the law
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Somente por meio da lei,
01:32
gave me an "opportunity" to get care,
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que me deu uma "oportunidade"
de conseguir tratamento,
01:35
that I began my journey of recovery.
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é que iniciei minha jornada
rumo à recuperação.
01:39
My journey of recovery
has been filled with love and with joy,
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E ela tem sido plena de amor e alegria,
01:43
but it hasn't been without pain.
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mas não sem dor.
01:45
Like many of you, I've lost too many
friends and family to this disease.
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Como muitos de vocês, perdi amigos
e familiares demais para essa doença.
01:49
I've heard too many
heartbreaking stories
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Ouvi inúmeras histórias comoventes
01:51
of people who've lost
loved ones to addiction.
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de quem perdeu pessoas queridas
para a dependência química.
01:54
And I've also lost
countless friends to HIV and AIDS.
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Também perdi inúmeros amigos
para o HIV e a AIDS.
01:59
Our current opioid epidemic
and the AIDS epidemic
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Nossas atuais epidemias
de opioides e de AIDS,
02:02
tragically have much in common.
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tragicamente, têm muito em comum.
02:06
Right now, we are in the midst of one
of the greatest health crises of our time.
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Vivemos hoje em meio
a uma das maiores crises na saúde.
02:11
During 2014 alone, 28,000 people
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Somente em 2014, 28 mil pessoas
02:15
died of drug overdoses associated
with prescription drugs and heroin.
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morreram de overdose de drogas associadas
a drogas prescritas e heroína.
02:22
During the 1980s, scores of people
were dying from HIV and AIDS.
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Durante a década de 1980, um monte
de gente estava morrendo de HIV e AIDS.
02:27
Public officials ignored it.
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As autoridades ignoraram isso.
02:30
Some wouldn't even utter the words.
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Alguns nem mesmo pronunciavam as palavras.
02:33
They didn't want treatment.
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Eles não queriam tratamento.
02:36
And tragically, there are many parallels
with our current epidemic.
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E tragicamente há muitos paralelos
com nossa epidemia atual.
02:40
Some called it the gay plague.
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Alguns a chamavam de "praga gay".
02:43
They called for quarantines.
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Exigiam quarentena.
02:46
They wanted to separate
the innocent victims from the rest of us.
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Queriam separar as vítimas
inocentes do resto de nós.
02:52
I was afraid we were losing this battle
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Tive medo de perdermos essa batalha,
02:54
because people were
blaming us for being sick.
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pois as pessoas nos culpavam
por estarem adoecendo.
02:58
Public policy was being held hostage
by stigma and fear,
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A política pública era refém
do estigma e do medo
03:03
and also held hostage
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e também eram reféns
03:05
were compassion, care,
research, recovery and treatment.
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a compaixão, o cuidado, a pesquisa,
a recuperação e o tratamento.
03:11
But we changed all that.
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Mas nós mudamos tudo isso.
03:14
Because out of the pain of those deaths,
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Porque, a partir da dor dessas mortes,
assistimos a um movimento
social e político.
03:17
we saw a social and political movement.
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03:20
AIDS galvanized us into action;
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A AIDS nos impulsionava para a ação;
03:24
to stand up, to speak up and to act out.
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a protestar, a falar e a agir.
03:30
And it also galvanized
the LGBT movement.
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Ela também alavancou o movimento LGBT.
Sabíamos que era uma batalha pela vida,
porque nos calar significava morrer,
03:34
We knew we were
in a battle for our lives
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03:36
because silence equaled death,
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03:38
but we changed,
and we made things happen.
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mas nós mudamos isso,
e fizemos as coisas acontecerem.
03:42
And right now, we have the potential
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E agora temos o potencial
03:45
to see the end of HIV/AIDS
in our lifetime.
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de ver o fim do HIV/AIDS em nossos dias.
03:50
These changes came in no small part
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Essas mudanças vieram em grande parte
03:53
by the courageous, yet simple decision
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pela decisão corajosa, porém simples,
03:57
for people to come out
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de as pessoas se assumirem
03:59
to their neighbors,
to their friends, to their families
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para seus vizinhos,
seus amigos,
suas famílias
04:05
and to their coworkers.
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e seus colegas.
04:08
Years ago, I was a volunteer
for the Names Project.
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Há alguns anos, fui voluntário
do Names Project.
04:12
This was an effort started
by Cleve Jones in San Francisco
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O projeto foi um esforço iniciado
por Cleve Jones em São Francisco
para mostrar que as pessoas
que morreram de AIDS
04:15
to show that people who died of AIDS
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04:17
had names
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tinham um nome,
04:19
and faces and families
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tinham um rosto,
uma família
04:23
and people who loved them.
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e pessoas que as amavam.
04:27
I still recall unfolding
the AIDS memorial quilt
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Ainda me lembro de desenrolar
o AIDS memorial quilt
04:32
on the National Mall
on a brilliant day in October, 1988.
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no National Mall, num dia
maravilhoso, em outubro de 1988.
04:43
So fast forward to 2015.
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Vamos avançar para 2015.
04:46
The Supreme Court's decision to strike
down the ban on same-sex marriage.
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A decisão da Suprema Corte
de legalizar o casamento
entre pessoas do mesmo sexo.
04:51
My husband, Dave, and I walk over
to the steps of the Supreme Court
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Dave, meu marido, e eu fomos
até a escadaria da Suprema Corte
04:54
to celebrate that decision
with so many other people,
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para celebrar aquela decisão
com tantas outras pessoas,
04:57
and I couldn't help but think
how far we came around LGBT rights
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e aquilo me fez pensar quão longe
chegamos com os direitos LGBT
05:03
and yet how far we needed to go
around issues of addiction.
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e, mesmo assim, o quanto
ainda precisamos avançar
nas questões relativas
à dependência química.
05:10
When I was nominated
by President Obama
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Quando o presidente Obama me indicou
para diretor de Políticas de Drogas,
05:12
to be his Director of Drug Policy,
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fui bem aberto sobre minha recuperação
e sobre o fato de ser gay.
05:14
I was very open about my recovery
and about the fact that I was a gay man.
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05:18
And at no point during
my confirmation process --
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E em nenhum momento
da minha confirmação no cargo,
05:21
at least that I know of --
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pelo menos que eu saiba,
05:22
did the fact that I was a gay man
come to bear on my candidacy
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o fato de que eu ser gay
foi um obstáculo à minha indicação
05:26
or my fitness to do this job.
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ou minha qualificação para o cargo.
05:29
But my addiction did.
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Mas a minha adição foi.
05:32
At one point, a congressional staffer
said that there was no way
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Em dado momento, um funcionário
do Congresso disse que não havia chance
05:36
that I was going to be confirmed
by the United States Senate
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de eu ser confirmado
pelo Senado norte-americano
05:39
because of my past,
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devido ao meu passado,
05:40
despite the fact that I had been
in recovery for over 20 years,
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apesar do fato de eu estar
em recuperação há mais de 20 anos,
05:44
and despite the fact
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e apesar do fato de esse emprego
demandar um pouco de conhecimento
05:45
that this job takes a little bit
of knowledge around addiction.
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quanto à dependência química.
05:48
(Laughter)
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(Risos)
05:51
So, you know, this is the stigma
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Sabem, esse é o estigma
05:54
that people with
substance use disorders
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que pessoas com transtornos
do uso de substâncias
05:56
face every single day,
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enfrentam todo santo dia,
05:58
and you know, I have to tell you
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e vou lhes dizer uma coisa,
06:00
it's still why I'm more comfortable
coming out as a gay man
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é por isso que me sinto mais confortável
me assumindo como gay
06:03
than I am as a person
with a history of addiction.
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do que como uma pessoa
com uma história de dependência.
06:07
Nearly every family in America
is affected by addiction.
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Quase toda família nos EUA
é afetada pela dependência química.
06:11
Yet, unfortunately, too often,
it's not talked about openly and honestly.
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Apesar disso, infelizmente, não é comum
se falar aberta e honestamente sobre isso.
06:18
It's whispered about.
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Falamos dela pelos cantos.
06:19
It's met with derision and scorn.
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É algo visto com escárnio e desprezo.
06:23
We hear these stories,
time and time again, on TV, online,
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Estamos cansados de ouvir
essas histórias na TV, na internet,
06:28
we hear it from public officials,
and we hear it from family and friends.
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tanto das autoridades públicas
quanto de familiares e amigos.
06:33
And those of us with an addiction,
we hear those voices,
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E nós, que temos uma dependência,
ouvimos essas coisas
06:37
and somehow we believe that we are
less deserving of care and treatment.
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e de alguma forma acreditamos sermos menos
merecedores de assistência e tratamento.
06:43
Today in the United States,
only one in nine people
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Hoje, nos EUA, apenas uma em nove pessoas
06:46
get care and treatment for their disorder.
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consegue assistência e tratamento
para seu transtorno.
06:49
One in nine.
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Uma em nove.
06:50
Think about that.
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Pensem nisso.
Em geral, pessoas com outras doenças
conseguem assistência.
06:52
Generally, people with other diseases
get care and treatment.
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06:55
If you have cancer, you get treatment,
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Quem tem câncer, recebe tratamento.
06:57
if you have diabetes, you get treatment.
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Quem tem diabetes, recebe tratamento.
06:59
If you have a heart attack,
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Quem tiver um infarto,
07:01
you get emergency services,
and you get referred to care.
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recebe pronto atendimento
e cuidados posteriores.
07:05
But somehow people with addiction
have to wait for treatment
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Mas pessoas com dependência química
têm de esperar por tratamento
07:08
or often can't get when they need it.
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ou não conseguem o que precisam.
07:11
And left untreated, addiction
has significant, dire consequences.
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E, sem tratamento, a dependência
tem consequências sérias, graves.
07:16
And for many people
that means death or incarceration.
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E, para muitas pessoas,
isso significa morte ou prisão.
07:21
We've been down that road before.
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Já vimos esse filme antes.
07:23
For too long our country felt
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Por muito tempo, nosso país achou
que o problema seria resolvido.
07:24
like we could arrest our way
out of this problem.
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07:27
But we know that we can't.
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Mas sabemos que não conseguimos.
07:30
Decades of scientific research has shown
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Décadas de pesquisa científica mostraram
que essa é uma questão médica,
07:33
that this is a medical issue --
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que é uma doença crônica
07:35
that this is a chronic medical condition
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07:37
that people inherit
and that people develop.
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que as pessoas herdam e desenvolvem.
07:42
So the Obama administration
has taken a different tack on drug policy.
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Assim, o governo Obama trilhou
uma via diferente na política das drogas.
07:46
We've developed and implemented
a comprehensive plan
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Desenvolvemos e implementamos
um plano abrangente
07:49
to expand prevention services,
treatment services,
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para expandir serviços
de prevenção, de tratamento,
07:52
early intervention and recovery support.
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intervenção precoce e apoio à recuperação.
07:56
We've pushed criminal justice reform.
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Pressionamos por uma reforma
judiciária penal.
07:59
We've knocked down barriers
to give people second chances.
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Derrubamos barreiras para dar
uma segunda chance às pessoas.
08:02
We see public health and public safety
officials working hand in hand
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Vemos autoridades de saúde
e de segurança pública trabalhando juntas
08:06
at the community level.
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no nível da comunidade.
Vemos autoridades policiais
direcionando pessoas para tratamento,
08:08
We see police chiefs across the country
guiding people to treatment
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08:11
instead of jail and incarceration.
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em vez de cadeia e encarceramento.
08:14
We see law enforcement
and other first responders
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Vemos policiais e outros socorristas
08:17
reversing overdoses with naloxone
to give people a second chance for care.
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revertendo overdoses com naloxona
para dar às pessoas uma segunda chance.
08:23
The Affordable Care Act
is the biggest expansion
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A assistência à saúde
do governo Obama foi o maior avanço
08:26
of substance use disorder
treatment in a generation,
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do tratamento do transtorno do uso
de substância numa geração,
08:29
and it also calls for the integration
of treatment services within primary care.
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e ela também tenta integrar
os tratamentos dentro da atenção básica.
08:36
But fundamentally,
all of this work is not enough.
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Mas todo esse trabalho,
na realidade, não é o suficiente.
08:40
Unless we change the way
that we view people with addiction
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A não ser que mudemos nossa forma
de ver as pessoas com adição
08:44
in the United States.
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nos Estados Unidos.
08:47
Years ago when I finally
understood that I had a problem
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Anos atrás, quando finalmente
entendi que tinha um problema
08:51
and I knew that I needed help,
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e percebi que precisava de ajuda,
tive muito medo de pedir.
08:53
I was too afraid to ask for it.
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08:56
I felt that people would think
I was stupid, that I was weak-willed,
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Senti que as pessoas
poderiam achar que eu era burro,
sem força de vontade,
09:01
that I was morally flawed.
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que tinha problemas de caráter.
09:05
But I talk about my recovery
because I want to make change.
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Mas falo sobre minha recuperação
porque quero fazer parte da mudança.
09:10
I want us to see that we need to be open
and candid about who we are
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Quero mostrar que precisamos ser
abertos e francos sobre quem somos
09:16
and what we can do.
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e o que podemos fazer.
09:18
I am public about my own recovery
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Falo abertamente sobre minha recuperação,
09:20
not to be self-congratulatory.
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1920
não para me gabar.
09:23
I am open about my own recovery
to change public opinion,
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Falo abertamente sobre minha recuperação
para mudar a opinião pública,
09:27
to change public policy
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1896
mudar as políticas públicas,
09:29
and to change the course of this epidemic
and empower the millions of Americans
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mudar o curso dessa epidemia
e empoderar os milhões de norte-americanos
09:33
who struggle with this journey
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1856
que lutam nesse processo
09:35
to be open and candid
about who they are.
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1960
de serem abertos e francos sobre quem são.
09:38
People are more than their disease.
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As pessoas são maiores do que sua doença.
09:41
And all of us have the opportunity
to change public opinion
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3296
E todos nós temos a oportunidade
de mudar a opinião pública
09:45
and to change public policy.
168
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1640
e mudar as políticas públicas.
09:48
All of us know someone
who has an addiction,
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2280
Todos conhecemos alguém
com uma dependência química
09:51
and all of us can do our part
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1936
e todos nós podemos fazer nossa parte,
09:53
to change how we view people
with addiction in the United States.
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4160
para mudar como vemos as pessoas
com dependência química nos EUA.
09:58
So when you see
someone with an addiction,
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2416
Por isso, quando virem
alguém com esse problema,
10:00
don't think of a drunk or a junkie
or an addict or an abuser --
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não enxerguem um bêbado ou drogado,
ou um viciado ou um dependente,
10:07
see a person;
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1200
vejam uma pessoa;
10:10
offer them help;
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1496
ofereçam ajuda;
10:11
give them kindness and compassion.
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1720
tratem-na com bondade e compaixão.
10:14
And together, we can be part
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2216
E juntos podemos fazer parte
10:16
of a growing movement
in the United States
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2056
de um crescente movimento
nos Estados Unidos
10:18
to change how we view
people with addiction.
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2080
para mudar como vemos
as pessoas com adição.
10:21
Together we can change public policy.
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2120
Juntos podemos mudar políticas públicas.
10:24
We can ensure that people
get care when they need it,
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Podemos assegurar tratamento
às pessoas quando elas precisarem,
10:28
just like any other disease.
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como ocorre com qualquer outra doença.
10:31
We can be part of a growing,
unstoppable movement
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3696
Podemos ser parte de um movimento
crescente e sem volta
10:34
to have millions of Americans
enter recovery,
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3016
do ingresso de milhões
de norte-americanos na reabilitação,
10:37
and put an end to this epidemic.
185
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2096
e colocar um ponto final nessa epidemia.
10:39
Thank you very much.
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Muito obrigado.
10:41
(Applause)
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2376
(Aplausos)
Translated by Raissa Mendes
Reviewed by Maricene Crus

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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