Addiction is a disease. We should treat it like one
TED簡介：2016 |在美國，只有九分之一的人得到了他們需要的，治療上癮和藥物濫的療程。前國家醫(yī)藥政策負責(zé)人，邁克爾·波提切利希望結(jié)束這種疾病，并以友善、同情和公正來對待有癮的人。在這個引人思考的演講中，他鼓勵百萬在康復(fù)治療中的美國人說出他們的故事，并抵抗藥物濫用等疾病。
演講者：Michael Botticelli邁克爾·波提切利
片長：10：49
視頻+中英對照翻譯+MP3音頻原文：癮是一種疾病
中英文對照翻譯
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.
28年前，我的人生陷入低谷，如果你遇見我，你可能看不出來。我在一個德高望重的學(xué)校有一份很好的工作。當(dāng)然，我穿著得體，但是我的內(nèi)心卻在被侵蝕。
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.
我在一個充滿上癮的家庭長大，當(dāng)我還是一個孩子的時候，我對自己的性取向也很疑惑。雖然那個時候我無法直說，作為一個同性戀小孩長大，讓我有了自我封閉和缺乏自信的問題。但是喝酒把這一切都帶走了。
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.
像很多人一樣，我很小就開始喝酒，我喝著酒上完了大學(xué)。當(dāng)我在80年代初終于出柜時，唯一一個地方，我能夠見到其他同性戀，來社交，來展現(xiàn)真我，就是同性戀酒吧。然而你在同性戀酒吧里做的事情是什么？喝酒。而且我喝了，很多。
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.
我的故事并不時獨一無二。像上百萬美國人，我的疾病無法被診斷。它讓我選擇我永遠不會選擇的人、地方和事情，直到我由此觸犯了法律。我有了一個“康復(fù)治療”的“機會”，然后我開始了改過自新的旅程。
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.
我改過自新的旅程充滿了愛和快樂，但是也有痛苦。像你們中的很多人，我因為這個疾病 失去了太多的朋友和家人。我聽說了太多令人傷心的故事，關(guān)于人們因為上癮失去了喜歡的人，我也因為艾滋病失去了無數(shù)朋友。
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.
現(xiàn)在不斷增長的鴉片類藥品的使用和艾滋病的傳播，不幸的有很多相同點?，F(xiàn)在，我們處在歷史上最嚴重的醫(yī)療保健危機中。單單在2014年，兩萬八千人死于因為處方藥和海洛因 的過度使用。在20世紀80年代，很多人死于艾滋病。政府無視了這個問題，有些甚至無法說出那個詞，他們不想接受治療。
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.
不幸的是，這和我們現(xiàn)在的（同性戀）意識的風(fēng)潮有很多相同之處。有些人稱之為同性戀瘟疫，他們呼吁隔離，他們想要將無辜 的”受害者“（非同性戀）和我們隔離。我很擔(dān)心我們會在這場戰(zhàn)爭中失敗，因為人們都在責(zé)怪生病的我們。公眾政策被恐懼和不安綁架，被綁架的還有同情、關(guān)心、醫(yī)療研究、恢復(fù)和治療。
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.
但是我們改變了這一切。因為那些逝者造成的傷痛，我們開啟了一個社會和政治的運動，艾滋病促使我們行動，讓我們站出來，大聲表達自己的意愿，并付諸行動這也促使了LGBT運動。我們知道我們在為我們的生活而斗爭，因為沉默意味著死亡，但是我們改變了，我們使事情成真。
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.
現(xiàn)在，我們有希望在我們?nèi)松锌吹桨滩〉慕Y(jié)束。這些改變由很大程度上靠通過勇敢卻簡單的決定，讓人們走出家門，到他們的社區(qū)，他們的朋友，他們的家人，和他們的同事那里。
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.
幾年前，我是“名字計劃”的一個志愿者，這個組織由克里夫·瓊斯在舊金山成立，為了展示死于艾滋病的人的名字，臉龐和家庭以及愛他們的人。我依舊記得展開艾滋病紀念被子在1988年10月的一天的國家廣場。
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.
快進到2015，最高法院決定取消同性婚姻的禁令。我的丈夫，戴夫和我走到最高法院的樓梯，和其他人一起慶祝這個決定，我不禁思考我們在 LGBT維權(quán)上走了這么遠，但是我們在成癮問題上還需要走多遠。
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.
當(dāng)我被奧巴馬總統(tǒng)提名為他的醫(yī)藥政策負責(zé)人時，我對我改過自新和同性戀非常開放。在我接受審核的過程中，我并沒有注意到作為同性戀影響到我的候選和我能否勝任這份工作。不過真正的阻礙是我的癮?一次，一個國會工作人員說，我的任職不可能會被參議院通過，因為我的一些過去歷史，盡管我在20年來改過自新，盡管這份工作和有關(guān)的癮的知識沒有什么關(guān)系。
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.
所以這個就是有對物品上癮的人每天面對的，而且我不得不說，這也是為什么我更愿意承認我是同性戀，相比于承認我有藥癮的歷史。
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.
幾乎美國的每一個家庭都被癮影響。但是不幸的是，這并不經(jīng)常被公開和誠實地討論。這只被私底下談?wù)?，這受到鄙視和嘲諷。我們聽說這些故事，一次又一次， 在電視上，在網(wǎng)絡(luò)上，從政府和家人朋友中聽說。但是有上癮的人聽到了這些事情，不知怎么的認為我們不值得關(guān)心和治療?，F(xiàn)在在美國，只有九分之一的人接受針對他們上癮的治療和照顧。九分之一，好好想想。
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.
大體上來說，有其他疾病的人們接受治療和照顧。?如果你有癌癥，你接受治療。如果你有糖尿病，你接受治療。如有你心臟病突發(fā)，你接受急救，然后接受康復(fù)治療。但是不知道為什么上癮的人需要等待治療，或者在需要的時候接受不到。沒有治療，癮會造成很嚴重的后果。對于很多人，這意味著死亡或者入獄。我們都曾經(jīng)歷過這些。
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.
這么久以來，我們的國家認為我們能夠通過逮捕來解決問題。但我們知道這不行。幾代科學(xué)家的研究表明這個健康問題是一個長期的疾病，人們生來就有或者后天養(yǎng)成的。
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.
所以奧巴馬政府改變了毒品政策。我們創(chuàng)造并實施了一個全面的計劃，擴大預(yù)防措施、治療、早期干預(yù)和恢復(fù)治療。我們加快了法律上的改革，我們消除了人們得到第二次機會的障礙，我們看見了公共健康和安全部門在社區(qū)內(nèi)團結(jié)協(xié)作。
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.
我們看見全國的警察引導(dǎo)人們接受治療，而不是直接把他們逮捕和收監(jiān)。我們看見執(zhí)法者和工作人員把毒品改成納洛酮，給人們第二次機會。平價醫(yī)療法案是這個世紀對上癮治療的最大進步，這份法案倡導(dǎo)把康復(fù)治療整合到基礎(chǔ)醫(yī)療保障中。但是總而來說，這些并不夠，除非我們改變美國人們對有上癮的人的觀念。
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.
幾年前，當(dāng)我終于意識到我有問題，我知道我需要幫助的時候，我因為害怕而不敢請求幫助。我擔(dān)心人們會覺得我很傻、意志脆弱，覺得我道德有缺陷。但是因為我希望改變，所以我會談?wù)撐业目祻?fù)治療。我想讓人們知道，我們需要真誠開放的對待我們是誰，和我們能做什么。
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.
我公開我的康復(fù)治療，不是為了炫耀，我公開我的康復(fù)治療是為了改變公眾的意見，為了改變政策，和改變這個疾病的現(xiàn)象，并使百萬受其折磨的美國人有能力開放真誠的對待他們是誰。疾病代表不了一個人，每一個人都有機會改變公眾的觀念和政策。
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.
每一個人都認識某些上癮的人，而且每一個人都可以為改變美國人們對上癮的人的觀念做出一份貢獻 如果你看到有上癮的人，不要只看到一個酒鬼、癮君子或者濫用者，要看到一個人類，向他們提供幫助，給他們友善和同情。團結(jié)一致，我們可以成為一個美國正冉冉升起的一個運動的一部分，來改變我們看待有癮的人的觀念。
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.
團結(jié)一致，我們能夠改變政策。我們可以保證讓人們得到他們需要的治療，?就像其他疾病一樣。我們可以成為一個不斷進步的美國運動的一部分，讓百萬美國人的得到康復(fù)治療，并結(jié)束這個不好的風(fēng)潮。
Thank you very much.(Applause)
謝謝。（鼓掌）
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