【TED演讲56】上瘾是一种疾病，但是很少得到治疗！演说者：Michael Botticelli

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演说题目：上瘾是一种疾病，但是很少得到治疗！演说者：Michael Botticelli

在美国，只有九分之一的人得到了他们需要的，治疗上瘾和药物滥的疗程。前国家医药政策负责人，Mochael希望结束这种疾病，并以友善、同情和公正来对待有瘾的人。他鼓励百万在康复治疗中的美国人说出他们的故事，并抵抗药物滥用等疾病。

中英对照翻译

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，如果你遇见我，你可能看不出来。我在一个德高望重的学校有一份很好的工作。当然，我穿着得体，但是我的内心却在被侵蚀。

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.

我在一个充满上瘾的家庭长大，当我还是一个孩子的时候，我对自己的性取向也很疑惑。虽然那个时候我无法直说，作为一个同性恋小孩长大，让我有了自我封闭和缺乏自信的问题。但是喝酒把这一切都带走了。

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.

像很多人一样，我很小就开始喝酒，我喝着酒上完了大学。当我在80年代初终于出柜时，唯一一个地方，我能够见到其他同性恋，来社交，来展现真我，就是同性恋酒吧。然而你在同性恋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.

我的故事并不时独一无二。像上百万美国人，我的疾病无法被诊断。它让我选择我永远不会选择的人、地方和事情，直到我由此触犯了法律。我有了一个“康复治疗”的“机会”，然后我开始了改过自新的旅程。

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.

我改过自新的旅程充满了爱和快乐，但是也有痛苦。像你们中的很多人，我因为这个疾病 失去了太多的朋友和家人。我听说了太多令人伤心的故事，关于人们因为上瘾失去了喜欢的人，我也因为艾滋病失去了无数朋友。

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. 

现在不断增长的鸦片类药品的使用和艾滋病的传播，不幸的有很多相同点。现在，我们处在历史上最严重的医疗保健危机中。单单在2014年，两万八千人死于因为处方药和海洛因 的过度使用。在20世纪80年代，很多人死于艾滋病。政府无视了这个问题，有些甚至无法说出那个词，他们不想接受治疗。

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，这和我们现在的（同性恋）意识的风潮有很多相同之处。有些人称之为同性恋瘟疫，他们呼吁隔离，他们想要将无辜 的”受害者“（非同性恋）和我们隔离。我很担心我们会在这场战争中失败，因为人们都在责怪生病的我们。公众政策被恐惧和不安绑架，被绑架的还有同情、关心、医疗研究、恢复和治疗。

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. 

但是我们改变了这一切。因为那些逝者造成的伤痛，我们开启了一个社会和政治的运动，艾滋病促使我们行动，让我们站出来，大声表达自己的意愿，并付诸行动这也促使了LGBT运动。我们知道我们在为我们的生活而斗争，因为沉默意味着死亡，但是我们改变了，我们使事情成真。

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.

现在，我们有希望在我们人生中看到艾滋病的结束。这些改变由很大程度上靠通过勇敢却简单的决定，让人们走出家门，到他们的社区，他们的朋友，他们的家人，和他们的同事那里。

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.

几年前，我是“名字计划”的一个志愿者，这个组织由克里夫·琼斯在旧金山成立，为了展示死于艾滋病的人的名字，脸庞和家庭以及爱他们的人。我依旧记得展开艾滋病纪念被子在1988年10月的一天的国家广场。

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.

快进到2015，最高法院决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楼梯，和其他人一起庆祝这个决定，我不禁思考我们在 LGBT维权上走了这么远，但是我们在成瘾问题上还需要走多远。

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.

当我被奥巴马总统提名为他的医药政策负责人时，我对我改过自新和同性恋非常开放。在我接受审核的过程中，我并没有注意到作为同性恋影响到我的候选和我能否胜任这份工作。不过真正的阻碍是我的瘾 一次，一个国会工作人员说，我的任职不可能会被参议院通过，因为我的一些过去历史，尽管我在20年来改过自新，尽管这份工作和有关的瘾的知识没有什么关系。

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.

所以这个就是有对物品上瘾的人每天面对的，而且我不得不说，这也是为什么我更愿意承认我是同性恋，相比于承认我有药瘾的历史。

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.

几乎美国的每一个家庭都被瘾影响。但是不幸的是，这并不经常被公开和诚实地讨论。这只被私底下谈论，这受到鄙视和嘲讽。我们听说这些故事，一次又一次， 在电视上，在网络上，从政府和家人朋友中听说。但是有上瘾的人听到了这些事情，不知怎么的认为我们不值得关心和治疗。现在在美国，只有九分之一的人接受针对他们上瘾的治疗和照顾。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.

大体上来说，有其他疾病的人们接受治疗和照顾。 如果你有癌症，你接受治疗。如果你有糖尿病，你接受治疗。如有你心脏病突发，你接受急救，然后接受康复治疗。但是不知道为什么上瘾的人需要等待治疗，或者在需要的时候接受不到。没有治疗，瘾会造成很严重的后果。对于很多人，这意味着死亡或者入狱。我们都曾经历过这些。

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.

这么久以来，我们的国家认为我们能够通过逮捕来解决问题。但我们知道这不行。几代科学家的研究表明这个健康问题是一个长期的疾病，人们生来就有或者后天养成的。

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. 

所以奥巴马政府改变了毒品政策。我们创造并实施了一个全面的计划，扩大预防措施、治疗、早期干预和恢复治疗。我们加快了法律上的改革，我们消除了人们得到第二次机会的障碍，我们看见了公共健康和安全部门在社区内团结协作。

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.

我们看见全国的警察引导人们接受治疗，而不是直接把他们逮捕和收监。我们看见执法者和工作人员把毒品改成纳洛酮，给人们第二次机会。平价医疗法案是这个世纪对上瘾治疗的最大进步，这份法案倡导把康复治疗整合到基础医疗保障中。但是总而来说，这些并不够，除非我们改变美国人们对有上瘾的人的观念。

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. 

几年前，当我终于意识到我有问题，我知道我需要帮助的时候，我因为害怕而不敢请求帮助。我担心人们会觉得我很傻、意志脆弱，觉得我道德有缺陷。但是因为我希望改变，所以我会谈论我的康复治疗。我想让人们知道，我们需要真诚开放的对待我们是谁，和我们能做什么。

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.

我公开我的康复治疗，不是为了炫耀，我公开我的康复治疗是为了改变公众的意见，为了改变政策，和改变这个疾病的现象，并使百万受其折磨的美国人有能力开放真诚的对待他们是谁。疾病代表不了一个人，每一个人都有机会改变公众的观念和政策。

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.

每一个人都认识某些上瘾的人，而且每一个人都可以为改变美国人们对上瘾的人的观念做出一份贡献 如果你看到有上瘾的人，不要只看到一个酒鬼、瘾君子或者滥用者，要看到一个人类，向他们提供帮助，给他们友善和同情。团结一致，我们可以成为一个美国正冉冉升起的一个运动的一部分，来改变我们看待有瘾的人的观念。

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.Thank you very much.

团结一致，我们能够改变政策。我们可以保证让人们得到他们需要的治疗， 就像其他疾病一样。我们可以成为一个不断进步的美国运动的一部分，让百万美国人的得到康复治疗，并结束这个不好的风潮。谢谢