And you probably wouldn't be able to tell that if you met me.

二十八年前，我的內心充滿絕望。

I had a good job at a well-respected academic institution.

但是當你遇見我時， 可能根本看不出來。

I dressed well, of course.

我有一份很好的工作， 任職於受人尊敬的學術機構。

But my insides were rotting away.

當然，我的外表光鮮亮麗。

You see, I grew up in a family riddled with addiction,

但是我的內心腐朽不堪。

and as a kid, I also struggled

我生長在一個 充滿物質成癮的家庭，

with coming to terms with my own sexuality.

在孩童時期， 我也因為自己的性傾向

And even though I couldn't name it then,

而內心充滿掙扎。

growing up as a gay kid

儘管當時的我， 並不知道這是怎麼回事，

just compounded my issues of isolation and insecurities.

但是身為一個同性戀者，

But drinking took all of that away.

成長只是加劇了我的孤立和不安。

Like many, I drank at an early age.

但是喝酒，能帶走這些感覺。

I continued to drink my way through college.

和許多人一樣，我很早就開始喝酒。

And when I finally did come out in the early 1980s,

我的整個大學生涯，也持續在喝酒。

about the only places to meet other gay people,

在 80 年代初期，我終於決定出櫃，

to socialize,

而當時只有在同性戀酒吧， 才能遇到其他同性戀者，

to be yourself, were gay bars.

與他人來往，

And what do you do in gay bars?

或是作回我自己。

You drink.

你在同性戀酒吧會做什麼？

And I did --

喝酒。

a lot.

我也是，

My story is not unique.

而且喝了很多。

Like millions of Americans, my disease progressed undiagnosed.

我的故事並不獨特。

It took me to people and places and things

就和數百萬計的美國人一樣， 我的酒癮在不知不覺中逐漸惡化。

that I never would have chosen.

它把我帶領到，

It wasn't until an intersection with the law

我絕對不想選擇的人、地和事物。

gave me an "opportunity" to get care,

直到我觸犯法律，

that I began my journey of recovery.

給了我一個接受治療的「機會」，

My journey of recovery has been filled with love and with joy,

於是開始了我的戒除成癮之旅。

but it hasn't been without pain.

我的戒癮之旅充滿了愛和喜悅，

Like many of you, I've lost too many friends and family to this disease.

但它並非沒有痛苦。

I've heard too many heartbreaking stories

和你們當中的許多人一樣， 成癮問題讓我失去太多朋友和家人，

of people who've lost loved ones to addiction.

我聽過太多人的心碎故事，

And I've also lost countless friends to HIV and AIDS.

都是由於物質成癮， 而失去所愛的人。

Our current opioid epidemic and the AIDS epidemic

我也有數不清的朋友 感染愛滋病毒和愛滋病而死。

tragically have much in common.

不幸的是，我們目前的 鴉片成癮和愛滋病，

Right now, we are in the midst of one of the greatest health crises of our time.

兩者擁有許多共同之處。

During 2014 alone, 28,000 people

現在，我們正處於 當代最大的健康危機之中。

died of drug overdoses associated with prescription drugs and heroin.

光是在 2014 年，就有 28000 人

During the 1980s, scores of people were dying from HIV and AIDS.

由於過量使用處方藥 和海洛因導致死亡。

Public officials ignored it.

在 1980 年代，很多人因 感染愛滋病毒和愛滋病而死亡。

Some wouldn't even utter the words.

政府官員視而不見。

They didn't want treatment.

有些官員甚至避而不談。

And tragically, there are many parallels with our current epidemic.

他們不想面對。

Some called it the gay plague.

而可悲的是，這與目前 物質成癮的流行有許多相似之處。

They called for quarantines.

有些人將同性戀視為瘟疫。

They wanted to separate the innocent victims from the rest of us.

他們要求隔離同性戀者。

I was afraid we were losing this battle

他們希望將這些無辜的犧牲者 與其他的民眾隔離。

because people were blaming us for being sick.

我很擔心我們正在從 這場戰役中落敗，

Public policy was being held hostage by stigma and fear,

因為人們責怪我們帶來疾病。

and also held hostage

羞辱和恐懼

were compassion, care, research, recovery and treatment.

不止綁架了公共政策，

But we changed all that.

也綁架了同情，關懷， 研究，戒癮和治療。

Because out of the pain of those deaths,

但是，我們改變了這一切。

we saw a social and political movement.

因為從這些生離死別的痛苦中，

AIDS galvanized us into action;

我們看到了 社會和政治運動正在興起。

to stand up, to speak up and to act out.

愛滋病促使我們行動，

And it also galvanized the LGBT movement.

讓我們站起來，大聲說出口， 並付諸行動。

We knew we were in a battle for our lives

而這也激勵了同志文化運動。

because silence equaled death,

我們知道，我們正在為 自己的生命而戰鬥，

but we changed, and we made things happen.

因為沉默等於死亡；

And right now, we have the potential

但我們要改變，我們要讓改變發生。

to see the end of HIV/AIDS in our lifetime.

而現在，我們有希望看到 愛滋病毒及愛滋病

These changes came in no small part

在我們有生之年消失。

by the courageous, yet simple decision

這些改變，是由一大群人

for people to come out

作出一項勇敢卻簡單的決定：

to their neighbors, to their friends, to their families

他們公開宣告出櫃，

and to their coworkers.

直接面對他們的鄰居、 他們的朋友、他們的家人，

Years ago, I was a volunteer for the Names Project.

以及他們的同事。

This was an effort started by Cleve Jones in San Francisco

好幾年前， 我是「名冊計劃」的志工。

to show that people who died of AIDS

這項由克利夫·瓊斯 在舊金山發起的活動，

had names

展示了死於愛滋病的患者

and faces and families

他們的名字、

and people who loved them.

他們的臉孔、他們的家人

I still recall unfolding the AIDS memorial quilt

以及喜愛他們的人。

on the National Mall on a brilliant day in October, 1988.

我還記得，當愛滋紀念拼布 在國家廣場展開時的情景，

So fast forward to 2015.

那是在 1988 年 10 月， 充滿光輝的一天。

The Supreme Court's decision to strike down the ban on same-sex marriage.

接著我們很快來到 2015 年。

My husband, Dave, and I walk over to the steps of the Supreme Court

根據最高法院的決定， 推翻了同性婚姻禁令。

to celebrate that decision with so many other people,

我的丈夫戴夫，和我一起 走到最高法院外的階梯，

and I couldn't help but think how far we came around LGBT rights

和許多人一同慶祝這項決定，

and yet how far we needed to go around issues of addiction.

我忍不住想起，我們走了多遠的路， 來捍衛同志族群的權利；

When I was nominated by President Obama

而對於全國各地的成癮問題， 我們仍然有很遠的路要走。

to be his Director of Drug Policy,

當我被歐巴馬總統提名，

I was very open about my recovery and about the fact that I was a gay man.

擔任他的毒品管制政策主任時，

And at no point during my confirmation process --

我完全公開了我的戒癮過程， 以及身為同性戀者的事實。

at least that I know of --

在國會的審查過程中， 從頭到尾都沒有──

did the fact that I was a gay man come to bear on my candidacy

至少就我所知──

or my fitness to do this job.

沒有因為我是同性戀者的事實 而影響我的候選資格，

But my addiction did.

或者我擔任這項職務的能力。

At one point, a congressional staffer said that there was no way

但是我的成癮記錄卻受到質疑。

that I was going to be confirmed by the United States Senate

有一次，一名國會助理 表示「不可能」。

because of my past,

由於我過去的成癮記錄，

despite the fact that I had been in recovery for over 20 years,

我不可能通過 美國參議院的同意任命，

and despite the fact

儘管事實上 我已經戒除成癮二十多年，

that this job takes a little bit of knowledge around addiction.

儘管擔任這項職務，

(Laughter)

需要對於成癮有一點瞭解。

So, you know, this is the stigma

（笑聲）

that people with substance use disorders

所以，你知道，

face every single day,

對於物質使用成癮的人來說，

and you know, I have to tell you

這是每一天都得面對的污名，

it's still why I'm more comfortable coming out as a gay man

而且你知道嗎？我必須告訴你，

than I am as a person with a history of addiction.

這就是為什麼我覺得 出櫃承認自己是同性戀，

Nearly every family in America is affected by addiction.

會比承認自己的成癮歷史， 來得舒服一些。

Yet, unfortunately, too often, it's not talked about openly and honestly.

幾乎每個美國家庭， 都受到物質成癮的影響。

It's whispered about.

然而，不幸的是，很多時候， 這個話題無法被開誠佈公地討論。

It's met with derision and scorn.

它只能在私底下討論。

We hear these stories, time and time again, on TV, online,

它還遭受到嘲諷和鄙視。

we hear it from public officials, and we hear it from family and friends.

一次又一次， 我們從電視上、網路上、

And those of us with an addiction, we hear those voices,

從政府官員，或是家人和朋友口中， 聽到這些故事。

and somehow we believe that we are less deserving of care and treatment.

對於我們這些成癮者來說，

Today in the United States, only one in nine people

不知為何，這些聲音卻讓我們相信， 我們並不值得受到照顧和治療。

get care and treatment for their disorder.

如今在美國，九個成癮者當中，

One in nine.

只有一位能得到照顧和治療。

Think about that.

只有 1/9。

Generally, people with other diseases get care and treatment.

想想看。

If you have cancer, you get treatment,

一般來說，人們得到其他疾病， 都能得到照顧和治療。

if you have diabetes, you get treatment.

如果你有癌症，你得到治療；

If you have a heart attack,

如果你有糖尿病，你得到治療。

you get emergency services, and you get referred to care.

如果你的心臟病發作，

But somehow people with addiction have to wait for treatment

你會接受急救，並且得到後續照顧。

or often can't get when they need it.

但不知何故，成癮的人需要治療時，

And left untreated, addiction has significant, dire consequences.

他們必須等待， 甚至經常得不到治療。

And for many people that means death or incarceration.

而成癮患者如果沒有即時接受治療， 將會造成嚴重、可怕的後果。

We've been down that road before.

對許多人來說， 結局就是死亡或被監禁。

For too long our country felt

我們一直走在這條道路上。

like we could arrest our way out of this problem.

長期以來，我們的國家認為，

But we know that we can't.

我們可以藉由逮捕成癮者， 來解決這個問題。

Decades of scientific research has shown

但我們很清楚，我們做不到。

that this is a medical issue --

數十年來的科學研究顯示，

that this is a chronic medical condition

這是一個醫學問題──

that people inherit and that people develop.

這是一種慢性疾病，

So the Obama administration has taken a different tack on drug policy.

而且一代傳一代，不斷地發展。

We've developed and implemented a comprehensive plan

因此歐巴馬政府對於毒品管制政策， 採取了不同的方針。

to expand prevention services, treatment services,

我們制定並實施了更為廣泛的計畫，

early intervention and recovery support.

包括擴大預防服務，治療服務，

We've pushed criminal justice reform.

早期介入，以及戒癮支持。

We've knocked down barriers to give people second chances.

我們推動刑事司法改革。

We see public health and public safety officials working hand in hand

我們排除萬難，給人們重生的機會。

at the community level.

我們看到，公共衛生與公共安全官員

We see police chiefs across the country guiding people to treatment

在社區層面攜手合作。

instead of jail and incarceration.

我們看到全國各地的警察局長， 引導人們進行治療，

We see law enforcement and other first responders

而不是將他們關進監牢。

reversing overdoses with naloxone to give people a second chance for care.

我們看到執法部門 與第一線的急救人員，

The Affordable Care Act is the biggest expansion

使用納洛酮救回成癮者， 給他們後續治療、獲得重生的機會。

of substance use disorder treatment in a generation,

歐巴馬的「可負擔健保法案」，

and it also calls for the integration of treatment services within primary care.

對於物質濫用成癮的治療， 是本世紀最大的突破，

But fundamentally, all of this work is not enough.

並且要求將成癮治療 納入基本的保險給付範圍。

Unless we change the way that we view people with addiction

但是從根本來說， 所有這些工作仍然不夠。

in the United States.

除非我們能改變整個美國

Years ago when I finally understood that I had a problem

看待成癮者的方式。

and I knew that I needed help,

幾年前，當我意識到我有問題時，

I was too afraid to ask for it.

我知道我需要幫助，

I felt that people would think I was stupid, that I was weak-willed,

但是我害怕尋求協助。

that I was morally flawed.

我覺得人們會認為我很愚蠢， 意志薄弱，

But I talk about my recovery because I want to make change.

我在道德上是有缺陷的。

I want us to see that we need to be open and candid about who we are

但是，我會談論我是如何戒癮， 因為我想作出改變。

and what we can do.

我希望讓大家看到， 我們需要開誠佈公，說出我們是誰，

I am public about my own recovery

以及我們能做些什麼。

not to be self-congratulatory.

我公開自己的戒癮過程，

I am open about my own recovery to change public opinion,

不是為了自我誇耀。

to change public policy

我公開自己的戒癮過程， 是為了改變輿論，

and to change the course of this epidemic and empower the millions of Americans

改變公共政策， 改變這個流行病的歷程，

who struggle with this journey

並對於還在這條路上奮鬥的 數百萬美國人，

to be open and candid about who they are.

給他們力量，

People are more than their disease.

讓他們能坦率地說出自己是誰。

And all of us have the opportunity to change public opinion

我們應該重視人，更勝於重視疾病。

and to change public policy.

我們大家都有機會 可以改變大眾的觀念，

All of us know someone who has an addiction,

改變公共政策。

and all of us can do our part

我們所有人都知道哪些人成癮；

to change how we view people with addiction in the United States.

我們所有人， 都可以盡自己的一分力量，

So when you see someone with an addiction,

改變美國看待成癮者的方式。

don't think of a drunk or a junkie or an addict or an abuser --

所以當你看到某位成癮者時，

see a person;

不要只想到他是一位酒鬼、 煙毒犯、癮君子或是藥物濫用者，

offer them help;

把他視為一個人，

give them kindness and compassion.

給他們幫助，

And together, we can be part

給他們友善和同情。

of a growing movement in the United States

同時，我們可以成為

to change how we view people with addiction.

美國正在持續增長的浪潮 當中的一份子，

Together we can change public policy.

改變我們看待成癮者的方式。

We can ensure that people get care when they need it,

我們可以一起改變公共政策。

just like any other disease.

我們可以確保 人們在需要時得到照顧，

We can be part of a growing, unstoppable movement

就像任何其他疾病一樣。

to have millions of Americans enter recovery,

我們可以成為這股不斷增長、 無法阻擋浪潮的一份子，

and put an end to this epidemic.

讓數百萬美國人進入戒癮之路，

Thank you very much.

並且結束物質成癮的流行。

(Applause)

非常感謝大家。