Pubdate: Mon, 23 Jun 2014
Source: Boston Globe (MA)
Copyright: 2014 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52
Author: Brian MacQuarrie

SUBSTANCE HELP FROM ONE WHO STRUGGLED

US Drug Czar Botticelli Builds on the Lessons of His Own Recovery

WORCESTER - Michael Botticelli knows this crowd. They are his people, 
the often-underpaid foot soldiers of the no-finish-line struggle to 
stem the scourge of addiction. And hundreds of them return the love, 
giving him rock-star treatment as he walks across the stage at 
Worcester State University.

"It's hard to get the words out: I work in the White House," said the 
56-year-old Botticelli, looking slightly sheepish. "It's really wild."

Botticelli is the country's acting drug czar, leading the nation's 
fight against substance abuse less than two years after performing a 
similar job with the Massachusetts Department of Public Health.

He is also the first person in addiction recovery to hold the job, 
having turned his life around since a drunken driving accident on the 
Massachusetts Turnpike more than 25 years ago. And unlike some of his 
predecessors, Botticelli is not a police officer, does not come from 
the military, and is not a doctor.

Instead, he brings trench-level experience in treatment and 
prevention to the post, and decades of extending a hand instead of a 
threat to people struggling with substance abuse. Since his 
appointment in March, the mantra has remained the same.

"There is no shame in this. This is a disease," Botticelli said in 
Worcester, addressing a recent conference sponsored by the New 
England School of Addiction and Prevention Studies.

Much of what Botticelli brings to his bully pulpit finds its 
foundation in his own cathartic story. It's a story rooted in family 
alcoholism, and it's a journey that led to desperation as a young man 
in Boston before Botticelli emerged in sobriety and began a long run 
as director of the state's Bureau of Substance Abuse Services.

"I can look back at my own experience and say this didn't have to 
happen this way. And that, from both the positive and problematic 
perspective, is what's helpful about being in recovery," Botticelli said.

"I walk across the street every day, and I go to the senior staff 
meeting in the Roosevelt Room" at the White House, Botticelli added. 
"I run by the president's chief of staff, all his senior staff are in 
the room, and I say to myself, 'How the hell did I get here?' "

Botticelli got there despite drinking regularly since he was a high 
school junior, spiraling into alcoholism through his 20s, and being 
arrested for drunken driving in 1988 after a rear-end crash with a 
disabled truck on the Massachusetts Turnpike.

He recalled being handcuffed to his hospital bed and later being 
unable to drive because his checks to the Registry of Motor Vehicles 
bounced when he tried to reinstate his license. Eviction notices 
began arriving with soul-sapping regularity at his Boston apartment.

"I knew I had to stop drinking, but I couldn't imagine what life was 
like on the other side," said Botticelli, who paused as his eyes 
welled up. "I thought, if I stop, my life is going to be over. I'll 
just be this kind of miserable wretch and sit around all day doing nothing."

Botticelli, an openly gay man married to his longtime partner, said 
his turn to sobriety was jump-started 25 years ago at a recovery 
meeting for gays in Boston.

"I remember being astounded by the fact that there were 200 gay men 
and lesbians who were happy. It seemed like there was light coming 
out of their eyes, and it was something that I wanted," said 
Botticelli, a native of Troy, N.Y. "It's not to say that they weren't 
having problems, but there was this level of collegiality and 
community that I just didn't know existed."

Shortly afterward, Botticelli began work in the recovery field even 
as he built, day by day, on an alcohol-free life. After a brief stint 
in the private sector, he began working for the state Department of 
Public Health in 1994 in a succession of jobs: coordinator for 
HIV-related policies and services, assistant director for policy and 
planning, chief of staff to the public health commissioner, and 
director of substance abuse services from 2003 to 2012.

"He's a remarkable leader. He's humble and smart . . . and he has a 
great strategic sense about designing systems," said Andy Epstein, 
former special assistant to the public health commissioner. "If 
you're going to be a bureaucrat, he's a great one."

Now, Botticelli is trying to bring to the national arena some of the 
strategies and programs he said worked well in Massachusetts. That 
includes expanded use of drugs such as Narcan and Suboxone to help 
opioid addicts, and a broad, integrated approach to prevention that 
involves stakeholders from health care, government, law enforcement, 
the courts, and addicts and their families.

His approach caught the eye of Gil Kerlikowske, the previous drug 
czar, when he visited Massachusetts during Botticelli's tenure as 
substance-abuse director. Kerlikowske, who had been Seattle police 
chief and now is commissioner of US Customs and Border Protection, 
asked Botticelli to leave Massachusetts and become his deputy 
director at the Office of National Drug Control Policy.

Specifically, Kerlikowske was impressed with the creation of a 
recovery high school in Boston under Botticelli's watch; the state 
pilot program that enabled Quincy police to carry Narcan to reverse 
opioid overdoses; and the expansion of treatment for substance abuse 
at community health centers.

For these programs and others, Botticelli said, Massachusetts is 
regarded as a national leader. "It's a pretty remarkable place," he 
said. "There was always this thread of social justice that 
underpinned all the work we were doing."

For Botticelli, the best way to fight substance abuse is to reduce 
demand instead of funneling immense amounts of money and manpower 
into jailing dealers and penalizing users. In the country's long and 
fitful war on drugs, this approach can seem revolutionary.

"That's a monumental shift when we think about what the balance of 
law enforcement, treatment, and prevention is in the country," said 
Hilary Jacobs, who succeeded Botticelli as director of the state's 
Bureau of Substance Abuse Services.

That assessment was echoed by Kevin Norton, chief executive officer 
of Lahey Health Behavioral Services, who interacted with Botticelli, 
often on a weekly basis, during his tenure in Massachusetts.

"Michael is an incredible advocate for treatment services, for making 
sure that the voice of the consumer is always heard," Norton said. 
"Our war on drugs hasn't done anything, and to have someone in that 
role who values and recognizes the audience around treatment is incredible."

For all his innovative ideas, Botticelli raised some eyebrows in 
Massachusetts when, during congressional testimony in February, he 
defended the Obama administration's opposition to federal 
legalization of marijuana. However, he also testified under tough 
questioning that he does not think marijuana is as dangerous as alcohol.

Many media outlets seized on Botticelli's testimony as evidence of 
mixed signals from the administration. Far more than in Boston, the 
words he utters in Washington have the potential to go viral. But 
that exponentially greater power, Botticelli said, can be an advantage.

"You realize the magnitude of what this office can do merely by 
promoting effective programs," he said.

Promoting the message also includes high-visibility stories of 
recovery, including his own.

It's a story, Botticelli said, that "speaks to the redemptive power 
of treatment and how it can restore people's lives."
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MAP posted-by: Jay Bergstrom