Pubdate: Mon, 01 Sep 2014
Source: Chicago Tribune (IL)
Copyright: 2014 Chicago Tribune Company
Contact: http://drugsense.org/url/IuiAC7IZ
Website: http://www.chicagotribune.com/
Details: http://www.mapinc.org/media/82
Author: Katie Zezima, The Washington Post
Page: 12

FROM ROCK BOTTOM TO THE TOP POST FOR U.S. DRUG POLICY

25 Years Sober, Man at Helm of Nation's Substance Abuse Effort Has 
Firsthand Experience

LYNN, Mass. - America's top drug control official had a confession.

Michael Botticelli was seated on a tattered purple couch in an old 
Victorian in this city just outside Boston. Above his head was a 
photo of Al Pacino as a drug kingpin in "Scarface" and gathered 
around him was a group of addicts who live together in the house for 
help and support. On one door hung a black mailbox labeled "Urine," 
where residents must drop samples for drug tests. Botticelli was 
listening to their stories of addiction and then offered this:

"I have my own criminal record," he said.

"Woo-hoo!" one man yelled after Botticelli's declaration. The crowd 
burst into applause.

The nation's acting drug czar has a substance abuse problem.

Botticelli, 56, is an alcoholic who has been sober for a 
quarter-century. He quit drinking after a series of events including 
a drunken-driving accident, waking up handcuffed to a hospital bed 
and a financial collapse that left him facing eviction.

Decades later, Botticelli has been chosen to spearhead the Obama 
administration's drug policy, which is largely predicated around the 
idea of shifting people with addiction into treatment and support 
programs and away from the criminal justice system.

Botticelli's story is the embodiment of that policy choice, one that 
he credits with saving his life.

The approach at the White House Office of National Drug Control 
Policy has been, Botticelli said, a "very clear pivot to, kind of, 
really dealing with this as a public health-related issue of looking 
at prevention and treatment." He now heads an office that has shifted 
away from a war on drugs footing toward expanding treatment and 
preventing drug use through education. Botticelli became the acting

director of drug control policy earlier this year, about a year and a 
half after he went to Washington to be former drug czar Gil 
Kerlikowske's deputy. Kerlikowske is now U.S. Customs and Border 
Protection commissioner.

The White House last week formally nominated Botticelli to take over 
the job permanently. It is a job that has previously been held by law 
enforcement officials, a military general and physicians. But for 
now, it is occupied by a recovering addict.

The nation is in the midst of an epidemic of prescription drug and 
heroin abuse. The number of drug overdose deaths increased by 118 
percent nationwide from 1999 to 2011, most of it driven by powerful 
prescription opioids and a recent shift that many users are making 
away from prescription drugs to heroin, which can be cheaper and more 
accessible.

Drug trends and issues tend to vary geographically, making a 
sustained national effort difficult. Insurance companies often do not 
cover inpatient treatment, and an obscure federal rule restricts the 
expansion of addiction treatment under the Affordable Care Act.

The White House is also grappling with the legal, financial and 
political implications of medical and legalized marijuana. 
Botticelli's office has taken the administration's toughest stance 
against legalization.

"Part of this is, 'How do we look at solutions that work for the 
entirety of the drug issue?' " he asked. "And not just the entirety 
of the drug issue, but the entirety of the population?"

Botticelli is trying to expand on some of the programs he used at the 
Massachusetts Department of Public Health, where he was director of 
the state's bureau of substance abuse services. They include allowing 
police to carry naloxone - a drug commonly known as Narcan that can 
reverse a heroin overdose - and helping people who have completed 
treatment find stable housing and jobs.

Botticelli spends much of his time on the road, meeting with state 
and local officials. He visits treatment programs where he is, by all 
accounts, treated like a rock star by people with substance abuse 
issues, a group he calls "my peeps." While Botticelli easily shares 
his struggles, those who have worked with him said that he doesn't 
let it dictate policy.

"He was very good at separating his story from the work, which I 
think allowed him a little more objectivity," said Kevin Norton, CEO 
of Lahey Health Behavioral Services in Massachusetts.

Botticelli drank in high school and college, and he once got fired 
from a bartending job after repeatedly telling the manager he 
couldn't work, only to show up as a patron. In the 1980s, he moved to 
Boston, where he spent most of his time outside of work at the Club 
Cafe, a Boston gay bar. Along with a group of regulars, Botticelli 
would stay well into the next morning, knocking back drinks and 
ridiculing people heading to the gym below the bar for an early workout.

"A lot of the center of gay life, particularly in urban areas, 
focused on bars," Botticelli said. "And so that's where you went to 
socialize, to meet people."

In May 1988, Botticelli was drunk when he left a Boston bar and drove 
west on the Massachusetts Turnpike. What happened next is hazy: He 
may have been reaching for a cigarette in the console of his car. 
Botticelli's car collided with a disabled truck. He remembers being 
placed on a stretcher and put in an ambulance.

Hours later, he woke up in the hospital, handcuffed to a bed. A state 
trooper stood sentry in his room. Botticelli was lucky: His injuries 
consisted mainly of bumps and bruises. He was taken to the state 
police barracks, got booked and had his license suspended.

"At some level I knew I had a problem," Botticelli said. "But at 
another level, because my license was taken away, I thought that my 
problems were solved. Because I wasn't drinking and driving anymore, 
so how could it really be an issue?"

The case was continued without a finding after Botticelli paid the 
fines and restitution associated with it. It is no longer a matter of 
public record.

Botticelli had to ask his brother for the money to make the payments, 
and his downward spiral continued that summer. He ended a 
relationship and drank heavily, despite going to a court-ordered 
course on the dangers of drinking and driving, and to a 12-step recovery group.

"I felt that because I wore a suit to work and a lot of the other 
people in the class came from more blue-collar jobs, that somehow I 
was better and I didn't have a problem. There was a sense of 
arrogance about me," he said.

Botticelli's path to recovery began, of all places, in a bar. He met 
a man who acknowledged that he was an alcoholic. The two swapped 
stories and went on a date. The romance didn't materialize, but they 
remained friends. Botticelli was soon after served an eviction notice 
and called his brother, who asked if Botticelli was an alcoholic.

"I finally said, 'Yes,' " he said. "I remember distinctly thinking to 
myself, 'If I say I'm an alcoholic, there's no going back.' "

Botticelli's friend took him to a 12-step meeting in downtown Boston. 
The following night, Botticelli stepped into the Church of the 
Covenant in Boston, a neo-

One of Botticelli's recent trips took him back to Boston last month. 
Soon after arriving, he was smoking a cigarette outside a Starbucks 
when a woman had a question: Why are there burly agents standing 
around? (He gets a protective detail.) They chatted; she told 
Botticelli she was addicted to prescription painkillers, progressed 
to heroin and became homeless. She began recovery months earlier and 
started working at Starbucks the week before.

"And that was like 'Oh, my God, our work is done here,' " Botticelli 
said. "Anything else was going to pale in comparison to just 
listening to people's stories."

Botticelli's day in Massachusetts was packed with meetings on what he 
called his home turf. There was a round table with more than a dozen 
doctors, nurses, law enforcement agents and others. He met with 
Boston Mayor Marty Walsh, also an alcoholic, and had sandwiches with 
law enforcement agents who spoke about the massive spike in heroin 
addiction. In Lynn, a city of about 90,000, there were 188 opiate 
overdoses and 18 deaths in 2013; as of July 31, there were 163 
overdoses and 20 deaths.

Botticelli hugged and shook hands with residents at the group home 
with the tattered purple couch and spoke to the men about the 
struggles of addiction and finding what he called a bridge job, 
something that you do while getting better to make money and get back 
into the workforce.

"Don't be ashamed to work at Dunkin' Donuts," one of the men said. 
Botticelli nodded.

Hours later, Botticelli stood outside the church where his recovery 
started and marveled at how he got from there to the White House.

"When I first came here ... all I wanted to do was not drink and have 
my problems go away," he said. "I'm standing here 25 years later, 
working at the White House. And if you had asked me 25 years ago when 
I came to my first meeting here if that was a possibility, I would've 
said you're crazy. But I think it just demonstrates what the power of 
recovery is."
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MAP posted-by: Jay Bergstrom