TheSubstanceAbuseandMental

HealthServicesAdministration

01/18/2017

ReflectionsonRecovery:AninterviewwithMichaelBotticelli,
DirectorofNationalDrugControlPolicy
Thisweek,DirectorofNationalDrugControlPolicyMichaelBotticelliwilldepartaftertwoyearsofserviceastheleaderofthe
ObamaAdministrationsdrugpolicyefforts.Wesatdownwithhimtohearhisideasabouthiswork,therelationshipbetween
ONDCPandSAMHSA,andwherethefieldofrecoveryisheaded.
Whataresomeofthethingsyouthinkhavechangedabouttheideaofrecoveryduringyourcareer?
Themostsignificantchangeinhowpeopleviewrecoveryisthatithastrulybecomeamovement.Intheearlydays,thetradition
ofanonymityin12stepprogramskeptmanypeoplefromtalkingaboutbeinginrecovery.Sotherewasntavisibleandvocal
recoverymovementthatyoucouldseeotherthanthefellowshipthatpeoplein12stepprogramshadwitheachother.

WhenIstartedastheDirectoroftheBureauofSubstanceAbuseServicesattheMassachusettsDepartmentofPublicHealth,I
wasfairlyopenaboutmyrecovery.Somepeoplecounseledmenottobepublicaboutitatthetime.Butsincethen,especially
overthepastfiveyears,itsreallytakenoffasamovement.Todaysyoungpeoplewhoareinrecoveryaremoretransparent,
openandhonestaboutwhotheyare.Therehasbeenagrowingscientificacknowledgmentoftherolerecoveryplays,andnow
weseerecoverycoachesandrecoverycommunityorganizations.SoIthinkwereseeingitbothasaservicemovementaswellas
anadvocacymovement.
WhatareyourmostsignificantachievementsattheOfficeofNationalDrugControlPolicy?
ThroughthecourseoftheObamaadministration,wehavereallychangedtheconversationandreframedhowweapproach
issuesofsubstanceuseandaddiction.Whilewestillhavesomewaystogo,thereisgeneralconsensusacrosspoliticalstripes,
withpublichealthandpublicsafety,thatthisisahealthissue.Whilelawenforcementandourjusticesystemhavearoletoplay,
substanceuseandaddictionneedtobedealtwithasahealthissue.Thatisalegacythisadministrationleavesforthosewho
follow.
Ithinkwereatthepointwheremostofusunderstandthatpeoplewithaddictionneedtreatmenttheyneedhealth
interventions,andthatarrestandincarcerationwilldolittleornothingtochangethetrajectoryofpeoplewithsubstanceuse
disorder.
Isthereamomentthatreflectsthatunderstanding?
CertainlywatchingthePresidentsignthe21st CenturyCuresActwasahugemomentfornotonlyusatONDCP,butallofusin
thefield.Iwassittingnextto[SAMHSADeputyAssistantSecretaryforMentalHealthandSubstanceUse]KanaEnomotoasit
wassigned,andmanyotherpeopleinthefieldwereapartofthatsigningceremony.Preventionandtreatmentofopioid
addictionisatoppriorityfortheadministration,andwebackedthatupwithahugeinvestment.
HowhasyourrelationshipwithSAMHSAhelpedadvancedrugcontrolpolicy?
SAMHSAhasplayedahugeroleininourexecutionandimplementationofapublichealthbasednationaldrugcontrolstrategy.
SAMHSAisprobablyourpremierpartner,ifyouwill,intermsofmovingfrompolicytoimplementationonapracticalbasis.Our
strategyhasfocusedonpublichealthresponseslikemonitoring,prevention,earlyintervention,treatmentandrecoverysupport,
andincreasingaccesstomedicationassistedtreatment.Idbehardpressedtothinkofasinglehealthfocusedstrategyitemwe
havethatSAMHSAhasnotplayedasignificantroleinaccomplishing.SoitwasveryimportanttomepersonallythatwhenI
cameinasDeputyDirectorofNationalDrugControlPolicyandthenasDirector,thatwehadastrongongoingpartnership
SAMHSAleadership.
WhataresomeofthesignificantaccomplishmentsonwhichyouvecollaboratedwithSAMHSA?
Thisisrecentsoitstopofmindmaybe.The21st CenturyCuresActobviouslygaveusasubstantialinfusionofdollars.SAMHSA
didatremendousamountofworktogetthemoneyoutassoonaspossible.Thefundingopportunitywasannouncedtheday
afterthelegislationwassigned.Weworkedcloselywiththemintermsofthestructureoftheapplication.

Thefundingisoneexample,butifyoulookoverthepastfouryears,Icouldthinkofprobably20examplesinourresponseto
theopioidepidemicthatSAMHSAhelpedorchestrate.RecoveryMonthisanothergoodexample.SAMHSAhasforalongtime
beentheorganizerofRecoveryMonthnationallyandhelpedcoordinatelocalevents.WithoutSAMHSA,Idontthinkwewould
haveasstrongofarecoverymovement.
Whatdoyouseecomingnextinthefieldofrecovery?
Acouplethings.Ithinkwevecomealongway,whetheritshealthsystemsorMedicaidorstateandcommunityprovidersreally
understandingtherolethatpeersinrecoveryplayintheservicedeliverystructure.Andnotjustintreatmentprograms.Wenow
havepeerrecoverycoachesreimbursedbyMedicaidandotherpayers,andwehaveseenpeersaspartsofserviceteamsand
emergencydepartmentsandprimarycaresettings.Sofromtheservicestandpoint,wehavecomealongway,butwearestill
understandingtheroleofpeersinourservicedeliverysystem.
AnotherchangeIwouldliketoseeisthis:Itshouldnothappenbyaccidentthatpeopleinrecoveryareinpolicymakingrolesat
thefederal,stateandlocallevels.Weshouldstrivetomakesurewehavepeopleinrecoveryinthoseroles.Theyhavean
understandingthatnooneelsecanbringtothetable.Iwouldliketoseecontinuedadvocacyforrecovery.
Whatadvicedoyouhaveforotherswhoareinrecovery?
Partofwhatisimportantisforanyonewhoisinrecoveryanddoesadvocacy,tobegroundedandsecureintheirownrecovery
beforeventuringoutinother,morepublicways.SometimesIveworriedwhenIveseenpeoplewhoareveryearlyinrecovery
playingapublicandprominentrole.Imnotsayingtheyshouldnttalkaboutitatall,butearlyrecoveryisstressfulenough.
Thenagain,evenatthislevel,itsimportantformetoputmyrecoveryaboveajoborpoliticalenvironment.Recoveryisthe
greatesttreasurewehave.
Whatwouldyousaytothefamilyandfriendswhoareclosetosomeoneinrecovery?
Youcantunderestimatethesupportoffriendsandfamily.Substanceusedisordersdontaffectjustoneperson.Itsimportant
forthepeoplearoundsomeonewhoisinrecoverytounderstandthefundamentalsofwhataddictionis,andwhatitmeansto
beinrecovery.Sometimespeoplethinktheyrebeingsupportive,buttheymaynotbe.Italsoagoodideaforthoselovedones
tohavesomesupportthemselvessotheycannotonlytakecareofthemselvesbutoffersupportforalovedonewhoisinearly
recovery.

Ad d i cti on

M i ch ael Botti cel l i

Op i oi d

R ecovery

S u b stan ce Use

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