ONDCP Blog

A Veterans Day Message

This Veterans Day, we join President Obama, the U.S. Department of Veterans Affairs (VA), and the entire country in honoring our Nation’s veterans. Since the dawn of our country, these brave men and women have fought for and protected the freedoms that make America great. We owe them our deepest gratitude all year round, but today, in particular, we pause to thank them for their selflessness and their service.

There are many ways to honor and thank all who served in the United States Armed Forces this Veterans Day. Join a ceremony near you, and lend your voice online to a simple message of thanks on social media. The VA offers a variety of web-based and phone services online, particularly for veterans in need of mental health services. Visit this page for more information.

Here at the Office of National Drug Control Policy, we are proud to work alongside veterans who lend their talent and energy to the important task of reducing drug use and its consequences across the country. Before he led ONDCP or the Seattle and Buffalo police departments,  Director Gil Kerlikowske served in the United State Army, where he was awarded the Presidential Service Badge.  

This weekend, we honor our ONDCP leadership and staff who have served proudly, as well as the millions of veterans across the Nation.

A Different Kind of Birthday

Today marks 25 years since I started my journey of recovery. 

Coincidentally, the same year I started that journey—in fact, the very same month—a law was created to establish the office where I now serve President Obama.

Photo: Deputy Director Botticelli addressing a group of new American citizens at their naturalization ceremony.

I know that today is just another day, but it is a day filled with joy and gratitude as I think about how my life has changed. While I am so grateful for the opportunities my recovery has given me, it is really the profound internal changes that matter most.  I am not the person I was 25 ago.  Some parts of the country refer to these milestones as “birthdays,” which is very appropriate given that recovery means a chance at a new life filled with meaning, purpose, joy and love.  As I have often said, my story is not unique.  I am one of millions of Americans who found a way back from the grip of addiction through the kindness and caring of many, many people.

Like many people with addictions, one of the biggest obstacles I faced in asking for help was that I could not imagine a life without drinking.  Even though my life was a disaster, I could not see how stopping would lead to a happy and fulfilling life.  What would people think of me if I said I had an addiction?  What would my boss think?  Would I ever have a social life again filled with friends?  I did not see people like me living a happy life in recovery.

I can’t help but think that the recent Supreme Court rulings on gay marriage were in large part driven by the simple, yet courageous act of gay men and lesbians coming out to their family, friends, neighbors and co-workers.  It changed public opinion and drove public policy.  The same was true with people with HIV and even people with cancer faced fear, shame and stigma.  When Magic Johnson announced that he was HIV positive, there was a significant increase in the number of people getting tested. ACT Up demanded expedited research and drug approval, funding for services and a compassionate response by the medical community. Any great movement to change public perception and public policy has often been fueled by people who are affected “coming out” of the shroud of secrecy and invisibility.

Photo: Deputy Director Botticelli representing ONDCP at the West Virginia Behavioral Health Conference.

Yet, for too many people and their families, asking for help and seeking care for a substance use disorder is still saturated with shame.  Despite the fact that nearly every family and community in America is affected by addiction, it remains part of our collective denial. According to the National Survey on Drug Use and Health, only about 1 in 10 people with a diagnosable substance use disorder get treatment at a specialty facility.  Compare this to diabetes where the treatment rate is 84%[1].  For those who do get treatment, it is often in the most acute stages where, even though effective, treatment is more challenging and costly.  The economic cost of excessive alcohol use is estimated to be $223 billion, with health care accounting for $24.6 billion of these costs.[2]  The economic cost of illicit drug use is estimated to be $197 billion, with health care accounting for $11.4 billion of these costs.[3]  None of these figures compare to the pain, anguish and grief addiction causes.

Decades of scientific research have given us an irrefutable understanding of addiction as a health issue, a chronic medical condition with genetic, biologic and environmental risk factors.  It requires a comprehensive public health approach using evidenced-based prevention, early intervention, treatment and recovery support services.  The 2013 National Drug Control Strategy, the Obama Administration’s blueprint for drug policy, is based on this understanding. It puts forth more than 100 action items across federal government to prevent drug use and its consequences.  It dismisses a “war on drugs” approach, while acknowledging the vital role that federal, state and local law enforcement play in reducing the supply of drugs. With a public health framework at its foundation, the Strategy sets forth an agenda that tackles systemic challenges like over-criminalization, lack of integration with mainstream medical care, insurance coverage and legal barriers to fully restoring people to productive and meaningful lives. The implementation of the Affordable Care Act addresses some of these systemic issues by dramatically increasing coverage for treatment and ensuring that services are comparable to other chronic conditions for over 62 million Americans.

All of these advancements, however, are not enough unless we fundamentally change the way many people think about addiction. The Parternship at DrugFree.org and The New York State Office of Alcoholism and Substance Abuse Services (OASAS) estimate that there are more than 23 million individuals in recovery. Millions of people in recovery are living meaningful, productive lives full of joy and love and laughter—and I am just one of them. It is time for those of us in recovery, and those that care for and love us, to join the growing movement to put a face and voice to this disease; to lift the curtain of invisibility and to show others the endless possibilities of a life in recovery.  

It is a time to make that simple, yet courageous decision to be counted, to be seen and to be heard.

Michael Botticelli is the Deputy Director of National Drug Control Policy.

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Substance Abuse Prevention is Suicide Prevention

When we prevent or successfully treat substance abuse, we prevent suicides. There is a powerful connection between the missions of the substance abuse prevention and treatment communities and the suicide prevention community – and  much to be gained when these groups come together around their common goals.

Drug poisoning deaths have increased 120 percent in recent years – from 17,415 in 2000 to 38,329 in 2010.  The majority (58 percent) of the drug deaths involved pharmaceuticals, and 75 percent of those deaths involved prescription pain relievers.[i] In 2010, U.S. emergency departments treated 202,000 suicide attempts in which prescription drugs were used as the means, 33,000 of which were narcotic pain relievers.[ii]

The suicide and substance abuse prevention fields need to align their efforts to promote healthy individuals and healthy communities.

Many of the factors that increase the risk for substance abuse, such as traumatic experiences, also increase the risk for suicidal thoughts and behaviors,[iii],[iv]  and substance abuse, like mental health problems, is linked with a several-fold increase in suicide risk.[v],[vi]

There is hope, however: Prevention works, treatment is effective, and recovery is possible. Life skills that support effective problem-solving and emotional regulation, connections with positive friends and family members, and social support can protect individuals from both substance abuse and suicide. Treatment and support are important precursors for recovery from substance abuse as well as recovery from suicidal thoughts.[vii],[viii]

In September 2012, a newly revised National Strategy for Suicide Prevention (NSSP) was released by the National Action Alliance for Suicide Prevention (Action Alliance) in conjunction with the Office of the Surgeon General.  The Action Alliance is a public-private partnership, jointly launched in 2010 by the Secretaries of Health and Human Services and Defense, envisioning a Nation free from the tragic experience of suicide. The connection between suicide prevention and the prevention and treatment of substance abuse is either implicit or explicit in each of the 13 goals of the NSSP, as it should be.  Recognizing this, the NSSP calls for several actions, including:

• Train staff in substance abuse treatment settings to ask their clients and patients directly and in a non-judgmental way whether they are having thoughts of suicide or think things would be better if they were dead. Ask on intake and periodically throughout the course of treatment, and ask in a way that opens the door for a truthful response.
• Work with individuals, families and other social groups, and communities to reduce access to drugs, especially access to lethal quantities of drugs among individuals at increased risk for suicide.  This includes reducing stocks of medications kept in the home, locking up commonly abused medications, and encouraging the proper disposal of unused and unneeded prescription drugs, a key component of the 2013 National Drug Control Strategy.

Let us commit to stronger collaboration between substance abuse and suicide prevention efforts at all levels: community, state, tribal, and national. And let’s take action. The stakes are too high to do otherwise.

Dr. Litts is the Executive Secretary for the National Action Alliance for Suicide Prevention.  Previously, David held a variety of leadership positions in the Nation’s suicide prevention movement, including the Air Force’s pioneer suicide prevention program (1996-1999) and development of the 2001 National Strategy for Suicide Prevention.

Ms. Carr is a Senior Policy Analyst with the National Action Alliance for Suicide Prevention. Previously, she was the Suicide Prevention Specialist for the Massachusetts Department of Public Health and the Education Coordinator for the Massachusetts/Rhode Island Regional Center for Poison Control and Prevention.

The National Action Alliance for Suicide Prevention is the public-private partnership advancing the National Strategy for Suicide Prevention (NSSP) by championing suicide prevention as a national priority, catalyzing efforts to implement high priority objectives of the NSSP, and cultivating the resources needed to sustain progress.