Acting “˜Drug Czar’ Walks the Talk

Michael Botticelli
National Journal
Clara Ritger
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Clara Ritger
May 28, 2014, 9 a.m.

In front of a bois­ter­ous courtroom packed with re­cov­er­ing drug ad­dicts and their fam­ily mem­bers sat an ar­ray of se­cur­ity guards and one neatly dressed White House of­fi­cial. Mi­chael Bot­ti­celli, act­ing dir­ect­or of the Of­fice of Na­tion­al Drug Con­trol Policy, makes a habit of stop­ping by gradu­ation ce­re­mon­ies for the drug-court sys­tem — for both per­son­al and pro­fes­sion­al reas­ons.

The event last week in down­town Wash­ing­ton saw five people gradu­ate from the city’s drug court, an al­tern­at­ive to the crim­in­al-justice sys­tem that provides treat­ment for ad­dicts and, in some cases — de­pend­ing on state and loc­al laws — al­lows them to re­turn to so­ci­ety without a re­cord provided they haven’t re­lapsed.

Three of four drug-court gradu­ates re­main ar­rest-free for at least two years after leav­ing the pro­gram, ac­cord­ing to the Na­tion­al As­so­ci­ation of Drug Court Pro­fes­sion­als. The drug-court sys­tem star­ted about two dec­ades ago, and already more than 2,700 drug courts are op­er­at­ing in the United States, ac­cord­ing to the Na­tion­al Drug Court In­sti­tute.

Bot­ti­celli was not com­pletely out of place in the crowd; 26 years ago, at the age of 30, he was brought to court for drunk­en driv­ing. He re­mem­bers the judge giv­ing him two choices: Enter the crim­in­al-justice sys­tem or get help for his al­co­hol ad­dic­tion. He chose the lat­ter.

Bot­ti­celli’s ex­per­i­ence led him to a life­time of work help­ing people with sub­stance-ab­use prob­lems. After com­plet­ing a treat­ment pro­gram in 1988, he spent three years in private-treat­ment and sub­stance-ab­use work, an­oth­er 11 years in the sub­stance-ab­use di­vi­sion at the Mas­sachu­setts Pub­lic Health De­part­ment, and nine more years as dir­ect­or of the state’s Bur­eau of Sub­stance Ab­use Ser­vices. He be­came deputy dir­ect­or of the White House drug-policy of­fice in late 2012, then rose to act­ing “drug czar” in March when Gil Ker­likowske be­came com­mis­sion­er of U.S. Cus­toms and Bor­der Pro­tec­tion.

Bot­ti­celli says he’s an ex­ample of the po­ten­tial that lies in giv­ing second chances to people who come in­to con­tact with the crim­in­al-justice sys­tem through their struggle with ad­dic­tion.

His story is also a prime ex­ample of where Amer­ica’s drug policy is headed: to­ward provid­ing the pub­lic health re­sources needed to pre­vent and treat ad­dic­tion be­fore it be­comes a crim­in­al-justice prob­lem.

“Ad­dic­tion is a dis­ease,” Bot­ti­celli said. “The crim­in­al-justice sys­tem plays a key role, but fun­da­ment­ally we have to deal with this as a pub­lic health is­sue. We have to make sure that we’re im­ple­ment­ing good pre­ven­tion pro­grams, in­ter­ven­tion pro­grams, and treat­ment pro­grams and have crim­in­al-justice policy that di­verts people away from the crim­in­al-justice sys­tem.”

Bot­ti­celli comes from an up­state New York fam­ily with a his­tory of ad­dic­tion, but he didn’t know that put him at risk. It wasn’t un­til he hit bot­tom fol­low­ing a drunk-driv­ing ac­ci­dent that he got help — and that’s not soon enough, Bot­ti­celli said.

“We don’t say to people with high blood pres­sure, we’re go­ing to wait un­til you have a heart at­tack,” he said. “You’re peri­od­ic­ally check­ing their blood pres­sure and in­ter­ven­ing.”

Bot­ti­celli ex­pects the Af­ford­able Care Act to have a big im­pact on doc­tors’ abil­ity to catch ad­dic­tion in reg­u­lar screen­ings and checkups, be­cause the health law re­quires in­sur­ance com­pan­ies to cov­er pre­vent­ive ser­vices at no ad­di­tion­al cost to the con­sumer.

“If people are able to get more timely treat­ment and in­ter­ven­tion,” he asked, “will they not end up in the crim­in­al-justice sys­tem?”

That’s a hy­po­thes­is yet to be tested, but Bot­ti­celli is con­fid­ent, giv­en what he’s seen in pre­vi­ous stud­ies on the im­pact of ac­cess to treat­ment on crime and ar­rest stat­ist­ics.

“What you see is that the cost sav­ings gen­er­ated by treat­ment comes from two main areas: de­creased crime and crim­in­al-justice in­volve­ment, and de­creased health care costs,” he said.

Bey­ond treat­ment, the White House drug-con­trol of­fice is work­ing to en­sure that drug-court gradu­ates have the tools they need to re­in­teg­rate in­to so­ci­ety. Hous­ing, edu­ca­tion, and em­ploy­ment can be big hurdles for re­cov­er­ing ad­dicts, and ef­fect­ive pub­lic policy re­quires co­ordin­at­ing the ef­forts of the Justice, Labor, and Hous­ing and Urb­an De­vel­op­ment de­part­ments.

But even the com­munity of drug-court par­ti­cipants can be a last­ing sup­port sys­tem in it­self.

At the ce­re­mony, a man still in the re­cov­ery pro­gram stood up and ad­mit­ted he was sup­posed to be among the gradu­ates, but he had re­lapsed. “I wish that I was gradu­at­ing,” he said, greeted with notes of sup­port from the crowd.

One gradu­ate’s wife also stood up. “I’d just like to say thanks to this pro­gram, be­cause I got my hus­band back,” she said.

Dan­cer and 2007 gradu­ate Cathy Hurt was among the dis­tin­guished guests in­vited to of­fer an ad­dress. “I wasn’t a bad per­son, I just did bad things,” Hurt said, look­ing over at the gradu­ates. “It’s time for you to show people that we do re­cov­er, and we do lead lives that make a dif­fer­ence.”

Hurt opened her first dance school — My Turn­ing Pointe School of Dance — in early May.

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