Translator: Rhonda Jacobs Reviewer: Ellen Maloney
Do you remember where you were on June 12th, 2016?
A few of you might, but I'm betting the vast majority probably don't.
On June 12th, 2016, a lone gunman walked into Pulse Nightclub, killing 46 people
in the deadliest mass shooting by a single gunman in U.S. history.
Now let's go back about a decade.
How about August 29th, 2005.
Do you remember where you were?
We've got a few heads nodding out there.
That was Hurricane Katrina.
Over 1,800 dead in the costliest natural disaster
ever to hit the North American continent.
Now let's go back another few years and go for 100 percent recognition.
Do you remember where you were on September 11th, 2001?
Everybody's head nodding now.
The September 11th attacks left over 3,000 dead
in the worst terrorist attack in U.S. history.
Do you remember how you felt?
Were you confused?
Afraid?
Did you feel sick?
Were you vulnerable?
Every time this happens, we're becoming more and more desensitized.
We frequently see news coverage of mass shootings, natural disasters
that result in enormous loss of life,
terrorist attacks,
and then we change the channel to watch something more friendly.
This is the society that we live in today, but the impact of these traumatic events
are no less serious on those who are directly affected,
and now the impact of emotional pain on our society
is more problematic than ever.
Do you remember where you were on April 20th, 1999?
Two students walked into Columbine High School
armed with shotguns, semi-automatic rifles, and a bevy of homemade explosives,
killing 12 students and a teacher,
in what was, at the time, the worst high school shooting in U.S. history.
I remember where I was.
I had just walked into the library with my best friend
in order to meet others preparing to go to lunch.
Moments later, a teacher ran through the same doors we'd just entered
yelling for everyone to get under the tables; that somebody had a gun.
I remember how I felt.
I was confused.
I was afraid.
I felt sick.
And I was vulnerable.
And just minutes later, I was playing dead underneath a table
next to a pool of blood.
I had just been shot,
and I had witnessed my best friend murdered right in front of me
as we were huddled together waiting for help to come.
I was broken.
I was in shock,
and I was in pain.
But my understanding of pain that day
was nothing like my understanding of pain today.
What's the first thing you think of when you think of pain?
Is it a broken arm? Headache? Sprained ankle?
Maybe a gunshot wound?
Those are the things that I used to associate with pain,
and they're pretty in line with the medical definition of pain:
A variably unpleasant sensation associated with actual or potential tissue damage
and mediated by specific nerve fibers to the brain
where its conscious appreciation may be modified by various factors.
Do you notice anything missing from that definition?
Do you see any mention of the emotional components of pain?
Me neither.
In 1996, the American Pain Society introduced the phrase,
"Pain is the fifth vital sign,"
meaning that when you walked into an emergency room,
the initial assessment of your condition was based on five data points:
pulse rate, temperature, respiration rate, blood pressure, and pain.
This was brought about by a cultural movement
that was adamant that we were under-treating pain.
And patient satisfaction surveys were put in place in order to track
the outcome and effectiveness of this new implementation.
And what better way to promote these new policies
than to tie physician and hospital compensation to patient satisfaction?
A recent survey by the industry group Physicians Practice
reports that three out of ten doctors are paid bonuses
based upon patient satisfaction surveys,
and hospitals with better scores receive bigger payments from insurers.
Naturally, administrators and physicians began to support this new movement
with the goal being to get everyone's pain to zero on the scale.
That was the mark.
The ethical dilemma immediately became,
"Do I issue this person narcotics in order to keep them happy,
or deny them, and potentially hurt my compensation,
the revenue of the hospital,
or at worst, open myself up to a grievance for under-treating pain
that could potentially result in the loss of my job?"
I have experience with pain.
Less than an hour after scrambling out the back door
of the Columbine High School library, I was medicated on a variety of substances
that were intended to sedate and to relieve pain.
I was 17 years old and I'd never drank a beer or smoked weed,
much less anything harder.
I had no idea of what these medications were even supposed to do.
All I knew at age 17 was that a lot of highly educated people
had prescribed me medications that were intended to make me feel better
and they were working,
only not in the fashion that they were intended.
Now if you only remember one thing from my talk today, let it be this:
Opioids are profoundly more effective
at relieving the symptoms of emotional pain
than they are at relieving the symptoms of physical pain.
I often think back to my pain that day
and if I were to rate it on the pain scale,
my physical pain would've been a three or a four,
and that was likely the response I offered when I was asked.
But my emotional pain was an absolute ten.
I was in agony beyond comprehension.
But that was never asked;
it was never talked about.
Acute physical pain ends relatively quick; complex emotional pain does not.
My physical pain had subsided in just a matter of days
but my emotional pain was just as debilitating
as it was lying in the hospital bed that day,
so I continued taking the medication that was prescribed for my pain.
I was addicted before I even knew what was happening.
A recent survey by the American Society of Addiction Medicine
reports that 86 percent of heroin users began by taking prescription opioids.
And in 2012 alone, over 259 million opioid prescriptions
were filled in the U.S.
That is more than enough to give every American adult
their own bottle of pills.
I very quickly began drug-seeking in order to soothe my emotional pain
and it was only a matter of months
before the prescriptions had turned to alcohol, marijuana, and elicit narcotics.
And as addiction always does, over the course of the next decade,
my tolerance continued to build, my life continued to be unmanageable,
and my emotional pain stayed unresolved.
It was like I had pressed a pause button on my emotional growth.
I was managing my pain in the only way I knew how,
and I wasn't alone.
I believe that emotional pain is what's driving the addiction epidemic.
Think of someone you know who struggles with addiction.
I'm betting you can point to an element
of unaddressed or unresolved emotional pain in that person.
Now think of a time you were in intense emotional pain
and how desperate you were to stop it.
What if you had been offered an immediate route to feeling better.
Imagine for a moment breaking your leg in an avalanche.
Now that injury alone can be a fairly traumatic experience,
but it's manageable.
With short term pain management, most would make a full recovery.
But now imagine sustaining that exact same injury,
only this time your close friend was skiing next to you,
and they didn't make it out of the avalanche alive.
It seems so crystal clear to me
that there would be two very different pain management strategies
for what would appear to be an identical physiological injury,
only there's not.
Emotional pain is toxic, it's pervasive, and society has programmed us to avoid it.
We medicate with alcohol and drugs, sex and pornography,
even television and technology,
and oftentimes, we're doing this without even knowing it.
Our society is literally being defined by this pain.
And now, more and more people are dying every month
because they're looking for solace in the only way they know how.
It's the way they were programmed.
Everyone has pain; it's unavoidable.
And I have a simple summary for how we got here.
We built a society that is filled with emotional pain and trauma.
We combined that with a healthcare system
that's intended to primarily treat physiological symptoms,
and then we put Big Pharma in the driver's seat,
aimed directly at profits with regulations that are easy to manipulate.
And now we're in the midst of what the former Surgeon General
called the worst public health crisis the nation has ever seen -
two years ago.
It has since worsened, and what was then the addiction epidemic
is now commonly referred to as the addiction pandemic.
And here's a glimpse of where we're at today.
The New York Times reported last month
that overdose deaths rose by 19 percent in 2016,
and preliminary data for 2017 shows that this trend is only worsening.
We've now far surpassed the worst years ever recorded for deaths caused by guns,
AIDS, and automobile accidents.
This data is appalling to me.
There are people in our society today who will still write this off
under the guise of, "They're just a bunch of junkies."
Well, I'm here to tell you ...
they're not.
They're fathers, mothers,
brothers, sisters,
they're children, sometimes not even in their teens.
They're people just like you and me,
trying to cope in the only way they know how,
and they're dying by the thousands every single month
at an ever-increasing rate.
Addiction is the only disease where we commonly wait
until it's at the highest levels of acuity before we try to do something about it.
And by then, it's often too late.
We have to start sooner.
We have to practice early interventions.
We have to educate youth with real world methods.
We have to stop thinking that people can be rehabilitated in thirty days,
and then we have to improve accessibility to long-term treatment.
We have to eliminate the stigma associated with addiction
and most importantly, we have to reform a broken healthcare system
that is slowly coming to terms
with the fact that they are responsible for this pandemic.
(Applause) (Cheers)
It took me over a decade of active addiction
and many more in recovery
before I finally learned the difference between feeling better
and actually being better.
Because I had to learn to lean into the pain.
I had to quit looking for the fast road to relief.
I had to do the emotional work that needed to be done
no matter how much it hurt.
And after multiple attempts at short-term treatment,
I finally found a willingness to do whatever it took,
and I stayed in a continuum of care for 14 consecutive months
in order to figure it out.
I had to go through the stages of grief that I should've been going through
at age 17, at age 29.
But I refused to keep running,
and it worked.
(Applause)
Fortunately for us, there is such a thing as post-traumatic growth,
and you're witnessing that on the stage before you today.
Post-traumatic growth is defined
as the positive psychological change that can occur in a person
after they've experienced a traumatic life event.
It implies that by finding a way to endure through significant suffering,
you can actually have meaningful development of personal character
and elevate yourself to a higher level of functioning.
But achieving post-traumatic growth requires that you lean into the pain.
You can't run from it.
You can't medicate it.
So now I have a challenge for you.
Take an audit of your current level of emotional pain.
Do you have grief or heartache that you aren't dealing with?
Has something traumatic happened to you that you haven't healed from?
If so, take a step towards addressing this pain.
Call a friend, talk to a therapist, just speak your truth to a stranger.
Take one small step to shed light on this darkness
because I've seen what darkness can do.
I've seen it in hospital rooms
when just one more didn't end up the way it was intended.
I've seen it in jails with people who were born addicted
and never had a chance to learn anything else.
I've seen it at funerals for children
who died before they ever had a chance to truly live.
And I've seen it from underneath a table in the library of my high school.
I want to leave you all with something that I wish I had known at age 17.
Whoever you are, whatever you're going through,
in whatever way you might be going through it, just know this:
in order to heal it, you have to feel it.
We're not going to solve the addiction pandemic overnight
but we will make progress when people start to understand
the difference between physical and emotional pain,
and then choose to do something about it.
In recovery, we often say, you keep what you have by giving it away.
Find the courage to lean into the pain, and you can be a force in helping others.
Thank you.
(Applause)