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Do you remember where you were
on June 12th, 2016?

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A few of you might, but I'm betting
the vast majority probably don't.

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On June 12th, 2016, a lone gunman walked
into Pulse Nightclub, killing 46 people

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in the deadliest mass shooting
by a single gunman in U.S. history.

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Now let's go back about a decade.

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How about August 29th, 2005.

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Do you remember where you were?

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We've got a few heads nodding out there.

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That was Hurricane Katrina.

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Over 1,800 dead
in the costliest natural disaster

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ever to hit the North American continent.

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Now let's go back another few years
and go for 100 percent recognition.

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Do you remember where you were
on September 11th, 2001?

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Everybody's head nodding now.

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The September 11th attacks
left over 3,000 dead

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in the worst terrorist attack
in U.S. history.

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Do you remember how you felt?

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Were you confused?

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Afraid?

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Did you feel sick?

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Were you vulnerable?

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Every time this happens, we're becoming
more and more desensitized.

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We frequently see news coverage
of mass shootings, natural disasters

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that result in enormous loss of life,

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terrorist attacks,

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and then we change the channel
to watch something more friendly.

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This is the society that we live in today,
but the impact of these traumatic events

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are no less serious
on those who are directly affected,

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and now the impact
of emotional pain on our society

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is more problematic than ever.

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Do you remember where you were
on April 20th, 1999?

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Two students walked
into Columbine High School

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armed with shotguns, semi-automatic
rifles, and a bevy of homemade explosives,

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killing 12 students and a teacher,

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in what was, at the time, the worst
high school shooting in U.S. history.

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I remember where I was.

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I had just walked into the library
with my best friend

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in order to meet others
preparing to go to lunch.

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Moments later, a teacher ran through
the same doors we'd just entered

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yelling for everyone to get under
the tables; that somebody had a gun.

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I remember how I felt.

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I was confused.

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I was afraid.

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I felt sick.

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And I was vulnerable.

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And just minutes later,
I was playing dead underneath a table

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next to a pool of blood.

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I had just been shot,

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and I had witnessed my best friend
murdered right in front of me

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as we were huddled together
waiting for help to come.

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I was broken.

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I was in shock,

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and I was in pain.

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But my understanding of pain that day

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was nothing like
my understanding of pain today.

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What's the first thing you think of
when you think of pain?

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Is it a broken arm?
Headache? Sprained ankle?

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Maybe a gunshot wound?

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Those are the things
that I used to associate with pain,

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and they're pretty in line
with the medical definition of pain:

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A variably unpleasant sensation associated
with actual or potential tissue damage

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and mediated by
specific nerve fibers to the brain

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where its conscious appreciation
may be modified by various factors.

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Do you notice anything missing
from that definition?

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Do you see any mention
of the emotional components of pain?

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Me neither.

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In 1996, the American Pain Society
introduced the phrase,

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"Pain is the fifth vital sign,"

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meaning that when you walked
into an emergency room,

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the initial assessment of your condition
was based on five data points:

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pulse rate, temperature, respiration rate,
blood pressure, and pain.

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This was brought about
by a cultural movement

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that was adamant
that we were under-treating pain.

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And patient satisfaction surveys
were put in place in order to track

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the outcome and effectiveness
of this new implementation.

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And what better way to promote
these new policies

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than to tie physician and hospital
compensation to patient satisfaction?

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A recent survey by the industry
group Physicians Practice

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reports that three
out of ten doctors are paid bonuses

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based upon patient satisfaction surveys,

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and hospitals with better scores
receive bigger payments from insurers.

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Naturally, administrators and physicians
began to support this new movement

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with the goal being to get everyone's
pain to zero on the scale.

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That was the mark.

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The ethical dilemma immediately became,

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"Do I issue this person narcotics
in order to keep them happy,

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or deny them, and potentially
hurt my compensation,

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the revenue of the hospital,

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or at worst, open myself up to a grievance
for under-treating pain

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that could potentially result
in the loss of my job?"

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I have experience with pain.

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Less than an hour
after scrambling out the back door

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of the Columbine High School library,
I was medicated on a variety of substances

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that were intended to sedate
and to relieve pain.

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I was 17 years old and I'd never
drank a beer or smoked weed,

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much less anything harder.

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I had no idea of what these medications
were even supposed to do.

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All I knew at age 17
was that a lot of highly educated people

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had prescribed me medications
that were intended to make me feel better

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and they were working,

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only not in the fashion
that they were intended.

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Now if you only remember one thing
from my talk today, let it be this:

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Opioids are profoundly more effective

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at relieving the symptoms
of emotional pain

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than they are at relieving
the symptoms of physical pain.

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I often think back to my pain that day

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and if I were to rate it
on the pain scale,

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my physical pain
would've been a three or a four,

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and that was likely the response
I offered when I was asked.

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But my emotional pain was an absolute ten.

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I was in agony beyond comprehension.

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But that was never asked;

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it was never talked about.

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Acute physical pain ends relatively quick;
complex emotional pain does not.

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My physical pain had subsided
in just a matter of days

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but my emotional pain
was just as debilitating

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as it was lying
in the hospital bed that day,

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so I continued taking the medication
that was prescribed for my pain.

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I was addicted before
I even knew what was happening.

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A recent survey by the American Society
of Addiction Medicine

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reports that 86 percent of heroin users
began by taking prescription opioids.

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And in 2012 alone, over 259 million
opioid prescriptions

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were filled in the U.S.

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That is more than enough
to give every American adult

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their own bottle of pills.

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I very quickly began drug-seeking
in order to soothe my emotional pain

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and it was only a matter of months

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before the prescriptions had turned to
alcohol, marijuana, and elicit narcotics.

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And as addiction always does,
over the course of the next decade,

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my tolerance continued to build,
my life continued to be unmanageable,

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and my emotional pain stayed unresolved.

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It was like I had pressed a pause button
on my emotional growth.

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I was managing my pain
in the only way I knew how,

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and I wasn't alone.

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I believe that emotional pain
is what's driving the addiction epidemic.

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Think of someone you know
who struggles with addiction.

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I'm betting you can point to an element

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of unaddressed or unresolved
emotional pain in that person.

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Now think of a time
you were in intense emotional pain

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and how desperate you were to stop it.

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What if you had been offered
an immediate route to feeling better.

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Imagine for a moment
breaking your leg in an avalanche.

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Now that injury alone
can be a fairly traumatic experience,

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but it's manageable.

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With short term pain management,
most would make a full recovery.

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But now imagine sustaining
that exact same injury,

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only this time your close friend
was skiing next to you,

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and they didn't make it
out of the avalanche alive.

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It seems so crystal clear to me

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that there would be two very different
pain management strategies

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for what would appear to be
an identical physiological injury,

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only there's not.

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Emotional pain is toxic, it's pervasive,
and society has programmed us to avoid it.

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We medicate with alcohol and drugs,
sex and pornography,

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even television and technology,

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and oftentimes, we're doing this
without even knowing it.

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Our society is literally
being defined by this pain.

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And now, more and more people
are dying every month

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because they're looking for solace
in the only way they know how.

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It's the way they were programmed.

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Everyone has pain; it's unavoidable.

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And I have a simple summary
for how we got here.

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We built a society that is filled
with emotional pain and trauma.

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We combined that with a healthcare system

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that's intended to primarily treat
physiological symptoms,

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and then we put Big Pharma
in the driver's seat,

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aimed directly at profits with regulations
that are easy to manipulate.

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And now we're in the midst
of what the former Surgeon General

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called the worst public health crisis
the nation has ever seen -

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two years ago.

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It has since worsened,
and what was then the addiction epidemic

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is now commonly referred to
as the addiction pandemic.

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And here's a glimpse
of where we're at today.

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The New York Times reported last month

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that overdose deaths rose
by 19 percent in 2016,

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and preliminary data for 2017
shows that this trend is only worsening.

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We've now far surpassed the worst years
ever recorded for deaths caused by guns,

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AIDS, and automobile accidents.

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This data is appalling to me.

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There are people in our society today
who will still write this off

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under the guise of,
"They're just a bunch of junkies."

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Well, I'm here to tell you ...

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they're not.

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They're fathers, mothers,

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brothers, sisters,

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they're children,
sometimes not even in their teens.

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They're people just like you and me,

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trying to cope
in the only way they know how,

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and they're dying by the thousands
every single month

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at an ever-increasing rate.

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Addiction is the only disease
where we commonly wait

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until it's at the highest levels of acuity
before we try to do something about it.

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And by then, it's often too late.

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We have to start sooner.

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We have to practice early interventions.

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We have to educate youth
with real world methods.

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We have to stop thinking that people
can be rehabilitated in thirty days,

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and then we have to improve accessibility
to long-term treatment.

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We have to eliminate the stigma
associated with addiction

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and most importantly, we have to reform
a broken healthcare system

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that is slowly coming to terms


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with the fact that they are responsible
for this pandemic.

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(Applause) (Cheers)

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It took me over a decade
of active addiction

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and many more in recovery

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before I finally learned the difference
between feeling better

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and actually being better.

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Because I had to learn
to lean into the pain.

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I had to quit looking
for the fast road to relief.

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I had to do the emotional work
that needed to be done

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no matter how much it hurt.

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And after multiple attempts
at short-term treatment,

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I finally found a willingness
to do whatever it took,

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and I stayed in a continuum of care
for 14 consecutive months

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in order to figure it out.

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I had to go through the stages of grief
that I should've been going through

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at age 17, at age 29.

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But I refused to keep running,

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and it worked.

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(Applause)

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Fortunately for us, there is such a thing
as post-traumatic growth,

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and you're witnessing that
on the stage before you today.

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Post-traumatic growth is defined

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as the positive psychological change
that can occur in a person

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after they've experienced
a traumatic life event.

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It implies that by finding a way
to endure through significant suffering,

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you can actually have meaningful
development of personal character

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and elevate yourself
to a higher level of functioning.

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But achieving post-traumatic growth
requires that you lean into the pain.

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You can't run from it.

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You can't medicate it.

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So now I have a challenge for you.

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Take an audit of your current level
of emotional pain.

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Do you have grief or heartache
that you aren't dealing with?

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Has something traumatic happened to you
that you haven't healed from?

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If so, take a step towards
addressing this pain.

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Call a friend, talk to a therapist,
just speak your truth to a stranger.

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Take one small step
to shed light on this darkness

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because I've seen what darkness can do.

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I've seen it in hospital rooms

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when just one more
didn't end up the way it was intended.

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00:13:32,461 --> 00:13:35,109
I've seen it in jails
with people who were born addicted

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and never had a chance
to learn anything else.

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I've seen it at funerals for children

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who died before they ever
had a chance to truly live.

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And I've seen it from underneath a table
in the library of my high school.

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I want to leave you all with something
that I wish I had known at age 17.

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Whoever you are,
whatever you're going through,

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in whatever way you might be
going through it, just know this:

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in order to heal it, you have to feel it.

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We're not going to solve
the addiction pandemic overnight

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but we will make progress
when people start to understand

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the difference between
physical and emotional pain,

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and then choose to do something about it.

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In recovery, we often say, you keep
what you have by giving it away.

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Find the courage to lean into the pain,
and you can be a force in helping others.

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Thank you.

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(Applause)