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MarkTyndall_2017P-_毒瘾治疗的减少伤害方案_
I remember the first time that I saw people injecting drugs. 我還記得第一次看到 別人注射毒品的經驗
injecting:v.(给…)注射(药物等);(给…)添加,增加(某品质);(inject的现在分词)
I had just arrived in Vancouver to lead a research project in HIV prevention in the infamous Downtown East Side. 我才剛剛到溫哥華主導一個研究計畫 是一個愛滋病防治計畫
Vancouver:n.温哥华(加拿大主要港市); HIV:n.艾滋病病毒; prevention:n.预防;阻止;妨碍; infamous:adj.声名狼藉的;无耻的;邪恶的;不名誉的; Downtown:n.市区;闹市区;adv.在市区;在热闹街上;到闹市区;adj.闹市区的;
It was in the lobby of the Portland Hotel, a supportive housing project that gave rooms to the most marginalized people in the city, the so-called "difficult to house." 事情就發生在波特蘭旅館的大廳 那裡有個住房支持計畫提供住所 給城市中最邊緣化的一群人 所謂「很難收容的人」
lobby:n.大堂;门厅;民众接待厅;游说;v.游说(从政者或政府); supportive:adj.支持的;支援的;赞助的; housing project:n.公房项目;公房区(常由政府为贫困家庭营造); marginalized:使边缘化;忽略;排斥(marginalize的过去式和过去分词); so-called:adj.所谓的;号称的;
I'll never forget the young woman standing on the stairs repeatedly jabbing herself with a needle , and screaming, "I can't find a vein ," 我永遠無法忘記 那個站在樓梯上的年輕女子 一邊不斷地用注射針猛刺自己 一邊大喊「我找不到血管」
repeatedly:adv.反复地;再三地;屡次地; jabbing:v.戳;猛击;用拨火棒等捅;n.戳;猛击;注射; needle:n.针;针头;指针;缝针;v.穿过;刺激;拿针缝;拿针穿; vein:n.血管;叶脉;[地质]岩脉;纹理;翅脉;性情;vt.使成脉络;象脉络般分布于;
as blood splattered on the wall. 同時血飛濺到牆上
splattered:v.把(水等)泼洒在…上;淋湿;飞溅(splatter的过去分词和过去式)
In response to the desperate state of affairs, the drug use, the poverty , the violence , the soaring rates of HIV, 為了因應層出不窮的 毒品濫用 貧窮 暴力
In response to:响应;回答;对…有反应; desperate:adj.不顾一切的;令人绝望的;极度渴望的; poverty:n.贫困;困难;缺少;低劣; violence:n.暴力;侵犯;激烈;歪曲; soaring:adj.翱翔的;高耸的;猛增的;v.高耸;高飞;猛增;(soar的现在分词形式)
Vancouver declared a public health emergency in 1997. 溫哥華市在 1997 年 宣佈進入公共衛生警戒狀態
emergency:n.紧急情况;突发事件;非常时刻;adj.紧急的;备用的;
This opened the door to expanding harm reduction services, distributing more needles , increasing access to methadone , and, finally , opening a supervised injection site . 此舉開啟了一扇門來擴展減害服務 分發更多注射針 讓美沙酮更容易取得 最後,還開設了一個 有人管理的安全注射站
expanding:v.扩大,增加,增强细谈;详述;(expand的现在分词) reduction:n.减少;缩小;降低;减价;折扣;缩图; distributing:v.分发;分配;分销;使散开;使分布;分散;(distribute的现在分词) needles:n.针数,千针本;[印刷]折页顶针(needle复数形式); methadone:n.美沙酮;美散痛; finally:adv.终于;最终;(用于列举)最后;彻底地; supervised:v.监督;管理;指导;主管(supervise的过去分词和过去式) injection:n.注射;大量资金的投入;(液体的)注入; site:n.地点;位置;场所;v.设置;为…选址;
Things that make injecting drugs less hazardous . 這些都能讓毒品注射的危險降低
hazardous:adj.有危险的;冒险的;碰运气的;
But today, 20 years later, harm reduction is still viewed as some sort of radical concept. 但 20 年後的今天 減害的概念仍然被視為 是某種極端的觀念
radical:n.自由基;激进分子;游离基;adj.根本的;彻底的;完全的;全新的;
In some places, it's still illegal to carry a clean needle. 帶著乾淨的注射針 在某些地方仍然不合法
illegal:adj.不合法的;非法的;n.非法移民;非法劳工;
Drug users are far more likely to be arrested than to be offered methadone therapy . 毒癮者被逮捕的機會 高過得到美沙酮治療的機會
therapy:n.治疗,疗法;
Recent proposals for supervised injection sites in cities like Seattle , Baltimore and New York have been met with stiff opposition : opposition that goes against everything we know about addiction. 有些近期提案建議把安全注射站 開設在像是西雅圖 巴爾的摩及紐約這類城市 卻被強力抵制 這種抵制和所有我們 對成癮的認知背道而馳
proposals:n.建议书(Proposal的复数);求婚; sites:n.网站(site的复数);遗址,举办地点;v.使...位于(site的单三形式); Seattle:n.西雅图(美国一港市); Baltimore:n.巴尔的摩(美国一座港市); stiff:adj.呆板的; v.僵硬地; n.死尸; v.诈骗; opposition:n.反对党;对立;在野党;对抗;
Why is that? 怎麼說呢?
Why are we still stuck on the idea that the only option is to stop using -- that any drug use will not be tolerated ? 為什麼很多人仍然堅持 阻止濫用毒品的唯一的選擇 是全面禁止施打毒品？
option:n.选择;可选择的东西; tolerated:v.容许;忍受;包容;有耐受性;(tolerate的过去式和过去分词)
Why do we ignore countless personal stories and overwhelming scientific evidence that harm reduction works? 為什麼我們還是不願意正眼看待 證明減害計畫是有效的？
ignore:v.驳回诉讼;忽视;不理睬; countless:adj.无数的;数不尽的; personal:adj.个人的;身体的;亲自的;n.人事消息栏;人称代名词; overwhelming:adj.势不可挡的; v.压倒; (overwhelm的现在分词) scientific:adj.科学的,系统的; evidence:n.证据,证明;迹象;明显;v.证明;
Critics say that harm reduction doesn't stop people from using illegal drugs. 有評論說,減害方案沒有辦法遏止 大眾吸食毒品
Critics:n.评论家;批评者;吹毛求疵的人(critic的复数);
Well, actually, that is the whole point. 其實這才是重點
After every criminal and societal sanction that we can come up with , people still use drugs, and far too many die. 就算加諸所有我們想到的 刑法和社會制裁 毒品濫用還是存在且太多人因此喪命
societal:adj.社会的; sanction:n.制裁,处罚;认可;支持;vt.制裁,处罚;批准;鼓励; come up with:提出;想出;赶上;
Critics also say that we are giving up on people by not focusing our attention on treatment and recovery . 很多批評說我們是在放棄毒癮者 因為我們沒有著重在治療和康復上
treatment:n.治疗;疗法;对待;处理;讨论; recovery:n.恢复,复原;痊愈;重获;
In fact, it is just the opposite. 事實上恰恰相反
We are not giving up on people. 我們沒有放棄毒癮者
We know that if recovery is ever going to happen we must keep people alive. 我們很清楚如果要讓他們恢復 我們得先讓他們能活下來
Offering someone a clean needle or a safe place to inject is the first step to treatment and recovery. 提供他們一支乾淨的注射針 或一個安全的注射地點 就是治療和康復的第一步
Critics also claim that harm reduction gives the wrong message to our children about drug users. 也有人批評說 減害計畫 讓我們的孩子對毒癮者有錯誤的印象
claim:v.要求;声称;需要;认领;n.要求;声称;索赔;断言;值得;
The last time I looked, these drug users are our children. 我最後一次看 這些毒癮者就是我們的孩子
The message of harm reduction is that while drugs can hurt you, we still must reach out to people who are addicted . 減少傷害所傳遞的訊息 是雖然毒品會傷害你 我們還是得要向成癮的人伸出手
addicted:adj.上瘾的;上瘾;成瘾;有瘾;入迷;
A needle exchange is not an advertisement for drug use. 換新注射針並不是幫施打毒品打廣告
exchange:n.交换;交流;交易所;兑换;v.交换;交易;兑换;
Neither is a methadone clinic or a supervised injection site. 安全注射站或美沙酮診所也不是
clinic:n.诊所;临床实习;(医院的)门诊部;门诊时间;
What you see there are people sick and hurting, hardly an endorsement for drug use. 在這些地方你只會看見生病受苦的人 根本不是在為吸食毒品做背書
endorsement:n.赞同,支持,认可;宣传,代言;违章记录;
Let's take supervised injection sites, for example. 以安全注射站為例
Probably the most misunderstood health intervention ever. 它可能是史上最被誤解的醫療介入了
misunderstood:adj.被误解的;v.误解,误会(misunderstand的过去式); intervention:n.介入;调停;妨碍;
All we are saying is that allowing people to inject in a clean, dry space with fresh needles, surrounded by people who care is a lot better than injecting in a dingy alley , sharing contaminated needles and hiding out from police. 我們要說的是 讓毒品成癮者 能在一個衛生乾淨的空間中 用新的注射針來施打藥物 身邊圍繞的是在乎他們的人 這樣的做法遠遠勝過讓他們 在骯髒巷子裡注射 共用針頭 躲著警察
dingy:adj.昏暗的;肮脏的; alley:n.小巷;小路;小径; contaminated:v.污染;玷污,毒害(人的思想或品德);(contaminate的过去分词和过去式)
It's better for everybody. 這樣對大家都好
The first supervised injection site in Vancouver was at 327 Carol Street, a narrow room with a concrete floor, a few chairs and a box of clean needles. 溫哥華的第一個安全注射站 位在卡羅街 327 號 一個小小的房間 水泥地板 幾張椅子 和一盒乾淨的針頭
Carol:v.欢乐地歌唱;唱耶诞颂歌;n.颂歌,赞美诗;欢乐之歌; narrow:adj.狭窄的; v.使窄小; n.峡谷; (场所,物品等的)狭窄部分; concrete:n.混凝土;adj.混凝土制的;确实的,具体的;vt.用混凝土覆盖
The police would often lock it down, but somehow it always mysteriously reopened , often with the aid of a crowbar . 警方常常把它鎖起來 可是它總是很神奇地又重新開張 通常是有鐵橇的幫忙
somehow:adv.以某种方法;莫名其妙地; mysteriously:adv.神秘地;故弄玄虚地;难以理解地; reopened:adj.问题未解决的;v.重新开放(reopen的过去分词);重新开始; crowbar:n.撬棍;铁橇;起货钩;
I would go down there some evenings to provide medical care for people who were injecting drugs. 我有時候會晚上到那裡去 提供醫療照護給在注射毒品的人
I was always struck with the commitment and compassion of the people who operated and used the site. 我總是被營運和使用該站點的人 展現的投入和同理心深深感動
commitment:n.承诺;投入;保证;许诺; compassion:n.同情;怜悯;
No judgment , no hassles , no fear, lots of profound conversation. 沒有評斷 沒有口角 沒有恐懼 有的是很多深刻的對談
judgment:n.判断;裁判;判决书;辨别力; hassles:n.激战(hassle的复数);v.与…争辩(hassle的第三人称单数); profound:adj.深厚的;意义深远的;渊博的;
I learned that despite unimaginable trauma , physical pain and mental illness, that everyone there thought that things would get better. 我了解到儘管有無法想像的傷痛 身體痛苦和精神疾病 但那裡的每個人相信 一切都會好轉
despite:prep.尽管,不管;n.轻视;憎恨;侮辱; unimaginable:adj.不可思议的;难以想像的; trauma:n.[外科]创伤(由心理创伤造成精神上的异常);外伤; physical:adj.[物]物理的;身体的;物质的;符合自然法则的;n.体格检查; mental:adj.精神的;脑力的;疯的;n.精神病患者;
Most were convinced that, someday, they'd stop using drugs altogether. 大部分人深信 有一天他們會完全脫離毒品
convinced:adj.坚信; v.使确信; (convince的过去分词和过去式)
That room was the forerunner to North America 's first government-sanctioned supervised injection site, called INSITE. 那間房間可說是引領北美的先驅 第一個政府批准的安全注射站點
forerunner:n.先驱;先驱者;预兆; North America:n.北美洲;
It opened in September of 2003 as a three-year research project. 它在 2003 年 9 月開張 是一項 3 年研究計畫
The conservative government was intent on closing it down at the end of the study. 保守黨政府一直試圖 在研究結束之後關閉它
conservative:adj.保守的;n.保守派,守旧者; intent on:专心致志于;抱定决心要实行;
After eight years, the battle to close INSITE went all the way up to Canada's Supreme Court . 8 年後 關閉 INSITE 的官司 一路打到加拿大的最高法庭
Supreme Court:最高法院;
It pitted the government of Canada against two people with a long history of drug use who knew the benefits of INSITE firsthand : 和加拿大政府分庭抗禮的是 兩個有多年毒癮 親身體驗過 INSITE 益處的人
pitted:adj.表面有小点(或小洞)的; v.使…表面有斑点; (pit的过去分词和过去式) firsthand:adj.直接的;直接采购的;直接得来的;adv.直接地;
Dean Wilson and Shelley Tomic. 狄恩威爾森和雪莉托米克
Dean:n.院长;系主任;教务长;主持牧师;
The court ruled in favor of keeping INSITE open by nine to zero. 法庭的判決同意讓 INSITE 從早上 9 點營運到午夜
The justices were scathing in their response to the government's case. 法官在回應檢方時嚴厲痛斥
justices:n.公平;公正;司法制度;审判;(justice的复数) scathing:adj.严厉的;严厉批评的;无情抨击的;v.损伤;损害;(scathe的现在分词)
And I quote : "The effect of denying the services of INSITE to the population that it serves and the correlative increase in the risk of death and disease 我引述一段話: 「否認 INSITE 提供服務給受惠大眾產生的效應 和毒品注射者相對增加的 死亡和生病的風險
quote:v.引用;报价;举例说明;开价;为(企业的股份)上市;n.引用; denying:v.否认;否定;拒绝承认;拒绝给予;(deny的现在分词) correlative:adj.相关的;有相互关系的;n.关联词;相关物; disease:n.病,[医]疾病;弊病;vt.传染;使…有病;
to injection drug users is grossly disproportionate to any benefit that Canada might derive from presenting a uniform stance on the possession of narcotics ." 以及從中獲得的利益
grossly:adv.很;非常; disproportionate:adj.不成比例的;不成比例地; derive:vt.源于;得自;vi.起源; uniform:adj.统一的;一致的;相同的;始终如一的;n.制服;v.使穿制服;使成一样; stance:n.立场;姿态;位置;准备击球姿势; possession:n.拥有;具有;属地;个人财产; narcotics:n.麻醉剂(narcotic的复数);麻醉毒品;
This was a hopeful moment for harm reduction. 對減害方案來說 這是個充滿希望的時刻
Yet, despite this strong message from the Supreme Court, it was, until very recently , impossible to open up any new sites in Canada. 然而 儘管最高法庭強烈表態 直到近期仍無法 在加拿大設立任何新站點
recently:adv.最近;新近;
There was one interesting thing that happened in December of 2016, when due to the overdose crisis , the government of British Columbia allowed the opening of overdose prevention sites. 在 2016 年 12 月 發生了一件有趣的事 當時因為用藥過量的危機 卑詩省政府允許開設用藥過量預防站
overdose:n.(一次用药)过量;v.一次用药过量; crisis:n.危机;危险期;决定性时刻;adj.危机的;用于处理危机的;
Essentially ignoring the federal approval process , community groups opened up about 22 of these de facto illegal supervised injection sites across the province. 完全不理會聯邦審核流程 社區團體在全省開設了 大約 22 個事實上 非法營運的安全注射站
Essentially:adv.本质上;本来; ignoring:v.忽略,忽视;(ignore的现在分词); federal:adj.联邦的;同盟的;联邦政府的;联邦制的;adv.联邦政府地; approval:n.批准;认可;赞成; process:v.处理;加工;列队行进;n.过程,进行;方法,adj.经过特殊加工(或处理)的; community:n.社区;[生态]群落;共同体;团体; de facto:adj.实际上存在的(不一定合法);
Virtually overnight , thousands of people could use drugs under supervision . 差不多就是一夜之間 數千人得以在安全監督下施打毒品
Virtually:adv.事实上,几乎;实质上; overnight:adj.夜间的; v.在夜间; n.(美)前一天的晚上; supervision:n.监督,管理;
Hundreds of overdoses were reversed by Naloxone , and nobody died. 靠著納洛酮救回數百個用藥過量的人 沒有人因此喪命
overdoses:vt.配药过量; n.药量过多(等于overdosage); vi.服药过量; reversed:v.颠倒; (reverse的过去分词和过去式) Naloxone:n.烯丙羟吗啡酮,[药]纳洛酮(吗啡拮抗药);
In fact, this is what's happened at INSITE over the last 14 years: 75,000 different individuals have injected illegal drugs more than three and a half million times, and not one person has died. 事實上 過去 14 年間 在 INSITE 也是這樣子 7 萬 5 千名注射非法毒品的人 注射次數超過 350 萬次 沒有任何人死亡
individuals:n.[经]个人;[生物]个体(individual的复数); injected:v.(给…)注射(药物等); (inject的过去分词和过去式)
Nobody has ever died at INSITE. 沒有任何人在 INSITE 身亡
So there you have it. 這些就是
We have scientific evidence and successes from needle exchanges methadone and supervised injection sites. 替換針頭 美沙酮 和安全注射站的 相關科學證據和成功案例
These are common-sense , compassionate approaches to drug use that improve health, bring connection and greatly reduce suffering and death. 這些常識性且充滿關懷的 處理毒癮方法 能夠改善健康 增進人與人的連結 並大大減少痛苦以及死亡
common-sense:adj.常识的;有生活经验得来的; compassionate:adj.慈悲的;富于同情心的;vt.同情;怜悯; approaches:v.靠近,接近; n.方式,方法,态度; improve:v.改进;改善; greatly:adv.很,大大地;非常;
So why haven't harm reduction programs taken off? 可是減害方案為什麼沒有大受歡迎？
Why do we still think that drug use is law enforcement issue ? 為什麼我們還認為 施打毒品是執法議題？
enforcement:n.执行,实施;强制; issue:n.重要议题;争论的问题;v.宣布;公布;发出;发行;
Our disdain for drugs and drug users goes very deep. 我們對於毒品和毒癮者有很深的誤解
disdain:n.蔑视;vt.鄙弃;
We are bombarded with images and media stories about the horrible impacts of drugs. 我們受到大量影視媒體的誤導 內容都是關於毒品的可怕影響
bombarded:v.轰炸(bombard的过去分词); adj.被轰击的; images:n.印象;声誉;形象;画像;雕像;(image的第三人称单数和复数) media:n.媒体;媒质(medium的复数);血管中层;浊塞音;中脉; horrible:可怕的,极讨厌的, impacts:n.影响; v.有影响,有作用;
We have stigmatized entire communities . 我們把整個族群污名化了
stigmatized:adj.受非难的;被污名化的;v.污辱;指责(stigmatize的过去分词); communities:n.社区;社会;团体;共有(community的复数)
We applaud military-inspired operations that bring down drug dealers. 我們對鏟除毒販的軍事行動喝采
applaud:v.欢呼;赞成; bring down:降低;打倒,打死;击落;
And we appear unfazed by building more jails to incarcerate people whose only crime is using drugs. 毫不懷疑地建立更多監獄來監禁 只是因為吸毒而入獄的人
unfazed:adj.未受干扰;不觉担忧; jails:n.监狱;监牢;拘留所;vt.监禁;下狱; incarcerate:v.监禁;下狱;禁闭;adj.监禁的;禁闭的;
Virtually millions of people are caught up in a hopeless cycle of incarceration , violence and poverty that has been created by our drug laws and not the drugs themselves. 有數百萬人被困在一個毫無希望的 充滿監禁 暴力 以及貧窮的循環 造成這個循環的並非毒品本身 而是我們的法律
incarceration:n.监禁;下狱;禁闭;
How do I explain to people that drug users deserve care and support and the freedom to live their lives when all we see are images of guns and handcuffs and jail cells? 我該怎麼解釋 毒癮者也值得被關心和支持 值得擁有生活自主權 而不是跟槍枝 手銬 牢房 這些印象綁在一起？
deserve:vi.应受,应得; handcuffs:n.手铐;v.用手铐铐住(某人);(handcuff的第三人称单数和复数)
Let's be clear: criminalization is just a way to institutionalize stigma. 簡單來說 加諸罪名是一種 把汙名化合理納入體制的做法
criminalization:刑事定罪; institutionalize:vt.使…制度化;
Making drugs illegal does nothing to stop people from using them. 將毒品非法化 並不能阻止大眾施打毒品
Our paralysis to see things differently is also based on an entirely false narrative about drug use. 我們僵化的觀點 是來自對施打毒品全然錯誤的描述
paralysis:n.麻痹;无力;停顿; narrative:n.叙述;故事;讲述;adj.叙事的,叙述的;叙事体的;
We have been led to believe that drug users are irresponsible people who just want to get high, and then through their own personal failings spiral down into a life of crime and poverty, losing their jobs, their families and, ultimately , their lives. 我們被誤導去相信 吸毒者是不負責任只追求快感的人 他們是被自己個人的失敗 捲入一個充滿犯罪和貧窮的人生 失去工作 家人 最終也失去了性命
irresponsible:adj.不负责任的;不可靠的; failings:n.失败; prep.如果没有…; adj.失败的; v.失败; spiral:n.螺旋;旋涡;螺旋形之物;adj.螺旋形的;v.使成螺旋形;vi.盘旋;螺旋形上升; ultimately:adv.最终;最后;归根结底;终究;
In reality, most drug users have a story, whether it's childhood trauma, sexual abuse , mental illness or a personal tragedy . 事實上大部分用毒者有自己的故事 不論是兒時的創傷 性侵害 精神疾病 或是個人的不幸
childhood:n.童年;幼年;孩童时期 sexual:adj.性的;性别的;有性的; abuse:n.滥用;虐待;辱骂;弊端;恶习,陋习;v.滥用;虐待;辱骂; tragedy:n.悲惨的事;不幸;灾难;悲剧作品;
The drugs are used to numb the pain. 毒品是用來麻痺痛苦的
We must understand that as we approach people with so much trauma. 當面對有著深沉創傷的人 我們必須要有這樣的理解
At its core , our drug policies are really a social justice issue. 毒品政策的核心 其實是個社會正義議題
core:n.核心;要点;果心;[计]磁心;vt.挖...的核; policies:n.政策;方针;原则;为人之道;保险单(policy的复数)
While the media may focus on overdose deaths like Prince and Michael Jackson, the majority of the suffering happens to people who are living on the margins , the poor and the dispossessed . 雖然媒體聚焦在用藥過量致死的例子 像王子和麥可傑克森 但是大部分的苦難 發生在處於社會邊緣的人身上 貧窮和無依無靠的人
majority:n.大部分:大多数:多数票:成年人: margins:n.边缘; v.给…镶边; (margin的复数) dispossessed:adj.被逐出的;无依无靠的;失去产业的;
They don't vote; they are often alone. 他們不投票 他們通常獨自一人
They are society's disposable people. 他們是隨時會被社會拋棄的人
disposable:adj.可任意处理的;可自由使用的;用完即可丢弃的;
Even within health care , drug use is highly stigmatized. 即使在醫療衛生領域中 吸毒也被嚴重污名化
health care:n.卫生保健; highly:adv.高度地;非常;非常赞许地;
People using drugs avoid the health care system. 施用毒品的人 通常會避開醫療衛生系統
They know that once engaged in clinical care or admitted to hospital, they will be treated poorly. 他們知道一旦有 醫療照護介入或是住院 他們就會受到很差的待遇
engaged in:从事于;忙于; clinical:adj.临床的;诊所的; treated:v.以…态度对待;把…看作;(treat的过去分词和过去式)
And their supply line , be it heroin , cocaine or crystal meth will be interrupted . 而他們的供應線 不論是海洛因 古柯鹼或冰毒 都會被切斷
supply line:n.(战争中军队的)补给线; heroin:n.[药][毒物]海洛因,吗啡; cocaine:n.[药]可卡因; crystal:n.水晶; adj.晶莹的; interrupted:v.插嘴; adj.被阻止的,中断的; (interrupt的过去分词和过去式)
On top of that, they will be asked a barrage of questions that only serve to expose their losses and shame. 此外 他們會被一大堆問題轟炸 逼他們揭露自己的失敗和恥辱
barrage:n.弹幕; vt.以密集炮火进攻; vi.以密集火力阻击; expose:v.揭露,揭发;使曝光;显示;
'"What drugs do you use?" 「你吸食哪一種毒品？」
'"How long have you been living on the street?" 「你流落街頭多久了？」
'"Where are your children?" 「你的孩子在哪裡？」
'"When were you last in jail?" 「你上次坐牢是甚麼時候？」
Essentially: "Why the hell don't you stop using drugs?" 基本上就是在問: 「你為什麼不停止吸毒？」
In fact, our entire medical approach to drug use is upside down . 事實上整個醫療系統 處理毒癮的方法弄反了
upside down:adj.颠倒的;乱七八糟的;
For some reason, we have decided that abstinence is the best way to treat this. 基於某種原因 我們自顧自地認定 最好的治療方式就是全面戒除
abstinence:n.节制;节欲;戒酒;禁食;
If you're lucky enough, you may get into a detox program. 如果你夠幸運 或可參加戒癮計畫
detox:n.戒瘾病房;戒瘾诊所;adj.用以解毒的;用以去毒的;vt.使戒去毒瘾(或酒瘾);
If you live in a community with Suboxone or methadone, you may get on a substitution program. 如果你住在一個提供舒倍生 或美沙酮療法的社區 你或許可以參與替代品計畫
substitution:n.代替;[数]置换;代替物;
Hardly ever would we offer people what they desperately need to survive: a safe prescription for opioids . 我們幾乎從來沒有提供毒癮者 他們生存最迫切需要的東西: 一個安全的類鴉片藥物處方
Hardly ever:几乎不;几乎从来不; desperately:adv.拼命地;绝望地;不顾一切地;极度地; prescription:n.处方;药方;医生开的药;开处方; opioids:n.阿片类药物;类阿片;鸦片类药剂(opioid的复数形式);
Starting with abstinence is like asking a new diabetic to quit sugar or a severe asthmatic to start running marathons or a depressed person to just be happy. 直接從完全戒除開始治療 就像是要糖尿病患者一下子戒掉糖 或是要嚴重氣喘患者去跑馬拉松 或是要憂鬱症患者開心點
diabetic:adj.糖尿病的,患糖尿病的;n.糖尿病患者; quit:v.离开;放弃;停止;使…解除;n.离开;[计]退出;adj.摆脱了…的;已经了结的; severe:adj.极为恶劣的;十分严重的;严厉的;苛刻的; asthmatic:adj.气喘的;似患气喘的;n.气喘患者; depressed:adj.沮丧的; v.使抑郁; (depress的过去式和过去分词)
For any other medical condition, we would never start with the most extreme option. 既然對任何其他醫療疾病 我們從來不會從最極端的療法開始
extreme:adj.极端的;极度的;偏激的;尽头的;n.极端;末端;最大程度;极端的事物;
What makes us think that strategy would work for something as complex as addiction? 那麼我們為什麼會認為這種方法 對於成癮這麼複雜的狀況會有用？
strategy:n.策略;行动计划;部署;战略; complex:adj.复杂的;合成的;n.复合体;综合设施;
While unintentional overdoses are not new, the scale of the current crisis is unprecedented . 意外用藥過量不足為奇 但是當前危機的規模是前所未見的
unintentional:adj.非故意的;无意识的; scale:n.规模;比例;鳞;刻度;天平;数值范围;v.衡量;攀登;剥落;生水垢; unprecedented:adj.空前的;无前例的;
The Center for Disease Control estimated that 64,000 Americans died of a drug overdose in 2016, far exceeding car crashes or homicides . 疾病管制局估計 2016 年就有 6 萬 4 千名 美國人死於用藥過量 遠遠超過車禍或自殺的死亡人數
estimated:adj.估计的;预计的;估算的; exceeding:adj.超越的; v.超过(数量); (exceed的现在分词) car crashes:n.车祸; homicides:n.杀人;杀人犯;
Drug-related mortality is now the leading cause of death among men and women between 20 and 50 years old in North America 毒品相關造成的死亡 如今是 20 到 50 歲 北美男性與女性的主要死因
mortality:n.死亡数,死亡率;必死性,必死的命运;
Think about that. 想一想
How did we get to this point, and why now? 我們是怎麼落入這個境況？ 為什麼是現在？
There is a kind of perfect storm around opioids. 類鴉片藥物帶來著一連串的災難
perfect storm:n.祸不单行;屋漏偏逢连夜雨;
Drugs like Oxycontin , Percocet and Dilaudid have been liberally distributed for decades for all kinds of pain. 像奧施康定（土海洛因） 醅鈳塞 第勞第拖這類毒品 數十年來都被大量開立配藥 做各種止痛用途
Oxycontin:奥施康定; Dilaudid:n.盐酸二氢吗啡酮(镇痛剂); liberally:adv.大方地;自由地;公平地;充足地; distributed:adj.分布的;分散的;v.分发;分配;使分布(distribute的过去分词和过去式)
It is estimated that two million Americans are daily opioid users, and over 60 million people received at least one prescription for opioids last year. 據估計 有兩百萬美國人 每天服用類鴉片藥物 超過六千萬人 去年至少拿過一次 類鴉片藥物的處方
This massive dump of prescription drugs into communities has provided a steady source for people wanting to self-medicate . 大量開立給民眾的處方藥 讓想要自行用藥的人 有穩定的藥品來源
massive:adj.大量的;巨大的,厚重的;魁伟的; dump:v.倾倒;抛售;抛弃;转存;n.垃圾场;转储;转存;废物堆; provided:conj.假如; v.提供; (provide的过去分词和过去式) steady:adj.稳定的; v.使稳定; v.稳定地; n.关系固定的情侣; source:n.来源;水源;原始资料; self-medicate:自我治疗;不照医生指示自己乱吃药;
In response to this prescription epidemic , people have been cut off, and this has greatly reduced the street supply 為了因應這種處方疫情 很多人的處方被取消了 這做法大幅降低了街頭的供應量
epidemic:n.流行病;蔓延;adj.传染病;流行性的;
The unintended but predictable consequence is an overdose epidemic. 結果就是非刻意製造但可以預期的 藥物濫用大流行
unintended:adj.无意识的;非计划中的; predictable:adj.可预言的; consequence:n.结果;重要性;推论;
Many people who were reliant on a steady supply of prescription drugs turned to heroin. 許多原本依賴處方藥穩定供應的人 轉向海洛因
reliant:adj.依赖的;可靠的;信赖的;
And now the illegal drug market has tragically switched to synthetic drugs, mainly fentanyl . 很不幸地現在的非法藥品市場需求 轉向合成藥品 主要是芬太奴
tragically:adv.悲剧地;悲惨地; synthetic:adj.综合的;合成的,人造的;n.合成物; mainly:adv.大多;大部分;主要地;首要地; fentanyl:n.芬太尼(主要用作止痛剂);
These new drugs are cheap, potent and extremely hard to dose. 這些新藥很便宜 強效 但是極難控制劑量
potent:adj.有效的;强有力的,有权势的;有说服力的; extremely:adv.非常,极其;极端地;
People are literally being poisoned. 使用者基本上是被毒害的
literally:adv.按字面:字面上:确实地:
Can you imagine if this was any other kind of poisoning epidemic? 各位能想像如果這是 另一種的中毒大流行嗎？
What if thousands of people started dying from poisoned meat or baby formula or coffee? 如果有數以千計的人開始死於 被下毒的肉品 嬰兒配方奶粉或咖啡
What if:如果…怎么办? formula:n.公式; adj.(赛车)方程式的(指赛车要符合规定的体积,重量及汽缸容量等);
We would be treating this as a true emergency. 我們會把它視為真正的緊急狀況
treating:v.以…态度对待;把…看作;处理;讨论;(treat的现在分词)
We would immediately be supplying safer alternatives . 我們會馬上供應比較安全的替代品
alternatives:n.可供选择的事物;(alternative的复数)
There would be changes in legislation , and we would be supporting the victims and their families. 立法也會因應改變 我們會支持受害者和他們的家人
legislation:n.立法;法律;
But for the drug overdose epidemic, we have done none of that. 但對於藥物濫用的流行病 我們卻完全沒有那麼做
We continue to demonize the drugs and the people who use them and blindly pour even more resources into law enforcement. 我們持續把藥品和用藥的人給妖魔化 甚至盲目地把更多資源投入執法單位
demonize:v.妖魔化;使…成为魔鬼; blindly:adv.盲目地;轻率地;摸索地; pour:v.倒; n.流出; (已熔金属的)一次浇注量; resources:n.[计][环境]资源; v.向…提供资金(resource的第三人称单数);
So where should we go from here? 我們接下來該怎麼做？
First, we should fully embrace , fund and scale up harm reduction programs across North America. 首先 我們應該全面接受資助 和擴展北美各地的減害計畫
embrace:n.拥抱,怀抱;v.拥抱;乐意采纳(思想、建议等);信奉;包括; fund:n.基金;资金;存款;v.投资;资助;
I know that in places like Vancouver, harm reduction has been a lifeline to care and treatment. 我知道像溫哥華這樣的地方 減害方案一直都是 照護和治療的生命線
lifeline:n.生命线;救生索;
I know that the number of overdose deaths would be far higher without harm reduction. 我知道如果沒有減害方案 用藥過量致死的人數會高出很多
And I personally know hundreds of people who are alive today because of harm reduction. 我自己本身就認識數百個
personally:adv.个人;亲自;本人;就本人而言;
But harm reduction is just the start. 但減害方案只是個開始
If we truly want to make an impact on this drug crisis, we need to have a serious conversation about prohibition and criminal punishment . 如果我們真的想處理毒品危機 我們得要認真嚴肅地探討 禁藥令和刑事懲處
prohibition:n.禁止;禁令;禁酒;诉讼中止令; punishment:n.惩罚;严厉对待,虐待;
We need to recognize that drug use is first and foremost a public health issue and turn to comprehensive social and health solutions. 我們得要承認 吸毒是最優先的公共健康議題 並尋求全面的社會與健康解決方案
recognize:v.认识;认出;辨别出;承认;意识到; first and foremost:首先;首要的是; comprehensive:adj.综合的;广泛的;有理解力的;n.综合学校;专业综合测验;
We already have a model for how this can work. 我們已經有一個可依循的模式
In 2001, Portugal was having its own drug crisis. 在 2001 年 葡萄牙發生毒品危機
Lots of people using drugs, high crime rates and an overdose epidemic. 高用藥率 高犯罪率 用藥過量也很普遍
They defied global conventions and decriminalized all drug possession. 他們不採用全球普遍的習慣做法 反而將毒品持有除罪化
defied:adj.受蔑视的;遭违抗的;v.违抗(defy的过去式); global:adj.全球的;总体的;球形的; conventions:n.[法]惯例;会议;[计]约定(convention的复数); decriminalized:vt.使合法化;非刑事化(等于decriminalise);
Money that was spent on drug enforcement was redirected to health and rehabilitation programs. 本來花在毒品執法的錢 轉用到健康和康復計畫上
redirected:v.重新使用;改寄;改变投递方向;(redirect的过去分词和过去式) rehabilitation:n.康复;恢复;善后;平反;复权;
The results are in. 出來的結果是
Overall drug use is down dramatically . 整體的吸毒比例大幅下降
Overall:v.全部; n.外套; adj.全面的; dramatically:adv.戏剧地;引人注目地;adv.显著地,剧烈地;
Overdoses are uncommon . 用藥過量案例變少了
uncommon:adj.不寻常的;罕有的;adv.非常地;
Many more people are in treatment. 更多人接受治療
And people have been given their lives back. 而且很多人被救回一條命
We have come so far down the road of prohibition, punishment and prejudice that we have become indifferent to the suffering that we have inflicted on the most vulnerable people in our society. 我們長年以來一直使用 禁令 懲罰和偏見 使我們漠視人們的痛苦 我們竟然去打擊社會上 最脆弱的那群人
down the road:只要沿着这条路;将来;在路上; prejudice:n.偏见;侵害;vt.损害;使有偏见; indifferent to:无兴趣,不关心;冷漠;不在乎; inflicted:把…强加给;使承受(inflict的过去式和过去分词); vulnerable:adj.易受攻击的,易受…的攻击;易受伤害的;有弱点的;
This year even more people will get caught up in the illegal drug trade. 今年還會有更多人陷於 非法毒品交易
Thousands of children will learn that their mother or father has been sent to jail for using drugs. 數以千計孩童的父母親 會因為吸毒而入獄
And far too many parents will be notified that their son or daughter has died of a drug overdose. 更多父母親會接到通知 得知他們的兒女因為用藥過量而死
notified:v.通知;报告;申报;(notify的过去式和过去分词)
It doesn't have to be this way. 這一切大可不必發生
Thank you. 謝謝
(Applause) （掌聲）