Dr. Charlotte Jeremy-Cuffy
The term addiction is a frightening term to many people, not only in our Caribbean community but on a global scale. This is not just for the community man, woman, or adolescent, but also for healthcare providers and other professionals.
Addiction refers to dependence on substances such as Marijuana, alcohol, cocaine, opiates and others. It also includes taking part in certain activities such as gaming, gambling and sex activities. It is a psychological and physical inability to stop consuming a chemical, drug, or substance or participating in certain activities, even though it is causing psychological and physical harm. In view of the harm that addiction causes, it is therefore deemed an illness – an illness or condition that needs a careful plan of treatment.
Addiction is known as a chronic disease of the brain that can also result from taking prescribed medications. The overuse of prescribed opioids painkillers, for example, causes 115 deaths every day in the United States. The Centers for Disease Control and Prevention estimates that the total “economic burden” of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.
When a person experiences addiction, they cannot control how they use a substance or partake in an activity, and they become dependent on it to cope with daily life. Most people start using a drug or first engage in an activity voluntarily. However, addiction can take over and reduce self-control.
According to World Health Organization (WHO), there are responses in the Primary Healthcare system for routine screening and brief interventions for harmful alcohol and drug use. This is crucial as it is noted that although there is screening, the intervention is brief. It can be deduced that not much is done as far as intervention in the prevention of and treatment of substance use disorder globally. This important fact now puts on the table the need to take the disease of addiction more seriously, to find ways of preventing and treating. There is a need to equip more health and human services professionals with the knowledge and skills to recognize and respond to the challenges of addiction.
In the Caribbean, Alcohol and Marijuana are the main drugs of use in most of the countries, with Crack Cocaine following. The practice of mixing substances is also wide in the region. Alcohol is seen as a social drink and persons are allowed to drink ‘responsibly’ – however, the line that separates a social drink from a problem drink is very thin. Marijuana is the substance which we see the young people more engaged in; be it because of peer pressure, experimenting or sacramental practice. Tobacco is also used throughout the region, but to a lesser extent than alcohol and even marijuana. There is a lot of experimentation with cigarettes, but current use rates are very low. What is very interesting is the comparison of use of cigarettes versus marijuana, where the prevalence of marijuana is overtaking cigarette prevalence in Caribbean youths.
Drug and alcohol are a recurring problem in the Caribbean and the world on a whole. According to Beverly Reynolds, Programme Manager, CARICOM Secretariat article Drug use, abuse significantly impacting Caribbean, 2012, the psycho-social blow could start with mere experimentation; develop into social exclusion, deterioration of family life and values, greed, stress, and inadequate life and social skills to deal with problems. The resulting outcome could be economic challenges which could become evident by high levels of unemployment, poverty, weak institutional framework and systems, weak law enforcement capacity, outdated legislation, gaps in the judiciary system and even inadequate or inappropriate technology. The consequences of illicit drug use could extend to crime-causing instability and insecurity and create health challenges, even contributing to the spread of HIV and other debilitating health conditions which will impact not just the Public health system but also social and economic development.
Although the knowledge of the consequences of addiction is wide spread, and although the use and abuse and dependence on those substances are known to be harmful, the quest for justice is now leading the entire world towards legalization of some of those substances.
With this staring us in the face, one of the best ways to prepare and tackle the situation is by preparing to handle the situation if not by prevention then by treatment, thus the need to train more personnel for the battle of addiction of drug and alcohol Use Disorder and other addictions.
Beverly Reynolds, Programme Manager, CARICOM Secretariat – “Drug use, abuse significantly impacting Caribbean, 2012”