Fernando Cobos, M.D.
PINEHURST – A national study has found that addiction and the risky use of tobacco, alcohol and other substances represent the largest preventable health problem in the United States.
According to two members of the FirstHealth of the Carolina staff who deal daily with the problems related to substance abuse, prevention comes with education.
About 40 million Americans – or 16 percent of U.S. residents ages 12 and up – are addicted to tobacco, alcohol or other drugs, according to a study from the National Center on Addiction and Substance Abuse (CASA) at Columbia University. Another 80 million are considered risky substance abusers – people who use substances in a manner that is potentially harmful to their health and safety.
Fernando Cobos, M.D., a psychiatrist with FirstHealth Behavioral Services, defines addiction as “the repetitive use of a substance despite negative consequences.”
“It is preventable through education,” he says.
According to Dr. Cobos, substance abuse begins with a conscious behavior. “At some point, the person makes the initial choice to experiment or use a drug,” he says. “It’s preventable in the sense that you educate people so they are aware of the dangers and risks, which hopefully will make them less likely to try something in the first place.”
Education is usually most effective when the individuals being educated are young and before they come under the negative influence of peers, Dr. Cobos says.
“As kids turn into teens, they become much more vulnerable to peer pressure,” he says. “Most abuse starts in the teenage years and goes into adulthood. If you get to adulthood without abusing alcohol or drugs, your chances are good you’re not going to become addicted later on.”
On the other hand, peer education and support can be extremely successful with tobacco-use prevention, especially when older kids are sharing the message with younger ones. In the FirstHealth TRU (Tobacco.Reality.Unfiltered) clubs in Moore, Montgomery, Hoke and Richmond counties, high school students are trained as role models on “how to say no” for middle school students.
“Kids are getting more information now through their peers,” says Cindy Laton, a certified tobacco-cessation specialist with FirstHealth Community Health Services. “The message is it’s not cool to smoke.”
As more and more public places – schools, hospitals, parks and restaurants, for example – adopt tobacco-free policies, it has also become more difficult to use tobacco, says Laton.
“These types of policies are motivating people to quit,” she says, “and tobacco-free schools have been a huge trendsetter for North Carolina. So has FirstHealth of the Carolinas, which was the first health system in North Carolina to adopt a tobacco-free policy.”
Yet tobacco-use remains “the norm” for many people, especially those who are raised in tobacco-using families, and the highly addictive nature of nicotine makes it extremely difficult to give up.
While there is no definable diagnosis of an “addictive personality,” Dr. Cobos says, addiction is common among certain psychiatric disorders. About 45 percent of the people who have been diagnosed with bipolar disorder also have a problem with alcohol, for example, and schizophrenics are also often smokers.
Genetics can also be a factor in a person’s risk of becoming addicted. Alcoholism can be common among members of a family, especially among males, Dr. Cobos says.
“Therefore,” he says, “prevention efforts should especially be directed at those who are felt to be particularly genetically vulnerable.”
Given all of the factors that can contribute to addiction, the best way to prevent a problem is simply to avoid the potentially addictive substance, both Dr. Cobos and Laton say.
“The bottom line is ‘don’t start,’” says Laton.
And if there is a problem, find the help to stop. It may not be easy.
“You may lose a ‘battle’ and relapse, but do not let that keep you from trying again and again until you succeed in achieving long-standing abstinence,” Dr. Cobos says. “My experience and training are that if you are repeatedly getting into trouble because of drugs or alcohol, it is likely that ‘little monster’ (of addiction) is there to stay and problems will just get worse and worse. It’s crucial to identify the problem as early as possible and not delay in seeking help.”
For more information on the substance abuse programs offered by FirstHealth Behavioral Health Services or the tobacco-prevention or quit-tobacco programs offered by FirstHealth Community Health Services, call (800) 213-3284.