Psychologist José Antonio Díaz Nóbregas believes that recovering from an addition, be it smoking, alcoholism or any other kind of substance, is a life-long process and recommends suffers join a support group. Photo: Nuria Barbosa

The irresponsible consumption of toxic substances and irrational obsessions created by modern-day society with its technological innovations and mania for gaming, consumption, and the internet, have led many experts to classify behavior-changing addictions, as a modern-day human tragedy.

In order to assess the true human impact of this phenomenon we must also consider those who suffer indirectly, such as partners, parents, children, siblings, close and distant relations, friends, neighbors, and even unknown victims of accidents or acts of violence caused by addiction.

According to data from the World Health Organization, abuse of, and dependency on, legal drugs (alcohol, tobacco), prescription medicines (pharmaceuticals) and illegal substances (marijuana, amphetamines, cocaine, opioids) account for 12.4% of all disease related-deaths worldwide and 8.9% of total years of life lost.

It is worth noting that 50% of this tragic figure is linked to global alcohol consumption, resulting in 200,000 deaths every year - 25,000 as a result of traffic accidents, which leave some 150,000 people physically or mentally disabled - and account for a quarter of the 4,000 liver transplants conducted every year.

It’s a similar situation with cigarettes, which are the only legal, mass consumed product which kills half of all long-time users.

It also harms individuals, society, and the environment in various ways. According to statistics compiled by international organizations, every year almost five million people worldwide die as a result of smoking, while those between 30 and 69 years of age account for almost half of fatalities, losing around 20 years of their life expectancy. Every cigarette shortens the smoker’s life by seven minutes.

According to Juan Emilio Sandoval Ferrer, secretary of the Cuban Psychiatry Society and director of its substance abuse department, addictions are characterized by a dependence on a substance or activities to which a person cannot function without, leading an individual to become consumed by the need to satisfy their craving, often resulting in negative mental, economic, and physiological effects.

Dr. Sandoval Ferrer, who also holds a Masters Degree in Social Psychiatry and Clinical Psychology, highlighted alcoholism as a leading cause of addiction in Cuba, affecting 4% of citizens over 15 years of age and identified as the most common type of addiction and introductory substance.

Professor Juan Emilio Sandoval Ferrer defines addiction as a dependence on a substance or activities to which a person cannot function without, and often resulting in negative mental, economic and physiological effects. Photo: Nuria Barbosa

Rising rates of alcoholism worldwide over recent years have seen the phenomenon become a global problem, with local governments struggling to tackle a problem with strong national and cultural ties and rooted in modern-day modes of capitalist consumption. What is more, “In our country there exists a certain ambivalence to excessive alcohol consumption, but a harsh rejection of the use of illegal drugs,” noted the professor who teaches at Havana’s University of Medical Sciences.


According to Dr. Sandoval Ferrer, patients are provided with material resources and free drug addiction treatment through the island’s national healthcare system. He went on to note that family members are involved in the healing process, while efforts are, on the whole, geared toward preventing this social problem.

“Addictions don’t discriminate based on a person’s age, gender, affiliation, or beliefs. They usually emerge within the family context because that is where patterns of behavior are learned and reproduced. Healing must be a social process involving friendship groups, educational centers, and workplaces.”

In this regard he cites the example of a young person suffering from an addiction to alcohol and other substances, “In this case,” he noted, “we must carry out preventative actions in schools to develop an attitude of rejection toward drugs.”

As such, Dr. Sandoval Ferrer believes that prevention is the key, the effectiveness of which is measured by an individual’s decision to delay trying drugs, and distance themselves from environments which encourages to such behavior.

For the psychiatrist, Cuba benefits from the close relationship, at all levels of society, between its health and educational institutions, in their efforts to address the issue starting at an early age, first by incorporating the issue into the curriculum, and later through conversations with experts, placing information on murals, and the work of local doctors with the family. “Young people must quickly learn the risks associated with addictions and the damage they cause,” he stated.


Cubans are also historic coffee drinkers, a custom which is largely accepted and encouraged in certain spaces, however when a person starts to suffer from headaches, irritability, and anxiety, these and other symptoms, point to excessive, and potentially addictive levels, of coffee consumption.

The same goes for medicines when consumed against a doctor’s instructions or via self-medication.

“Many medicines create habits and the best thing to do is take them for the time indicated and under the supervision of a doctor,” according to Sandoval Ferrer.

Alcohol consumption causes 200,000 deaths every year. Photo: Granma

Meanwhile, the development of technologies and communication devices are impacting social contact between human beings and their ability to hold daily and face-to-face conversations. Although such trends are present in Cuba, indicators haven’t reached concerning levels, like in other developed countries around the world.

Signs of addictive behavior linked to the use of computers, computer games, cell phones, and electronic devices exist within Cuban society.

Work addiction is also showing signs of increasing, with individuals brining their work home and prioritizing it over themselves and their family.
“Fortunately, given our customs and habits linked to our social relationships, we Cubans are quite well protected in regards to socialization; we show one another love and affection,” stated the doctor.


Granma International visited and spoke with members of an alcohol addiction psychotherapy group at Havana’s General Calixto García University Hospital, which meets on Wednesday afternoons.

Patients talked about the importance of seeking professional help toward overcoming addiction.

They highlighted as a first step, recognizing that you suffer from an addiction, and that this doesn’t make you a bad person, but simply a victim.

The members also noted that seeking professional advice is not a sign of weakness, because, although on occasion people are able to overcome their addiction alone, in the majority of cases it’s advisable to speak openly about the problem with someone you trust.

Once the individual has gotten over the active phase of addiction, they must then change their lifestyle, starting with their values, behavioral habits, aspirations, distancing themselves from undesirable friends, and socializing with people who lead healthier lives. Patients also recommended that sufferers frequent places where they know there won’t be smokers, drug-users, or alcoholics.

Psychologist and group leader José Antonio Díaz Nóbregas agrees, noting that this type of rehabilitation requires time and perseverance, and could take over a year.

Some patients need to be institutionalized to undergo a 21-day detox, while others just attend our therapy sessions, he reported.

“We don’t discriminate based on sex, age, profession or educational background. The groups are heterogeneous and completely open. Members come and go as they choose. The sessions consist of exchanging experiences and supporting one another. Patients can invite friends, family members, and associates. We focus on emotional growth, and never ban drinking,” adds the specialist.

“We don’t change people, people change themselves,” states Díaz Nóbregas, who also holds a Masters degree in Clinical Psychology and Mental Health, noting that these therapies aim to enable patients to develop their own personal tools which will allow them to reintegrate into society, family life, work, and study.

This process includes changing lifestyles in order to create trust, with a focus on partaking in pleasurable activities not based on the use of substances, and finding the beauty in life.

Patients receive advice and counseling, but every decision they make is ultimately their own. Psychology graduate and group volunteer, Miguel Cañedo Briones, shares a similar opinion, but also highlights the need for more materials explaining the damaging effects of addictions in doctor’s offices, polyclinics, stores, schools, and other public spaces.

Likewise, the Young Communist League and student organizations are broadening discussion of this issue, following instances of concerning behavior by youth in public spaces and party environments, which can lead to social indiscipline.

Meanwhile, patients praised the differentiated drug prevention efforts directed toward the island’s youth, and highlighted the importance of the family, educators, and the media, in addressing such issues which, despite not representing a widespread problem, merit a response.