He is sneaking out of the house early. His extremely tall stature distinguishes him from the yellow uniforms that crisscross the entrance to the high school. He kisses his colleagues, as is fashionable, and immediately shows off the box of filter cigarettes he has hidden. "For the exit," he predicts, and around him the curious eyes light up and the girls sign up too.

In the afternoon, there is smoke spread over the group. They talk at their own pace, listen to the music of the moment on the phones and stay "celebrating" in the first corner.

They stand out in the group because of their size and stories. His companions know that he goes out to town every weekend. He sells cell phone credit (the sister always recharges it from abroad) and drinks beer or rum (depending on the economy) until he loses his sanity and sometimes his conscience. His parents do not know his "tastes"; he tells them that he goes dancing with a girlfriend and receives compliments... "but what a romantic this little guy is..."

ATTRACTED BY THE NOVELTY

The teenager in our report, let us call him Noel, is not the only one with similar pernicious habits, at his school and in the neighborhood. Addictions, for the youngest, are a kind of forbidden game that ends up enslaving them when, paradoxically, they are looking for freedom, for novelty.

According to the World Health Organization, it is a physical and psycho-emotional disease, which creates dependency or need towards a substance, activity or relationship.

Psychologist Judith Noguera Martínez, in charge of Health Promotion at the Manuel Fajardo Polyclinic (also known as Piti) in this city, explains that there are various types of consumption and criteria for saying that a person is dependent on some drug. It is determined by the frequency, quantity and loss of freedom from these harmful compounds.

"Cuban society has many traditions associated by the public with cigarettes and alcohol," the specialist points out, "including festivities, domino games and other social contacts. This is what we call socio-cultural consumption. There is also the hedonic way, when they do it for pleasure; and the evasive way, to escape from a problem and originated, mainly, by family conflicts, loss of loved ones or break-ups".

As it is logical, youth is growing in the face of such practices. They learn the routines of their predecessors and are initiated into the same customs. Many start out on the socio-cultural route, reach a state of risk, move on to a harmful one and finally to dependency. That is the reality in Las Tunas. "In our environment, there is high consumption of tobacco and alcohol, which are legal drugs and gatekeepers, because they open the way to other illegal ones," he says.

STEP BY STEP

Addictions do not cure themselves, some, the most harmful, lead to serious physical and mental health disorders. In the case of adolescence and youth, the accompaniment of parents or other relatives who can detect the illness and seek help with the family doctor plays a leading role. From this level of care, an assessment is made and those who require it are referred to the provincial service of Inhabitability in the Clodomira Acosta psychiatric hospital.

According to the head of the ward at this institution, Yamirca Rivero Oduardo, the population between 19 and 30 years of age is the most affected and alcoholism, gambling and smoking are the most prevalent illnesses.

"After the evaluation," she says, "the patient is admitted for 21 to 30 days to be treated by a multidisciplinary team (psychologists, psychiatrists, occupational therapists, social worker...). During the process, the so-called alcoholic hallucinosis may appear, especially of a visual type. In these cases, the patient refers to the appearance of bugs, flies, bees...

"Other symptoms of that withdrawal phase are the tremors and the decay. We stabilize them with drugs and various techniques. After discharge, rehabilitation continues in Primary Care and here on Tuesdays and Thursdays, we do group psychotherapy." The intention is to reintegrate them into society so that they can recover their self-esteem and feel useful.

The use of legal drugs (alcohol, tobacco and infusions) and illegal drugs (marijuana, amphetamines, cocaine and opiates) can cause different diseases such as oral cancer, stomach cancer, laryngeal cancer, liver cancer and pancreatic cancer. From the psychic point of view, the person maintains the risk of suffering from alcoholic dementia.

"This is a chronic behavioral disorder, which depends largely on parenting patterns. Hence the importance of preventive actions within the family", details Rivero Oduardo.

At school, "Noel" has to walk clear. Once, the teacher discovered a box of cigarettes in his pants pocket and told his mother. He had to tell a great story, and in the end, she believed that the "bullets" were not his, "that he was just covering for a friend and he couldn't tell the truth."

The teacher has a "super heroin nose" to detect smoke and much more, alcohol hangovers. She is not easy to fool and not only in the classroom. We have to hide in the street because she appears on any corner and "takes the fun out of it."

In the fight against addiction, the educational sphere is key. From the curricular and extracurricular activity, treatment is given to this and other issues of great importance for the formation of new generations. This is what Magloiris Turruelles López, a methodologist from the Provincial Directorate of Education, says.

"It is a basic condition in the sector that the work of prevention goes through the processes developed in an educational institution, from the student's farewell in the morning to the afternoon," she explains.

"We approach this subject without taboos. In previous decades, it was not done that way, but already today, we speak clearly to students about the dangers of consuming toxic substances, including so-called hard drugs."

"Resolution 111 of 2017 of the Ministry of Education provides all structures with procedures for the design, implementation and control of preventive actions at each level of education. It always starts with a diagnosis, not only of unfavorable situations, but also of the potential of children and young people for certain activities. From this, an educational plan is drawn up and then it must be controlled and followed up."

"We have as a working system the monthly realization of the family education schools. In this course, we experienced that in the schools there was a dialogue, together with the Federation of Cuban Women, on the relevance of communication between school-family, family-child and teacher.

"We cannot build a generation without the support and positive influence of the home. That is a challenge today because there are tutors who delegate to teachers the responsibility of strengthening values".

The Young Communist League (YCL) in Las Tunas is also involved in addiction prevention through an intense and flexible program. Yudier Comendador, a member of the Provincial Bureau of the YCL, says that the dialogue with the youngest at all times possible, the multi-sectorial work and the promotion of healthy recreational spaces are the formula that is bearing outcomes here.

"We dedicate some time every year to update the information we have," specifies Yudier. We give priority to junior high schools, but we maintain our presence in senior schools and universities. Within the latter, especially in the student residences.

"Hand in hand with the Martí Youth Movement we have reached communities such as San José, Las Margaritas, Palancón, Alturas de Buena Vista and El Marabú. Going to these places with a message of NO to addictions, which is fresh, and said from the language of one youth to another, gives good results."

Comendador considers that the perception of risk is already more notable. That is why he laughs a little at those who state that access to information drives consumption and even traffic.

BETTER NOT TO START

There are some more daredevils on the group than Noel. They want to experience new sensations, try things out. He is a little wary of "mixers." He remembers that he was drinking once from a foreign bottle. Later on, he was feeling like "disconnected" from reality and could "float". He doesn't know what he did the rest of the night, but he was surprised at dawn as if he were possessed, dancing in front of his doorway, doing acrobatics and "very strange things". His mother cried a lot that day...

Addictions make no difference in age, gender, type of belief or cultural level. The consequences extend their suffering to parents, children, siblings, spouses, friends, neighbors, and even strangers, victims of accidents and acts of violence.

Adults who maintain some type of legal consumption in controlled quantities should avoid doing so in front of their children, since the latter, in adolescence, may begin by imitation.

No person needs a drug to fulfill a certain life project. According to specialists, teaching children to resolve conflicts from an early age, helping them to build their self-esteem and reinforcing their virtues and potential, is the best way to keep them away from this scourge. Likewise, affection, companionship and understanding can be effective in dismantling, within the youthful universe, the myth that "forbidden games" are attractive and fascinating.