There must be a coordinated effort by the health care system to combat and eradicate the scourge of addictions, the Island's top doctor told Rotarians yesterday.

John Cann, Government's Chief Medical Officer, was speaking at the Hamilton Rotary's weekly luncheon at the La Coquille Restaurant.

He is responsible for the regulation of the entire health care system, in the treatment of illnesses and addictions, and prevention of all kinds of disease.

Dr. Cann said tobacco, alcohol, and illicit drug abuse make up the major causes of preventable disease and accidents.

"Drug use should be viewed as a public health problem and we have the tools to tackle the problem,'' Dr. Cann said.

He added: "Most preventable health problems -- half of all deaths -- are caused by tobacco use, improper diet, lack of physical activity, alcohol misuse, unsafe sex, accidents and illicit drug use.'' "These are personal behaviours that through the public health system, we have the greatest potential to change,'' Dr. Cann said.

"The public health system carries out this change daily,'' Dr. Cann said, adding there are private and non-governmental organisations, in addition to the Department of Health, that can help carry out the mission.

Dr. Cann distinguished between primary prevention -- immunisation and education -- from secondary and tertiary prevention.

In secondary prevention the health care system detects and treats disease in its early stages, while the alleviation of the effects of the disease is the focus of the tertiary prevention.

He said the core of his department's and associated organisations' work involves the assessment, policy development, and seeing the policy is carried out and assuring the public that all is well.

Dr. Cann, a Howard University trained paediatrician, was careful to explain that people with addictions have illnesses just like people with a physical disease.

"Alcohol and drug addiction is a chronic disease with genetic, psychosocial, and environmental factors which influence its development and manifestations.'' "We know we can successfully prevent drug addictions,'' he continued, "alcohol and drugs affect virtually every part of the body.'' "Scare models'' or tactics often do not work in substance abuse prevention but proper education does.

"Health promotion is the key,'' Dr. Cann said. "But we can't work in isolation. It's a community problem and it must be based on scientifically sound programmes.'' He added: "We can be successful in the long term if we take the proper approach to prevention and education.'' "The National Drug Council and other organisations' education programmes are attempting to assess the community,'' Dr. Cann added. "So that we can get to grips with the problem.'' He explained that proper research is the best foundation for the assessment stage while narrowly focused programmes are likely to be unsuccessful.

"We have all of the tools to battle the Island's drug abuse problem,'' Dr.

Cann added.

`Most preventable health problems -- half of all deaths -- are caused by tobacco use, improper diet, lack of physical activity, alcohol misuse, unsafe sex, accidents and illicit drug use.' -- Dr. John Cann DRUGS DGS