Fragmentos da história da atenção à saúde para usuários de álcool e outras drogas no Brasil: da Justiça à Saúde Pública

Abstract

The purpose of this article is to identify, factors that could be associated to the establishment of the country's health policy for users of alcohol and other drugs in 2003. It makes particular use of semi-structured interviews, as well as a study of the literature and documents. The article shows that the Brazilian State's approach to alcohol and drugs emerged in the early 20th century with the creation of a legal and institutional apparatus designed to control the sale and use of drugs, justified by the need to assure public security and public health. This apparatus permitted the development of healthcare practices for drug users based on the penalties it proposed. The article concludes that even though the rationales behind legal and public health measures do not always coincide, some of the practices that emerged in the legal sphere did help provide the conditions needed for the creation of a health policy for alcohol and drug users in Brazil in 2003.

A experiência do comitê de bioética de um hospital público

“…The Brazilian Ministry of Health 27 considers the issue of public health and affirms its commitment to address problems associated with the consumption of alcohol and other drugs, enabling the development of a policy less focused on control and repression. The Ministry of Health considers the presence of drugs in contemporary societies as a complex phenomenon, and seeks to inaugurate practices aimed at overcoming moralist conceptions, still very present in Brazil when it comes to addressing issues related to the use of alcohol and other drugs 28 . However, despite this advancement in the field of public policies, the problem persists, assuming major proportions, which demands from all, including the HGSM, reflection and creative solutions, for which the BC is the appropriate locus.…”

Políticas sobre drogas no Brasil: a estratégia de redução de danos

“…Essa lacuna na saúde pública em relação à assistência aos usuários de drogas favoreceu a expansão das comunidades terapêuticas, modalidade de atendimento de cunho religioso e não governamental que se estende até os dias atuais e que novamente reforçou a manutenção do cuidado com o usuário de drogas fora do setor público de saúde (Alves, 2009;Machado & Miranda, 2007 Entre as estratégias de prevenção, estavam aquelas de redução de risco, como a "difusão de informação, controle dos bancos de sangue, estímulo e adestramento para o uso de condom e outras práticas de 'sexo mais seguro', testagem e aconselhamento" (Ayres et al, 2003, p. 120), e as estratégias de redução de danos voltadas para os usuários de drogas injetáveis -UDIs. Estes, pelo compartilhamento e pela reutilização de seringas e agulhas, assumiam comportamentos de risco de contágio e de difusão do HIV e de hepatites.…”

“…É provável que grande parte das dificuldades de implementação das estratégias de redução de danos se deva ao confronto entre a população-alvo das estratégias e a repressão policial, decorrente da confusão entre prevenção e repressão ou do desconhecimento da estratégia de redução de danos, de julgamentos morais, de preconceitos e de estigmatização do usuário de drogas (Domanico, 2006;Machado & Miranda, 2007).…”

Pharmacist professionals in the prevention of drug abuse: updating roles, and opportunities

“…Pharmacist professionals in the prevention of drug abuse 23 Assistance "alcohol and drugs" (Centros de Atenção Psicossocial "álcool e drogas" -CAPSad), and non-specialized organs (basic health units, family health programs and hospitals) (Machado, Miranda, 2007).…”

“…To this end, the "Policy of the Ministry of Health for Integral Care of Alcohol and Other Drugs Users" in which it "assumes integrally and articulately the challenge to prevent, treat and rehabilitate users of alcohol and other drugs, as a public health problem" (Brasil, 2004) requires the creation, at a national level, of multidisciplinary health teams to intervene in the healthdisease process of dependents. (Machado, Miranda, 2007).…”