Uso de medicamentos e uso de drogas: uma investigação sobre práticas de cuidado no CAPS ad

Abstract

This study sought to research from the perspective of professionals, the way in which drugs are prescribed and used in two Psychosocial Care Centers for Alcohol and Other Drugs (CAPS ad), in view of the medicalization processes and the Harm Reduction (HR) policy. In contrast to the prohibitionist paradigm, which aims to fully eliminate drugs from society, CAPS ad proposes comprehensive care practices, based on the HR strategy and considering the particularities of each individual. This proposal has been challenged by recent changes in drug policies and by the excessive tendency to medicalize users. In order to investigate this scenario, we carried out a qualitative, exploratory research, whose data were collected through semi-structured interviews applied to professionals from two services. The interviews aimed to understand how medications are prescribed, used and what function they operate in monitoring users, as well as to identify, through the professionals' discourse, which are the main care practices offered and the perception of HR. As a result, we have identified: the prescription of medications carried out unilaterally by psychiatry, not considering the other workers, nor the users themselves; the attribution of incurability to users, who contribute little to the construction of therapeutic projects, being excluded from this process; and the lack of understanding of the concept and proposal of HR, as we have perceive difficulties in theoretical understanding and in the practical application ofthis strategy. We infer that the way medications are prescribed in the investigated services pointto the fragmentation of care, as the medication is designed only by a professional, disregardingother knowledges and practices, and for the persistence of the abstinence logic, distancing themfrom the HR references and psychosocial care.