Do ato a circulação da palavra : a construção do cuidado a partir dos encontros com os usuários de drogas e profissionais de saúde.

Abstract

Drug use is considered a public health and social problem in contemporary society. It is known that the consumption of substances that alter the state of consciousness is not something unique to today's society, what changes are the intentions and/or purposes for their use. Recent data from the World Drug Report point to a significant increase in the consumption of alcohol and other drugs in the last 11 years, recently potentiated by the COVID-19 pandemic, which according to estimates has increased the risk of addiction, drawing the attention of the public sectors that are trying to think about actions and strategies on the subject. Given this conjuncture, we were interested in understanding the meanings produced by licit and illicit drug users about the care, especially with regard to psychotherapeutic and pharmacological treatment, offered in public health services. Specifically, we were interested in knowing the existing intervention proposals in the post-discharge from treatment, as well as identifying, from the narratives of health professionals working in public services for drug use, which are the available resources for the treatment of users. This is a research developed from two methodological axes: a literature review and two empirical, exploratory, descriptive studies with qualitative approaches, conducted in two public services of a city in the interior of Rio Grande do Sul: CAPS AD - III and Therapeutic Community, with users of services and health professionals. MANUSCRIPT I - DRUGS CONSUMPTION IN TIMES OF PANDEMIC: REFLECTIONS ON IMPACTS ON MENTAL HEALTH": In this article we aimed to reflect on the effects of quarantine and the increase of addictive behaviors in times of pandemic, bringing reflections on the implications of these for the mental health of the population. This is a narrative literature review of articles, reports and book chapters published since the beginning of the pandemic, being the main databases Medline (via Pubmed), Scielo and Scopus Elsevier, was used the descriptors "pandemics", "coronavirus", "mental health" and "additive behaviors. The findings point out that quarantine has had a negative impact on both the mental and physical health of the population, triggering psychological symptoms such as anxiety, depression, and additive behaviors. However, there are strategies that, when adopted together, can minimize the psychological effects of isolation and make this moment less unhealthy. In this sense, this study highlights the importance of offering interdisciplinary treatments and effective public health strategies in public health systems, so that they can meet the needs of this population by providing comprehensive care and treatment, and also by thinking about short, medium, and long-term actions to prevent addictive behaviors. MANUSCRIPT II – “FROM THE ACT TO THE CIRCULATION OF THE WORD: LISTENING AND SELF-NARRATIVE AS A WAY OF CARING FOR DRUG USE”: This article aims to characterize and analyze the profile of the user assisted in CAPSad- III and Therapeutic Community and the meanings produced by them about their relationship with drug use and treatment. The data analyzed resulted from a qualitative, descriptive, and exploratory research, with theoretical basis of psychoanalytic nature, with 10 licit and illicit drug users in treatment in two public services of the city: CAPSad-III and Therapeutic Community. The recordings and transcriptions were submitted to thematic analysis. The results showed that the profile of the participants is predominantly male, over 22 years old, mostly single, and that they use multiple drugs, in most cases, alcohol associated with cocaine and/or crack. The participants have a low level of education, which sometimes hinders their entry into the labor market and exposes them to a vulnerable condition. Drug use usually starts in early adolescence, around ten, twelve years of age. There seems to be a difficulty in perceiving the problems related to use and/or abuse in this phase of life, leading users to seek treatment late, at later ages, when significant losses of various orders worsen and become more evident. It is understood that drugs appear as an attempt to find refuge from the subject's uneasiness, to alleviate the diseases and pains of the soul, and as a means to deal with helplessness and existential emptiness. Listening and testimony are circumscribed in this scenario as a possibility of the passage from the act to the word, promoting other contours to the life story once written. The knowledge about the sociodemographic profile of users assisted in these public health services can contribute to the development of psychosocial rehabilitation strategies, as well as to the implementation of public policies. MANUSCRIPT III - "CHALLENGES TO CARE PRACTICES: PERCEPTION OF HEALTH PROFESSIONALS FROM A CAPSAD-III IN THE INTERIOR OF RIO GRANDE DO SUL": This study sought to know the perception of health professionals working in a CAPSad-III about the practice and care offered to drug users treated at the service. Through an empirical, exploratory, descriptive and qualitative study, four health professionals from a CAPSad-III in a city in the interior of Rio Grande do Sul were interviewed through a semi-structured script: a psychologist, a social worker, a physician and a nurse. The analytical corpus was configured from the Thematic Analysis. The findings of the study reveal that the main difficulties encountered by health professionals in the service in relation to professional practice are not related to users, but to administrative issues of the unit, such as: inadequate physical structure of the service, lack of human resources and activities for patients, gaps in the organization and flow of the social assistance and health network, and lack of preparation of professionals. As for the users: the lack of adherence to the service and treatment, lack of family support, and the profile of psychological functioning are the most recurrent. Still, external and/or social issues were highlighted, such as: environments that present greater social vulnerability, access to education, and income. Continuing education emerges as an important tool to problematize mental health practices, as well as to rethink the care directed to users of alcohol and other drugs within health services, in order to direct and foster discussions aimed at health promotion, the provision of a more articulated work between the different sectors that make up the RAS, seeking a comprehensive and humanized care that actually seeks the psychosocial reintegration and rehabilitation of drug users and the strengthening of their autonomy.