O pomo da discórdia? A constituição de um campo de lutas em torno das políticas públicas e das técnicas de cuidado em saúde dirigidas a pessoas que usam álcool e outras drogas no Brasil

Abstract

Harm Reduction (HR), a health care strategy directed to people who use alcohol and other drugs that does not place abstinence as the only goal of care, first became known through replacement therapies and the provision of sterile syringes to prevent bloodstream infections such as AIDS and viral hepatitis. It was through this conception that HR arrived in Brazil in 1989 in the city of Santos, suffering strong opposition from sectors of the justice system and law enforcement, but without causing further disputes between workers and researchers in the health field. Over the years, however, the encounter with the Brazilian psychiatric reform made it possible for HR to be elevated to a condition of a certain ethics in care practices. From this encounter, HR became controversial, dividing the health field into two sides: enthusiasts and opponents of HR. With the aid of a conceptual toolbox that leverages contributions of Foucault, Bourdieu and Spinoza , and through the analysis of texts and interviews with agents recognized among their peers, we concluded: even if the health care directed to this population had already been the subject of heated debate at specific times of the twentieth century, HR was constituted as a differentiated happening, which produced discontinuities and ruptures, reconfiguring the field of struggle around public policy and health care strategies aimed at people who use alcohol and other drugs in Brazil