Impacto de uma disseminação de práticas de prevenção ao uso de álcool e outras drogas na diminuição do estigma atribuído aos usuários pelos profissionais da APS

Abstract

Background: The misuse of alcohol and other drugs is considered an important public health problem. However, prevention and rehabilitation are insufficient mainly due to lack of professional qualification and significant stigmatization of substance user. The dissemination of practices to prevent alcohol and other drugs based on the model of Screening, Brief Intervention and Referral to Treatment (SBIRT) have been shown as effective means to promote changes in attitudes of health professionals. The aim of this study was to evaluate the impact of a spread of SBIRT in attitudes toward prevention practices to alcohol and other drugs and the stigma of substance use by professionals in Primary Health Care in two Brazilian cities. We used two antistigma strategies in the course of dissemination, education and contact. Methods: The study included 96 professionals, and 54 received training and supervision for implementation of SBIRT (intervention group) and 41 received no intervention (control group). The Follow-up was 3 months. Scales were applied to beliefs and attitudes, a range of ethical and vignettes to assess stigma in both groups at baseline and follow-up. T tests, Wilcoxon, Mann-Whitney, McNemar and chi-square test were used. Results: We noticed a strong trend to moralizing substance dependence by health professionals. Overall, there were no significant differences in groups at follow up in terms of attitudes or stigma. Conclusions: Apparently the intervention performed did not change the attitudes of professionals in relation to prevention practices (SBIRT) and stigmatization of addicts by professionals. However, it emphasizes the importance of new studies that address the use of anti-stigma strategies and evaluate the change in attitude of professionals in a context of implementation of SBIRT.