Avaliação da implementação das políticas públicas sobre álcool e outras drogas em nível municipal

Abstract

Although the use of alcohol and other drugs is associated with a variety of damage, this area was not a policy of attention to users until the early twenty-first century. Brazilian policies aimed at tackling this issue in public health have recently been formulated by the National Policy on Drugs (SENAD) and the Ministry of Health. The main guidelines of the implementation of national policies on alcohol and other drugs focus on the decentralization of actions. This study evaluated the implementation of SENAD and the Ministry of Health policies at a municipal level, identifying actions taken and actors involved. We conducted three field studies in selected cities by criteria of convenience, as "A" a large city that has a network specialized in this area, "B" a small city that has a City Council on Alcohol and Drugs (COMAD). And "C" also considered small and does not meet the two previous conditions. Data collection was performed through interviews with key informants, and documents of municipal politics. In total, 19 interviews were conducted. Data analysis was performed using the content analysis of a structural and thematic kind. In city A, there are barriers to the integration of the network of care to users and for the interaction of the actors involved, and the implementation of policies on alcohol and other drugs is limited to what is being prioritized for the mental health field. In the second city, we observed a linkage between local actors through COMAD recently deployed; however there is a tendency that the implementation of policies will be identified with the execution of actions through COMAD. In city C there were no local public actions in the area of alcohol and other drugs, and there are a palliative role of non-governmental actors and lack of a local debate. Despite the distinctions between the municipalities and different degrees of difficulties, it was found weaknesses in the implementation of the policies proposed by SENAD and the Ministry of Health, given the obstacles to have access to health care provision and the fragmentation of the subject alcohol and drugs in relation to a broader political scene.