ASSISTANCE TO DRUG USERS AT THE INTERFACE BETWEEN PSYCHOANALYSIS AND HARM REDUCTION: A NOT-ALL POLICY

Abstract

This article aims to analyze the policy of assistance to users of alcohol and other drugs in Brazil, articulating the ethics of psychoanalysis and Harm Reduction (HR) strategies to understand the advances and setbacks of public policies in recent decades. By revisiting the history of the Psychiatric Reform and the constitution of the Psychosocial Care Network (RAPS), it demonstrates how the rise of Therapeutic Communities (TCs) – marked by moralizing, religious, and punitive practices – represents a return to the asylum model, with serious violations of human rights, sustained by prohibitionist policies with state funding. In contrast, Harm Reduction, like psychoanalysis, proposes a non-universalizing approach, oriented by the case-by-case basis and the subject's involvement in their treatment, considering their choice of use, abuse, or abstinence. Thus, the article argues that any care in mental health, alcohol, and other drugs should be guided by a commitment to listening to individuality, respect for human rights, and territorial and community-based care. Constituting itself as a not-all-encompassing policy, this perspective must be able to include the distinct modes of enjoyment in the complexity of each subject's relationship with drugs and their uses.