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CARING FOR ALCOHOL USERS IN PRIMARY HEALTH CARE: MORALISM, CRIMINALIZATION AND ABSTINENCE THEORY

Abstract

The damages resulting from alcohol abuse gained prominence in the eighteenth century, with the rise of capitalism. Sanitary and governmental control measures followed the sociohistorical construction. In Brazil, the Alcohol and Drug Policy of the Ministry of Health, implemented in the first decade of the twenty-first century, proposed network care actions, including primary health care services. In spite of the efforts to train the professionals, the actions in health are little welcoming, stigmatizing and inefficient due to the complexity of the topic. With the aim of getting to know and analyzing the beliefs and health practices in the care offered to alcohol users in primary health care, we conducted this qualitative research with the health professionals of a primary health care service using semi-structured interviews and content analysis. The theoretical references related to collective health and social sciences support this analysis. The results pointed to moralizing and bigoted attitudes, with a practice that criminalizes alcohol use, mainly among lower-income classes, guided by normalized conducts, with a focus on the removal of risk and on complete abstinence, according to the hegemonic biomedical model, and distant from the needs of the subjects and the complexity that surrounds the issue.

primary health care; alcoholism; perception and social stigma

Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio Avenida Brasil, 4.365, 21040-360 Rio de Janeiro, RJ Brasil, Tel.: (55 21) 3865-9850/9853, Fax: (55 21) 2560-8279 - Rio de Janeiro - RJ - Brazil
E-mail: revtes@fiocruz.br