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Perception of basic education students about drugs: a look at the light of Merleau-Ponty

Abstract

OBJECTIVE

Unveil the perception of students from basic education about drugs.

METHODS

Phenomenological study based on Maurice Merleau-Ponyt, conducted with 14 students of a school in Bahia, Brazil, through the Focus Group, in the months of April to June of 2013. The reports have been analyzed based on the Ambiguity Analytics technique.

RESULTS

They have been presented in the form of three categories: common sense and scientific knowledge occupy opposite locus; drug addicts; the good and evil of legal and illegal drugs.

CONCLUSIONS

The students' perception of drugs intertwined with scientific knowledge and at the same time placing it at the center of the phenomenon, separating the lawful as good and illicit as bad, which points to the need for socio-educational measures among educators, students and family members, aimed at the decentralization of the drug place in the context in which the phenomenon happens so that we understand the complexity involved in the theme.

Keywords:
Adolescent; Street drugs; Philosophy; nursing

Resumo

OBJETIVO

desvelar a percepção de estudantes da educação básica sobre drogas.

MÉTODOS

Estudo fenomenológico fundamentado em Maurice Merleau-Ponty, realizado com 14 estudantes em escola do interior da Bahia, Brasil, por meio do Grupo Focal, entre abril e junho de 2013, os relatos foram analisados com base na Analítica da Ambiguidade.

RESULTADOS

Foram apresentados em três categorias: senso comum e conhecimento científico ocupam locus opostos; droga vicia; o bem e o mal das drogas lícitas e ilícitas.

CONCLUSÕES

a percepção dos estudantes sobre as drogas entrelaçada ao conhecimento científico e, ao mesmo tempo colocando-a no centro do fenômeno, separando as lícitas como boas e ilícitas como más, aponta para a necessidade de medidas socioeducativas, entre educadores, estudantes e familiares, que visem descentralizar o lugar da droga no contexto em que o fenômeno acontece para que compreendamos a complexidade envolvida no tema.

Palavras-chave:
Adolescente; Drogas ilícitas; Filosofia em enfermagem

Resumen

OBJETIVO

Conocer la percepción de los estudiantes de educación básica sobre las drogas.

MÉTODOS

Estudio fenomenológico basado en Maurice Merleau-Ponty, realizado con 14 estudiantes en el interior de una escuela de Bahía, Brasil, a través de un grupo de enfoque, los meses de abril a junio de 2013, las historias fueron analizados sobre la base de la técnica Analítica Ambigüedad.

RESULTADOS

Se presentan en forma de tres categorías: el sentido común y el conocimiento científica ocupan locus opuesto; drogadictos; el bien y el mal de las drogas legales e ilegales.

CONCLUSIÓN

La percepción de los estudiantes sobre las drogas entrelazadas al conocimiento científico y al mismo tiempo colocándola en el centro del fenómeno, separando las lícitas como buenas e ilícitas como malas, apunta a la necesidad de medidas socioeducativas, entre educadores, estudiantes y familiares, que visen Descentralizar el lugar de la droga en el contexto en que el fenómeno ocurre para que comprendamos la complejidad involucrada en el tema.

Palabras clave:
Adolescente; Drogas ilícitas; Filosofía en enfermería

INTRODUCTION

Drug use is a major global public health problem because of the diversity of aspects it involves, such as the potential for dependency and its serious social consequences11 Fiore M. O lugar do Estado na questão das drogas: o paradigma proibicionista e as alternativas. Novos Estud CEBRAP. 2012 mar; 92 9-21.. Generally, the first contact with the drug occurs during the adolescence phase, since this stage of life is marked by searches, discoveries, increasing the importance of groups, conflicts with themselves and with the family and the participation in new spaces that make them more vulnerable to external situations such as sexual risk behavior and drug use22 Monteiro , CFS Araújo TME, Sousa, CMM Carvalho MC, Martins, LLLS. Adolescentes e o uso de drogas ilícitas: um estudo transversal. Rev Enferm UERJ. 2012 lul-set;20(3):344-8..

The scientific literature suggests that there is an association, risk and protective factors for substance use among students in adolescence33 Elicker E, Palazzo LS, Aerts DRGC, Alves GG, Câmara S. Uso de álcool, tabaco e outras drogas por adolescentes escolares de Porto Velho-RO, Brasil. Epidemiol Serv Saúde. 2015;24(3):399-410.-44 Malta DC, Mascarenhas MDM, Porto DL, Barreto SM, Neto OLM. Exposição ao álcool entre escolares e fatores associados. Rev Saúde Pública 2014;48(1):52-62.. The intense search for personal identity, juvenile omnipotence and the desire for new experiences, combined with the challenge of family and social structure are identified as triggers for drug use among students33 Elicker E, Palazzo LS, Aerts DRGC, Alves GG, Câmara S. Uso de álcool, tabaco e outras drogas por adolescentes escolares de Porto Velho-RO, Brasil. Epidemiol Serv Saúde. 2015;24(3):399-410..

In the National Survey on School Health (NSSH), 8.7% of scholars reported experiencing some illicit drug, with tobacco being the most prevalent in the last 30 days among them55 Malta DC, Machado IE, Porto DL, Silva MMA, Freitas PC, Costa AWN, et al. Consumo de álcool entre adolescentes brasileiros segundo a Pesquisa Nacional de Saúde Escolar (PeNSE 2012). Rev Bras Epidemiol. 2014;17(Supl. 1):203-14.. Alcohol gains importance in 39.2% of scholars participating in a study in Porto Velho/RO33 Elicker E, Palazzo LS, Aerts DRGC, Alves GG, Câmara S. Uso de álcool, tabaco e outras drogas por adolescentes escolares de Porto Velho-RO, Brasil. Epidemiol Serv Saúde. 2015;24(3):399-410.. The research indicates that in 143 Brazilian cities the pattern of alcohol consumption among adolescents from 14 to 17 years old has been worrying, since 75.0% said they had already consumed alcohol at least once in their life.44 Malta DC, Mascarenhas MDM, Porto DL, Barreto SM, Neto OLM. Exposição ao álcool entre escolares e fatores associados. Rev Saúde Pública 2014;48(1):52-62.. A worldwide study conducted in countries such as Argentina, Peru and Uruguay found prevalence rates of 56.8%, 27.1% and 59.6%, respectively, regarding alcohol consumption among adolescents66 World Health Organization (CH). Global school-base student health survey. Geneva: WHO; 2015 [cited 2017 May 05]. Available from: Available from: http://www.who.int/chp/gshs/en .
http://www.who.int/chp/gshs/en...
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The concern that moves us is related to the association between lower school performance as low frequency, participation and occurrence of failures that are directly related to the drug use33 Elicker E, Palazzo LS, Aerts DRGC, Alves GG, Câmara S. Uso de álcool, tabaco e outras drogas por adolescentes escolares de Porto Velho-RO, Brasil. Epidemiol Serv Saúde. 2015;24(3):399-410.. The school environment itself can be considered a place of vulnerability, due to the easy circulation of these substances, the pressure of the groups for the use and the coexistence with adolescents involved in trafficking.

On the other hand, scholars point out that the school, seen as a transforming agent constituted in a protective environment can enable discussions and information about these substances77 Costa AG, Camurca VV, Braga JM, Tatmatsu DIB. Drogas em áreas de risco: o que dizem os jovens. Physis. 2012 abr-jun;22(2):803-19. . There is a need for studies that fill the gap regarding the objective data and in understanding the school context, family and social relationships, and ease of access to alcohol, tobacco and other harmful drugs in the eyes of those experiencing them, so that we can raise the intersubjectivities of these relations.

From this perspective, understanding the context of drug use as a phenomenal experience, since it involves a multifaceted universe, we will try to find the meanings and motives for the event from the study of the school space, in order to know the perceptions of the adolescents about the drug consumption, since the culture and the environment in which it is inserted and the world view, which directly influence the way they relate with them.

Thus, we establish as a research question: what is the perception of public elementary school students about the vulnerability and protection for drug use? In order to answer this question, we have defined as the objective of the study: to unveil the perception of students of basic education about drugs.

The objective of the research led us to the theoretical-philosophical reference of Maurice Merleau-Ponty about the human perception, whose description is consistent with the perspectives of the study. This theory asserts that perceiving is not a passive reception of the representations of what is given to us from the outside for further interpretation, but rather a direct contact with the world that takes the form of active involvement with the things around us.

We believe that a study of this nature favors the elaboration of strategies of reduction of the damages to the health, that are a result from the consumption of drugs, with emphasis to the strengthening of protective factors; it also appreciates the students' previous knowledge on the subject, as well as it explores the emerging doubts of this knowledge.

METHODS

It is a qualitative study based on the ontology of Merleau-Ponty’s experience, which describes the perception as the essence of the human being - a dialogical and intersubjective experience that expresses itself as generality88 Merleau-Ponty M. Fenomenologia da percepção. São Paulo: WMF Martins Fontes; 2015.. The article emerged from a thematic axis of a master's thesis entitled "The perception of primary and secondary school students on the vulnerability and protection for drug use"99 De Jesus IS. Percepção de estudantes do ensino fundamental e médio sobre vulnerabilidade e proteção para o uso de drogas [dissertação]. Jequié (BA): Programa de Pós-graduação em Enfermagem e Saúde, Universidade Estadual do Sudoeste da Bahia; 2013..

The setting of the research was a public school in Bahia, Brazil, where we conducted the study with 14 students of basic education, especially from elementary and high school. The procedure for approaching the study participants was by presenting the proposal in each classroom. As inclusion criteria, we have established: to be a primary and secondary school student of a public school of both genders, to be between 12 and 18 years old, to be regularly enrolled between the sixth and ninth year of elementary school and in first to third year of high school. The exclusion criterion was not to attend school regularly.

The students who offered to participate received the Free and Informed Consent Term (FICT), which explained how the study would be carried out and its possible discomforts and benefits. The students of legal age signed the term, the minors were told that they should sign the Free and Informed Consent Term, and turn over the FICT to those responsible for the corresponding authorization. Among those who signed the term and those who have brought the signature of their parents, a raffle was held with the prospect of obtaining at least one student from each grade, involving elementary and secondary education.

We use the Focus Group (FG) as a strategy to foster intersubjectivity, as this technique stimulates the interaction and communication among the people that are gathered, and it is mediated by a researcher who takes an active stance in producing the data1010 Krueger RA, Casey MA. Focus groups: a pratical guide for applied research. 5th ed. Singapore: Sage Publications Asia-Pacific, Inc.; 2015..

This information-gathering technique is compatible with the phenomenological proposition, which conceives perception not as a pure occurrence, but which appears at the intersection of our experiences, by the gearing of one another. In this way, it consists of an intersubjective process that forms a coexistential unit by the "resumption of my past experiences in my present experiences, of the experience of the other in mine"(8:18).

The FG meetings occurred between April and June of 2013 in two moments, lasting approximately one and a half hour, during which it was possible to listen to the students about drugs. The speeches have been recorded and the reports transcribed, and then analyzed through Ambiguity Analytics1111 Sena ELS, Gonçalves LHT, Granzotto MJM, Carvalho PAL, Reis HFT. Analítica da ambiguidade: estratégia metódica para a pesquisa fenomenológica em saúde. Rev Gaúcha Enferm. 2010 dez;31(4):769-75., a technique developed for studies that involve the human perception, considering that this is an ambiguous experience.

The technique consists in identifying and suspending theses that occur to the perception, understanding them as an ambiguous experience, in which simultaneously different natures operate: one that is impersonal and that imposes itself to us, independent of our will; and another, which is personal and involves our sociocultural character1111 Sena ELS, Gonçalves LHT, Granzotto MJM, Carvalho PAL, Reis HFT. Analítica da ambiguidade: estratégia metódica para a pesquisa fenomenológica em saúde. Rev Gaúcha Enferm. 2010 dez;31(4):769-75.. Thus, the intersubjectivity with the reports of the participants of the research revealed three theses on drugs, which were constituted in categories of the study, namely: common sense and scientific knowledge occupy opposing locus; drug addicts; the good and evil of licit and illicit drugs.

The study has met the ethical precepts that guide scientific research with human beings1212 Ministério da Saúde (BR), Conselho Nacional de Saúde. Resolução nº 466, de 12 de dezembro de 2012. Diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União [da] República Federativa do Brasil. 2013 jun 13;150 (112 Seção 1):59-62., being approved by the Research Ethics Committee of the Universidade Estadual do Sudoeste da Bahia under the protocol No. 054976/2012.

In order to identify the participants' speeches and preserve their anonymity, we have identified them with the names of painters of the Impressionist movement, which consisted of a rupture with the logic of 19th century French picturesque art, that valued the creation of optical effects of light and shadow, a resonant aspect in Merleau-Ponty, considering that the world always presents itself to us in profile, as in a background-image relationship, in which the unveiling of the figure candles the background and the unveiling of the background can reveal countless figures88 Merleau-Ponty M. Fenomenologia da percepção. São Paulo: WMF Martins Fontes; 2015..

RESULTS AND DISCUSSION

The results found in this research led us to elaborate three categories, which do not end in themselves, but open possibilities for new understandings with each reading, being: Common sense and scientific knowledge occupy opposing locus; Drug addicts and; The good and evil of licit and illicit drugs.

Common sense and scientific knowledge occupy opposing locus

The discussion of students' narratives about drugs was based on the objective of the study, and it was extended by the articulation between the theses perceived in the speech fragments, the studies that deal with drugs, and the philosophical reference of Maurice Merleau-Ponty. This dialogue enabled the experience of becoming another, leading to the emergence of the discussion between the opposing locus of common sense and scientific knowledge.

In the discussion of the students in Focus Group 1 about what they conceived as drugs, the substances mentioned were the following:

Marijuana, cocaine, LSD, ecstasy. (Claude Monet)

Some remedies, which are made of drugs, alcohol. (Edouard Manet)

Everything is drug, right, teacher? (Edgar Degas)

Even coffee is, right? (Auguste Renoir)

Even coffee is a drug, it contains caffeine. (Alfred Sisley)

Coca-Cola is also a drug, you know? (Camille Pissarro)

51, cognac, dueling pot. (Eliseu Visconti)

Whisky. (Almeida Júnior)

Beer, coke... (Timótheo da Costa)

Every kind of drink that contains alcohol is a drug. (Henrique Cavaleiro)

The students' discussion outweighed our expectations regarding their knowledge of the subject, particularly regarding the identification of some culturally accepted subtypes of drugs, despite the fact that in our daily lives the term drug is closely related to illicit substances.

Thus, the descriptions corroborate the pharmacological concept of drug as "a substance which, when administered or consumed by a living being, modifies one or more of its functions, except for those substances necessary for the maintenance of normal health"11 Fiore M. O lugar do Estado na questão das drogas: o paradigma proibicionista e as alternativas. Novos Estud CEBRAP. 2012 mar; 92 9-21.. They recognized the potential that licit drugs, like medicines and coffee, consumed by most people, have when acting on the human organism and its functions. They also recognize that the socio-cultural tradition ignores this potential.

The students' perception favors the suspension of the thesis that places scientific knowledge and common sense in opposing locus as if they were in themselves separate fields of knowledge. The academy, which conventionally produces and holds scientific knowledge, underestimates the potentialities of common sense to share, from the coexistence, the knowledge discussed in these environments. However, because of the globalization of information, the population tends to assimilate scientific discourse. Likewise, the tradition of scientific knowledge makes us realize that it was the common sense that mobilized and continues to make man produce science.

In addition, phenomenological thought brings to light the science's limitation of representing the world completely, to the point of closing in on itself, and closing all the questions beyond it. Therefore, it is science itself that imposes the challenge of reformulating it, so that there is always something to be produced, for there are no limits to observation, and we can imagine it more complete and more exact than that effected at a given moment1313 Merleau-Ponty M. Conversas - 1948. São Paulo: Martins Fontes; 2004. .

Thus, the existing science and knowledge already produced, interrogates us and leads us to the perception of the unthought-of that opens possibilities for the construction of new knowledge. It is from the already produced that we have something to produce, and to say something about it1414 Merleau-Ponty M. A prosa do mundo. São Paulo: Cosac & Naify; 2002..

It is relevant to highlight the dialogue between the scientist and the common sense in the production and dissemination of knowledge about drugs, since such sharing is a protective element in the context of harmful use. The discussion promoted with the students supports this assertion, because in dealing with strategies to prevent the drug use, in Focus Group 2 they considered the following:

Dialogue[...] (Auguste Renoir)

The reality, to know what it is that the person is living. (Henrique Cavaleiro)

Lecture, testimonial type. (Edouard Manet)

When a person is in a lecture, and he sees what that person is talking about, he already starts to put it in his mind: oh, what he's saying there, I’ve have gone through the same thing, in his mind: "man, I’m going through it as well, and that's why this woman is talking like that". Then, she'll think ... (Edgar Degas)

Dialogue... (Timótheo da Costa)

Talking, giving advice. (Claude Monet)

Guiding. (Almeida Júnior)

Incentivizing not to do it. (Vicente do Rego Monteiro)

Sit, talk [...] (Auguste Renoir)

Thus, the potential for protection emerges from the production of knowledge in partnership with adolescents, as they consider dialogic and interactive strategies to be more efficient because they favor the reflection and the critical judgment. Consequently, preventive programs that are merely limited to transmitting information are considered to be of no value and criticized by the majority of adolescents because they do not contemplate human aspects in their entirety1515 Zeitoune RCG, Ferreira VS, Silveira HS, Domingos AM, Maia AC. O conhecimento de adolescentes sobre drogas lícitas e ilícitas: uma contribuição para a enfermagem comunitária. Esc Anna Nery. 2012 jan-mar;16(1):57-63..

In addition, as students prefer to get acquainted with the subject of drugs with their friends, parents, teachers, and practitioners, the more informed people are, the better the chances of releasing coherent and relevant content1616 Rocha FM, Vargas D, Oliveira MAF. Cuidar de dependentes de substâncias psicoativas: percepções dos estudantes de enfermagem. Rev Esc Enferm USP. 2013;47(3):671-7..

It is important to highlight that listening to the testimonies from people who have already engaged in drugs in a harmful way - highlighting the fact that they have been able to resume their lives without commitment, due to the relationship they have established with the substance, was pointed out as a protective element by the students. This has already been signaled in a study that brings the perception of nursing students about the care of dependents of psychoactive substances, in which the interaction with them made them break certain prejudices and provided a broader perception of the problem as a complex phenomenon whose attention is not only due to the individual, but also to the family, the socioeconomic and cultural context in which these people are inserted1717 Organização Mundial da Saúde. Classificação de transtornos mentais e de comportamento da CID-10. Porto Alegre: Artmed; 1993..

The preventive context that values dialogue and interaction resonates in the Merleau-Pontyan philosophy, whose understanding of the production of knowledge is that it occurs in the context of the relationship, which is to say that it is an intersubjective construction and, as such , it does not have a defined locus, but transits at the intersection between the "we"88 Merleau-Ponty M. Fenomenologia da percepção. São Paulo: WMF Martins Fontes; 2015..

In the dialogical relationship, the speech of the other not only invites us to resume the spoken speech, but also leads us to a movement of ideas, which we would not be able to do alone88 Merleau-Ponty M. Fenomenologia da percepção. São Paulo: WMF Martins Fontes; 2015.. This movement finally opens us to strange meanings. "It is, thus, necessary that I admit, here, that I live not only my own thought, but that, in the exercise of speech, I become the one I listen to."(1:41). While the production of this knowledge occurs to us, another thesis is presented to us during the research and leads us to new discussions, as relevant and not less important as this.

Drug addicts

During the discussions carried out in Focus Group 1, emerged the thesis that is socioculturally constructed and defended over the years, including by health professionals, that drugs are substances capable of generating "addiction" (repetitive habit, addiction). When we debated on what criteria they thought that was used to consider a substance as a drug, the following comments emerged:

It leaves the person with an addiction. (Edgar Degas)

It addicts and causes sequelae, such as headache; the person feels ill-being, when it is not taken, it makes the person feel ill. (Camille Pissarro)

Some of them who are so addicted that when they use a type of drug, they invent another drug to use. (Eliseu Visconti)

The students emphasize that drugs, in addition to addiction, produce health damage, especially physical health and "cause sequelae". This conception strengthens the theories that focus on the issue of chemical dependence and the potential for abuse, that is related to psychoactive substances, which consist of a chronic and multicausal disease commonly associated with health damage and related to risky sexual behavior, and involvement with episodes of violence and accidents55 Malta DC, Machado IE, Porto DL, Silva MMA, Freitas PC, Costa AWN, et al. Consumo de álcool entre adolescentes brasileiros segundo a Pesquisa Nacional de Saúde Escolar (PeNSE 2012). Rev Bras Epidemiol. 2014;17(Supl. 1):203-14.. The speeches present the notion that drugs have an effect on the central nervous system and can produce changes in the psyche, that is, they are psychoactive substances. They used the term drug, which is generic, in order to identify psychotropic drugs as those that possess a tropism by the psyche1717 Organização Mundial da Saúde. Classificação de transtornos mentais e de comportamento da CID-10. Porto Alegre: Artmed; 1993..

Thus, the results point to the valorization of the biological to the detriment of the other dimensions that are intertwined in the constitution of the human experience. It is a naive view of the drug phenomenon, which does not include the subjective contexts of psychic and social suffering. The picture of physical damage, which drug abuse can generate, stands out against the background of other damages arising from the psychosocial field1515 Zeitoune RCG, Ferreira VS, Silveira HS, Domingos AM, Maia AC. O conhecimento de adolescentes sobre drogas lícitas e ilícitas: uma contribuição para a enfermagem comunitária. Esc Anna Nery. 2012 jan-mar;16(1):57-63..

In the discussion of Focus Group 1, we realized that there are still other theses reproduced in our culture about the concept of drugs, historically treated as one of the worst scourges of humanity or as a ghost that circles the world. These theses may have favored the emergence of stigma in relation to substance and users, generating suffering that assumes biopsychosocial contours1818 Feliz CB, Vianna ACF. O preconceito e o estigma na cobertura midiática sobre drogas no Rio de Janeiro. Contemporânea. 2015;13(3):566-81..

Since the term drug has taken on a broader meaning than that adopted by the WHO - extending its meaning to everything that is bad, lacking quality, and detrimental to health - it evokes negative feelings such as fear, sense of danger, marginalization and criminality1919 Bard ND, Antunes B, Roos CM, Olschowsky A, Pinho LB. Estigma e preconceito: vivência dos usuários de crack. Rev Latino-Am Enfermagem. 2016; 24:e2680.. The perception that the drug itself can cause addiction and damage to the physical health appears during the discussion mainly from the expressions:

Alcohol also causes addiction. (Claude Monet)

[...] now, the stone, it is miserable indeed. Regarding the stone there isn’t the one that says "oh I'm going to smoke just once and I'm going to stay there." No, as long as it does not see you with your head really done, it does not settle down. (Edgar Degas)

However, the psychoactive substance in itself should not be judged as being good or bad, especially if we consider that the same drug can act as a medicine and, as a toxicant2020 Trad S. Controle do uso de drogas e prevenção no Brasil: revisitando sua trajetória para entender os desafios atuais. In: Nery Filho A, MacRae E, Tavares LA, Nuñez ME, Rêgo M, organizadores. As drogas na contemporaneidade: perspectivas clínicas e culturais. Salvador: EDUFBA; 2012. p. 97-112.. In addition, drugs act in a unique way in each organism, and its real consequences cannot be determined, since the effects and damages caused by the use of substances are conditioned to the onset of consumption, frequency, quantity, physical, mental and social state2020 Trad S. Controle do uso de drogas e prevenção no Brasil: revisitando sua trajetória para entender os desafios atuais. In: Nery Filho A, MacRae E, Tavares LA, Nuñez ME, Rêgo M, organizadores. As drogas na contemporaneidade: perspectivas clínicas e culturais. Salvador: EDUFBA; 2012. p. 97-112..

When one considers the drug as being in itself, ignoring the relationship that the consumer establishes with it, the substance is labeled as guilty. Thus, it is underestimated that the possible harm to health in the integral sense comes from the link that the user establishes with the substance and the consequences that it brings. Sometimes this bond is so narrow that it tends to be prioritized, to the detriment of the innumerable possibilities of self-realization. In this sense, it is necessary to move the focus of the substances to the groups of consumers and the contexts in which the insertion and permanence in the universe of drugs occur regarding the dynamics of their consumption2020 Trad S. Controle do uso de drogas e prevenção no Brasil: revisitando sua trajetória para entender os desafios atuais. In: Nery Filho A, MacRae E, Tavares LA, Nuñez ME, Rêgo M, organizadores. As drogas na contemporaneidade: perspectivas clínicas e culturais. Salvador: EDUFBA; 2012. p. 97-112..

The cultural context of combating drugs reinforces the ambiguity experienced by the user. Nevertheless, the tradition of propagating that drug use "cause harm" - in the relationship that the user establishes with the drug and the very context in which it occurs, often in social events, in environments of interaction with friends - provides a positive experience of openness to new relationships, strengthening bonds of friendship, and even building new social networks. Thus, talking about drug use is not just talking about a biological issue, it is talking about an integral individual, for whom drugs have a specific representation1616 Rocha FM, Vargas D, Oliveira MAF. Cuidar de dependentes de substâncias psicoativas: percepções dos estudantes de enfermagem. Rev Esc Enferm USP. 2013;47(3):671-7..

Moreover, the phenomenon of dependence is not intrinsic to chemistry per se, but it also involves, in a very interwoven way, the psychological and social contexts that constantly mobilize an infinity of possibilities to those who use drugs. Of these, the substance constitutes only a necessary obscurity to the clarity that will make to see the figures that stand out in the horizon of the life.

This perception opens the possibility for us to rethink the convictions that engulf us and do not allow us to perceive the substance - experience that is re-signified by the consumption of the drug - that appears in the figure of the substance itself. For human conduct carries with it a fund of existence, which is always in motion and results from the relationship they establish with others and with the things that awaken our feelings and clothe us with humanity1313 Merleau-Ponty M. Conversas - 1948. São Paulo: Martins Fontes; 2004. .

In spite of the perception about the drug elaborated in this category, we will follow the duality that exists in this context, which now appears as ambiguous and intertwines, once presenting itself as a thesis, and then distancing itself.

The good and evil of licit and illicit drugs

Nonetheless, the drug use accompanies the history of mankind, prohibition and regulation of the use of substances that alter psychic functions, as well as their classification as to lawfulness, the so-called "war against drugs" is incomparably more recent, based on biased arguments that disregard or reject scientific grounds on the subject, often influenced by political arguments of vested interests1818 Feliz CB, Vianna ACF. O preconceito e o estigma na cobertura midiática sobre drogas no Rio de Janeiro. Contemporânea. 2015;13(3):566-81..

Such a context has contributed to the construction of value judgments about certain drugs in which substances considered licit are perceived as good or less harmful, while illicit drugs are demonized and considered a great evil that must be fought vigorously. The discussion in Focus Group 1 reflects the naturalization of the social conviction that generates the thesis that licit drugs are good and illicit drugs are bad:

[...] It is more harmful [illicit drugs]. (Henrique Cavaleiro)

Alcohol, I think it is different, I think alcohol only does bad if the person consumes too much. It's just like the drug too. (Timótheo da Costa)

How are you going to release this kind of [illicit] drug if it's a bad thing? It cannot exist. (Camille Pissarro)

The thesis that illicit drugs are more harmful than licit drugs alienate people to the point where students believe that licit drugs, because they are socially accepted, do not bring as many problems as illicit drugs. This is especially true for alcohol, since the media and society stimulate consumption, whether through advertising associated with wealth, humor, success and prestige, or through the close relationship of the substance with festive moments and fraternization1515 Zeitoune RCG, Ferreira VS, Silveira HS, Domingos AM, Maia AC. O conhecimento de adolescentes sobre drogas lícitas e ilícitas: uma contribuição para a enfermagem comunitária. Esc Anna Nery. 2012 jan-mar;16(1):57-63..

In this sense, it is understood that permissiveness and complacency regarding licit drugs seem to guarantee the investment of the media in advertisements that overvalue these substances; at the same time, the illegality of the drug discredits it, since it is associated with criminal conduct that is rejected socially. Such an image often turns the gaze toward profit, which presents itself as the bottom of conduct. In this way, the financial return to the legal market outlines the actual and potential public health damages that the abusive consumption of the licit drug may entail1818 Feliz CB, Vianna ACF. O preconceito e o estigma na cobertura midiática sobre drogas no Rio de Janeiro. Contemporânea. 2015;13(3):566-81..

The damages caused by the excessive consumption of licit substances, especially with regard to alcohol, are legitimated by the law itself by making it legal. This legitimization is not from the point of view of permission to use, but from the approval as a culturally authenticated behavior. And when we refer to the law, we consider not only the normatization, but social the construction itself and, according to Merleau-Pontyan philosophy, it is personality, that is, it is our cultural traditions that legitimize the thesis of the goodness of the licit substances88 Merleau-Ponty M. Fenomenologia da percepção. São Paulo: WMF Martins Fontes; 2015..

However, depending on the pattern of use, all drugs can cause serious problems to life, but they can also contribute to improving health in some situations. This understanding appeared in the discussion of Focus Group 1 as it follows:

Because there are [drugs] that are used for some diseases as well. Marijuana, there are people who smoke it to calm themselves, for heart problems, something like that[...] (Eliseu Visconti)

But marijuana also helps with some diseases, does not it? (Alfred Sisley).

The perception that some drugs have the potential to contribute to health, not only in the psychic but physical aspect, allows the suspension of the thesis that assigns value judgment to the action of drugs in the body. As, for example, the realization that drugs in themselves are not bad or good, they are chemicals that, introduced into the body, produce an effect. In this sense, the focus of public policies should not be the fight against drugs, but the human being, who seeks interaction with it. What needs to be done is to prevent people from putting themselves and others at risk while using drugs, and to reduce the harm that could not be avoided.

The conflict between legalizing or not opacifies what must be enlightened in terms of life protection, that is, overcoming the normative and pathological models in relation to the drug phenomenon and the recognition of intersubjectivity, subject in the context of drug use. Therefore, it is essential to recognize the social ambiguity that recriminates the use of some substances and legalizes others, using rational and simplistic arguments that synthesize the issue to physical and legal health, ignoring the affective and emotional aspects involved, as well as the information and contradictory positions among health professionals on the subject1919 Bard ND, Antunes B, Roos CM, Olschowsky A, Pinho LB. Estigma e preconceito: vivência dos usuários de crack. Rev Latino-Am Enfermagem. 2016; 24:e2680..

In order to do so, it is necessary to overcome some challenges such as: tensions between the governmental sectors of health, justice and public security, and to think of the issue as an intersectoral complex; social vulnerabilities and inequalities, and, above all, social and legal tolerance of abusive use of legal drugs, especially alcohol, underestimating the legal drugs and overestimating the illegal drugs2020 Trad S. Controle do uso de drogas e prevenção no Brasil: revisitando sua trajetória para entender os desafios atuais. In: Nery Filho A, MacRae E, Tavares LA, Nuñez ME, Rêgo M, organizadores. As drogas na contemporaneidade: perspectivas clínicas e culturais. Salvador: EDUFBA; 2012. p. 97-112..

The overcoming of the good/evil dichotomy in relation to drugs must be extrapolated to the same extent as that related to the licit/illicit, since the drug warfare built on this difference has tried to solve a complex problem - formed by numerous components that are connected to each other, which tend to have unexpected consequences - with a simple measure that only makes sense for problems that have predictable causes and consequences.

Considering that investing against a complex system, with great force, potentiates the unexpected consequences, the prohibitionist model of drugs is incompatible with the unique way of being of man in community in the world. This condition of being with the other generates an "existential vulnerability", impossible to be modified. Thus, any preventive approach that has as a fundamental principle to eradicate the use of drugs is doomed to failure1919 Bard ND, Antunes B, Roos CM, Olschowsky A, Pinho LB. Estigma e preconceito: vivência dos usuários de crack. Rev Latino-Am Enfermagem. 2016; 24:e2680..

It is only when we ask ourselves about the lawfulness of drugs that we reflect on how culture deals in a Manichean way with them. Also, it is only through the reflection and intersubjectivity that we will be able to resume traditions in a critical way, to transcend towards a culture that surpasses the good/evil of the licit/illicit, to value life and relationships, and to reduce the damages caused by the abusive use we do of drugs.

FINAL CONSIDERATIONS

The study has made it possible to unveil the perception of primary and secondary students about drugs, based on Maurice Merleau-Ponty, organized from the following categories: common sense and scientific knowledge occupy opposing locus; drug addicts; the good and evil of licit and illicit drugs. These categories favored the understanding of the need for a greater dialogue with the population in which we intend to present preventive policies, using the knowledge that already circulates and are produced to foster reflections and contextualized actions; the need to shift our gaze from the substance to people in vulnerability and their contexts; the overcoming of the dichotomy of good/evil, licit/illicit in relation to drugs, pondering social, political, legal and market issues that involve them.

We believe that the Merleau-Ponty's philosophy was very relevant for understanding the narratives of the study participants in relation to drugs, since it enabled us to unveil important theses related to the theme that may serve to construct more reflexive prevention strategies, within the scope of care management, which allows managers, health professionals and even education, a closer understanding of the reality of these subjects, especially adolescents in a school context, to rethink the place of the drugs in the history of people.

Discussing with students using group methodology while awakening the dialogue has given us the sense that much remains to be unveiled and that this "unsaid" is, perhaps, related to the historical and social construction stigmatizing the theme, the idiosyncrasies of the students who may not have placed something more personal.

In spite of having reached the proposed objective, we pointed out as a limitation of the study the scarcity of publications related to the theme, based on theoretical phenomenology, which, in a way, compromised the sustainability of the results unveiled, through the deepening of the dialogue with other scholars of the subject. The research announces the need to elaborate new studies in order to broaden the discussion on the topic

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Publication Dates

  • Publication in this collection
    2017

History

  • Received
    26 May 2016
  • Accepted
    01 June 2017
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