Excluídos pelo consumo ou consumidos pela exclusão? Uma reflexão sobre a diretriz da reinserção social na atenção psicossocial em álcool e drogas no SUS

Abstract

The guarantee of rights and the non-segregating model of community territorial care was materialized in Law 10.216/2001, covering people who abuse and depend on substances, understanding that psychic suffering can be the basis of these behaviors, as well as occur in the course of damage to health, relational and social consequences of this abuse. The study aimed to analyze the social reinsertion guideline, legally established in health/mental health care for people in psychological distress and with problems arising from alcohol and other drug abuse, rescuing the history of this guideline, seeking to identify and analyze its definitions and conceptualizations. The research is of the theoretical-conceptual type that allows adding the historical dimension to the understanding of the social related to the phases of the policies. Normative acts (decrees, ordinances, laws and resolutions), including mental health and drug policy, were analyzed, identifying in them the mention of social reintegration, seeking possible definitions and modes of action aimed at this purpose. A critical discussion is woven on this guideline based on formulations and theoretical categories of Marxist orientation such as: industrial reserve army, in the capitalist mode of production, understanding substance consumption as part of the process of individual and social reproduction, the social issue /pauperism, the inclusion-exclusion paradigm and the social determination of the health-disease process. The dynamics of capital, which make up the dynamics of capitalism, lead to precarious employment and unemployment and, consequently, to a class of workers without work, said to be excluded. This “social world of the excluded” is not created or chosen by them, but a condition in which they are pushed by circumstances beyond their control and beyond drug consumption.