Desafios no cuidado psicossocial aos usuários de substâncias psicoativas pelos agentes comunitários de saúde no território

Abstract

Throughout human existence, it is common to perceive the use of multiple psychoactive substances due to different reasons, meanings, and contexts. When addressing such theme, understanding how this demand reaches the Unified Health System (UHS) is essential, especially in Primary Health Care (PHC), as well as how it relates to the professional activities of Community Health Agents (CHAs). Thus, this research has as its main objective to comprehend how Community Health Agents in Primary Health Care take care of individuals who make harmful use of psychoactive substances. The field of research was a Basic Health Unit (BHU) in the city of Santa Cruz, RN. This is a case study of a qualitative nature, which was carried out through an intervention-research approach and based on the theoretical framework of Institutional Analysis. The activities that were developed with the CHAs took place between August and September, 2021. The data were collected through the three following instruments: a conversation circle, semi-structured interviews, and a research diary. In total, 01 conversation circle and 08 individual interviews were carried out. As for the diary, it was prepared during the experiences described above as a potential for analysis and reflection in the in loco meetings in the research. With regard to the analysis of the collected data, important concepts from the theoretical framework of Institutional Analysis were applied, such as order, demand, transversality, and implication. When analyzing the interfaces of the CHAs’ work experiences, the following results were found: a low demand at the BHU by users of psychoactive substances; valuation of the biomedical model and medicalization; hospitalization in therapeutic communities as an instituted possibility of care; low planning in the individual provision of care; and little coverage in intersectoral articulation. Therefore, although the CHAs’ work may be a challenging task, it is still possible to act in a daily collective construction that gives space for care based on the bond, listening, and welcoming guided by the principles that rule Harm Reduction, expanded clinic, and the UHS.