Moralidades sobre o uso problemático de álcool em uma unidade da Estratégia Saúde da Família no Rio de Janeiro.

Abstract

In this work, I analyze the practices and speeches of health professionals from a unit of the Family Health Strategy of the municipality of Rio de Janeiro - RJ in relation to alcohol use. I carried out an ethnographic research in this health unit over a period of five months, from August to December 2018, which included participant observation in the unit, in the meeting rooms, in the consultations and in the assigned territory, as well as semi-structured interviews with nine health professionals of this unit. The use of alcohol is a very widespread and accepted social act in many contexts. By its social variability, we can refer in the plural to uses of alcohol. Certain patterns of these uses are considered as a health problem, characterizing the diagnosis of problematic alcohol use. This was chosen as a category to understand the moralities that cross the practices of the professionals of the unit where I carried out this research. The problematic alcohol use contemplates an amplification of the medical classification related to the use of alcohol considered deviant, which was previously defined, more restrictively, as alcoholism. Several publications in the health area indicate that, considering epidemiological estimates, the problematic alcohol use is poorly diagnosed and, consequently, a significant proportion of people that could be classified according to this diagnosis is not receiving the treatment that would be indicated. In this research, I tried to problematize the production of hegemonic knowledge in the field of health and to describe, from another perspective, practices that were familiar to me. The data produced refer to the specificity of the reality of the place where the research was carried out and were contextualized in relation to the Brazilian National Health System (SUS) and Family Health Strategy (FHS) policies, World Health Organization (WHO) publications and in the field of Global Mental Health (GMH). These data were analyzed on two thematic axes and their subdivisions. The first one refers to the interface of control and care at the following levels: individual, family and community. The second thematic axis contemplates an understanding of these moralities from the concepts of deviance (BECKER, 2008), accusation (VELHO, 2003), stigma (GOFFMAN, 2002) and medicalization (CONRAD, 2007).