Drug abuse and addiction from the public health standpoint

Francisco I. Bastos Miriam Schenker About the authors

While it represents an undeniable paradox, because the main objective of the rule of law (“legal interest” comes first) is life in its individual and collective dimension (“life in society”), the idea that the use of drugs, and especially the types more closely associated with damage and risks that are abuse and addiction are a public health issue is far from being consensual. In the world today, no less than four perspectives on the subject coexist in a disharmonious, and even downright, contradictory manner, namely: a) the individual and collective perspective of health; b) the rule of law, which defines such conduct as violations or crimes, and in line with this view, punishes those involved; c) the concept that immoderate use results in a moral failure and/or sinful act, which is associated with moral intervention of secular or religious character; and, lastly, d) the perspective of social “plague,” which has a somewhat ambiguous explanation in most Western countries, but is present in numerous contexts, such as in the association between drug use and the breakdown of national security, which was very common in the 1980s and remains very influential until today (see statement of Indian Minister Rajnath Singh, on September 9, 2015, available at: http://zeenews.india.com/news/health/health-news/drug-abuse-threat-to-national-security-rajnath-singh_1738600.html).

In light of the above, it comes as no surprise that there is so much hesitation, not to mention open confrontation between different reform initiatives of the law on drugs and so many inconsistencies when the various public policies that are meant to deal with the issue are analyzed in a joint (the desirable expression here would be “integrated,” but unfortunately it is far removed from everyday life in the vast majority of societies) and comparative manner.

In this respect, works such as those collated in this special issue of Ciência e Saúde Coletiva are absolutely essential, since without avoiding dialogue with different disciplinary practices and actions and public and private initiatives, they preserve and strengthen the approach to health at different levels, ranging from individuals to the health of communities in its micro (e.g., their families and peer networks) and macro-social (social locations and segments) dimensions. The primary interest of the publications for legal drugs, especially promoting alcohol abuse from teenagers to seniors, including addicting the indigenous population to alcohol, reveals the relationship with the individual and social vulnerability of their life contexts. We have the impression that, in general, judges and legislators who presume to formulate policy for drug users are far removed from their everyday reality, and from the professionals who are on the leading edge of various specialties that monitor and provide care for them. Highlighting the importance of the “drug problem” from the standpoint of health encompasses the users, their families, their peers and their cultural and social context, and includes the users and those that are close to them in the dimension of “care,” which is essential for those exposed to potential damage associated with their usage habit.

It will be difficult to find more effective and humane approaches in the area of prevention, treatment and eventual reintegration into society of people who use psychoactive substances (whether defned as “drugs” [term overlapping illicit substances] or otherwise. This is also the case of tobacco, alcohol and the non-therapeutic use of psychotropic drugs and substances for sundry applications, such as organic solvents), if we do not gather scientific evidence and subject them to analysis and debate of interlocutors both within public health and in the broader society. This is the purpose of this special issue, that we now bring to the attention of our readers. Pleasant reading! May it stimulate refection and debate!

Francisco I. Bastos1, Miriam Schenker2,3
1Fundação Biblioteca de Manguinhos suíte 229 Oswaldo Cruz, ICICT, Fiocruz
2Departamento de Estudos Violência e Saúde Jorge Careli, Ensp, Fiocruz
3Departamento de Medicina Integral Familiar e Comunitária, UERJ

Publication Dates

  • Publication in this collection
    Jan 2016
ABRASCO - Associação Brasileira de Saúde Coletiva Rio de Janeiro - RJ - Brazil
E-mail: revscol@fiocruz.br