Abstract

Brazilian drug policies have undergone changes over time, bearing marks for each historical period and experienced sanitary-political interests. Nowadays, an anti-reformist character was perceived in changes concentrated on Law no. 13,840, of June 5, 2019. The aim of this study is to analyze the key elements of a normative document on drugs based on the Critical Discourse Analysis. We analyzed the Law no. 13,840 using Fairclough’s method for three-dimensional analysis and then discussed it with Foucault’s notions of Biopower and Biopolitics. We consider that the emphasis on involuntary hospitalization, therapeutic communities and abstinence opposes the Brazilian psychiatric reform movement. The development of oppressive care practices are hidden by the so-called ideological neutrality and scientific evidence.

Key words:
Public policy; Substance-related disorders; Mental health

Introduction

This paper aims to analyze the relational and ideational identity functions of the discourse of the Law No. 13.840/2019, which amended Law No. 11.343 of August 23, 2006 to refer to the National System of Public Policies on Drugs.

Until today, the ideological tensions, contradictions and power disputes that marked the normative documents which govern public policies on drugs have brought them closer to the paradigm of disciplinary control¹1 Silva MAB, Abrahão AL. Política de atenção integral aos usuários de álcool e outras drogas: uma análise guiada por narrativas. Interface (Botucatu) 2020; 24:e190080.

2 Guimarães TAA, Rosa LCS. A remanicomialização do cuidado em saúde mental no Brasil no período de 2010-2019: análise de uma conjuntura antirreformista. O Social em Questão 2019; 22(44):111-138.

3 Vargas AFM, Campos MM. A trajetória das políticas de saúde mental e de álcool e outras drogas no século XX. Cien Saude Colet 2019; 24(3):1041-1050.

4 Teixeira MB, Ramôa ML, Engstrom E, Ribeiro JM. Tensões paradigmáticas nas políticas públicas sobre drogas: análise da legislação brasileira no período de 2000 a 2016. Cien Saude Colet 2017; 22(5):1455-1466.

5 Delgado PG. Reforma psiquiátrica: estratégias para resistir ao desmonte. Trab Educ e Saúde 2019;17(2):1-4.^-66 Nunes MO, Lima Júnior JM, Portugal CM, Torrenté M. Reforma e contrarreforma psiquiátrica: análise de uma crise sociopolítica e sanitária a nível nacional e regional. Cien Saude Colet 2019; 24(12):4489-4498.. The association between legal and psychiatric knowledge in policy documents, for example, reveals the influence of Brazil’s adhesion to the International Opium Conference in the early 20th century, which culminated in the standardization of compulsory treatment in mental asylums³3 Vargas AFM, Campos MM. A trajetória das políticas de saúde mental e de álcool e outras drogas no século XX. Cien Saude Colet 2019; 24(3):1041-1050.^,77 Carvalho JC. A emergência da política mundial de drogas: o Brasil e as primeiras conferências internacionais do ópio. Oficina do Hist 2014; 7(1):153-176.. The documents mentioned are the Decree No. 14.969 of September 3, 1921, which approved the creation of a sanatorium for “drug addicts”, and the Decree No. 891 of November 25, 1938, which characterized “drug addiction” as a disease of compulsory notification, restricting the treatment to the inpatient regime³3 Vargas AFM, Campos MM. A trajetória das políticas de saúde mental e de álcool e outras drogas no século XX. Cien Saude Colet 2019; 24(3):1041-1050..

The gaps in care for people with needs by the use of alcohol and other drugs were filled by medical associations guided by a hygienist paradigm⁸8 Santos GA, Queiroz IS. Internação psiquiátrica compulsória de usuários abusivos de drogas: uma falência ao SUS e um desuso da Política de Redução de Danos. Gerais Rev Saúde Pública do SUS/MG 2016; 4(1):59-69., which replicated treatments based on hospitalization, social isolation and therapeutic work⁹9 Bolonheis-Ramos RCM, Boarini ML. Comunidades terapêuticas: "novas" perspectivas e propostas higienistas. Hist Cienc Saude - Manguinhos 2015; 22(4):1231-1248.. The derogatory representation of alcohol and drug users as degenerate or deviant permeated Brazilian psychiatry in the first decades of the 20th century and remained as a socially hegemonic imagery in the 21st century¹⁰10 Costa JF. História da psiquiatria no Brasil: um corte ideológico. Rio de Janeiro: Garamond; 2006..

The asylum is understood as a locus of power and psychiatric knowledge¹¹11 Amarante P. O homem e a serpente: outras histórias para a loucura e a psiquiatria. Rio de Janeiro: Fiocruz; 1996.. However, the body is relegated to the background in the history of psychiatry due to the difficulty in justifying “mental illness” based on organic causes¹²12 Caponi S. Michel Foucault e a persistência do poder psiquiátrico. Cien Saude Colet 2009; 14(1):95-103.. Thus, psychiatry takes as its object of power elements of everyday life and subjectivity - such as will, insomnia, passions, sadness, conflicts and behaviors - demarcating borders between normality and deviation, legitimizing pathologization under the premise of scientific knowledge¹²12 Caponi S. Michel Foucault e a persistência do poder psiquiátrico. Cien Saude Colet 2009; 14(1):95-103.

13 Rauter C, Peixoto PTC. Psiquiatria, saúde mental e biopoder: vida, controle e modulação no contemporâneo. Psicol em Estud 2009; 14(2):267-275.^-1414 Caponi S. Biopolítica e medicalização dos anormais. Physis 2009; 19(2):529-549..

When this conception is combined with the theory of degeneracy¹¹11 Amarante P. O homem e a serpente: outras histórias para a loucura e a psiquiatria. Rio de Janeiro: Fiocruz; 1996.^,1414 Caponi S. Biopolítica e medicalização dos anormais. Physis 2009; 19(2):529-549., understanding deviation as a hereditary threat, the deviant subject is segregated from the subjects and their rights, with the objective of restricting the dissemination of the so-called degenerates. Therefore, psychiatric knowledge does not focus only on the individual, but on populations, in view of the survival of some at the expense of others. It thus assumes contours of biopower and biopolitics¹⁴14 Caponi S. Biopolítica e medicalização dos anormais. Physis 2009; 19(2):529-549.

15 Candiotto C. Cuidado da vida e dispositivos de segurança: a atualidade da biopolítica. In: Branco GC, Veiga-Neto A, organizadores. Foucault: filosofia & política. São Paulo: Autêntica; 2011. p. 81-96.^-1616 Martins LAM, Peixoto Junior CA. Genealogia do biopoder. Psicol Soc 2009; 21(2):157-165..

The ideological reorganization contextualized in the period of redemocratization culminated in the questioning of the hygienist paradigm and in the leverage of the Psychiatric Reform Movement in Brazil (PRMB). The change in the way of conceiving mental health care in Brazil is reflected in legislation at the beginning of the 20th century under the Law No. 10.216/200117, a milestone in the achievement of the PRMB and the Anti-Asylum Movement (AAM)¹⁸18 Braga TBM, Farinha MG. Sistema Único de Saúde e a Reforma Psiquiátrica: desafios e perspectivas. Rev Abordagem Gestalt 2018; 24(3):366-378.. It then occurs the transition from the asylum model to the psychosocial model¹⁹19 Costa-Rosa A. O modo psicossocial: um paradigma das práticas substitutivas ao modo asilar. In: Amarante P, organizador. Ensaios: subjetividade, saúde mental, sociedade. Rio de Janeiro: Fiocruz; 2000. p. 141-168. with the successive expansion and capillarization of substitute services, such as the Psychosocial Care Centers (CAPS), succeeded by the reduction in the number of hospital admissions¹⁸18 Braga TBM, Farinha MG. Sistema Único de Saúde e a Reforma Psiquiátrica: desafios e perspectivas. Rev Abordagem Gestalt 2018; 24(3):366-378.^,2020 Macedo JP, Abreu MM, Fontenele MG, Dimenstein M. A regionalização da saúde mental e os novos desafios da Reforma Psiquiátrica Brasileira. Saude Soc 2017; 26(1):155-170.^,2121 Clementino FS, Miranda FAN, Pessoa Júnior JM, Marcolino EC, Silva Júnior JA, Brandão GCG. Atendimento integral e comunitário em saúde mental: avanços e desafios da reforma psiquiátrica. Trab Educ Saude 2019; 17(1):e0017713..

Regarding drug policies, the changes in the federal government in 2002 made room for the Harm Reduction²²22 Fiore M. A medicalização da questão do uso de drogas no Brasil: reflexões acerca de debates institucionais e jurídicos. In: Venâncio RP, Carneiro H, organizadores. Álcool e drogas na história do Brasil. São Paulo: Alameda; 2005. p. 257-290. (HR) perspective, included in normative documents from 2004 to 2011²³23 Brasil. Decreto no 4.345, de 26 de agosto de 2002. Institui a Política Nacional Antidrogas e dá outras providências [Internet]; 2002. [citado 2021 Fev 15]. Disponível em: www.planalto.gov.br/ccivil_03/decreto/2002/D4345impressao.htm
www.planalto.gov.br/ccivil_03/decreto/20...

24 Brasil. Portaria no 2.197, de 14 de outubro de 2004. Redefine e amplia a atenção integral para usuários de álcool e outras drogas, no âmbito do Sistema Único de Saúde - SUS, e dá outras providências [Internet]; 2004. [citado 2021 Fev 15]. Disponível em: bvsms.saude.gov.br/bvs/saudelegis/gm/2004/prt2197_14_10_2004.html
bvsms.saude.gov.br/bvs/saudelegis/gm/200...

25 Brasil. Portaria no 1.028, de 1o de julho de 2005. Determina que as ações que visam à redução de danos sociais e à saúde, decorrentes do uso de produtos, substâncias ou drogas que causem dependência, sejam reguladas por esta Portaria [Internet]; 2005. [citado 2021 Fev 15]. Disponível em: bvsms.saude.gov.br/bvs/saudelegis/gm/2005/prt1028_01_07_2005.html
bvsms.saude.gov.br/bvs/saudelegis/gm/200...

26 Brasil. Lei no 11.343, de 23 de agosto de 2006. Institui o Sistema Nacional de Políticas Públicas sobre Drogas - Sisnad; prescreve medidas para prevenção do uso indevido, atenção e reinserção social de usuários e dependentes de drogas; estabelece normas para repressão à produção não autorizada e ao tráfico ilícito de drogas; define crimes e dá outras providências [Internet]; 2006. [citado 2021 Fev 15]. Disponível em: www.planalto.gov.br/ccivil_03/_ato2004-2006/2006/lei/l11343.htm
www.planalto.gov.br/ccivil_03/_ato2004-2...

27 Brasil. Decreto no 6.117, de 22 de maio de 2007. Aprova a Política Nacional sobre o Álcool, dispõe sobre as medidas para redução do uso indevido de álcool e sua associação com a violência e criminalidade, e dá outras providências [Internet]; 2007. [citado 2021 Fev 15]. Disponível em: www.planalto.gov.br/ccivil_03/_ato2007-2010/2007/decreto/d6117.htm
www.planalto.gov.br/ccivil_03/_ato2007-2...

28 Brasil. Portaria no 1.190, de 4 de junho de 2009. Institui o Plano Emergencial de Ampliação do Acesso ao Tratamento e Prevenção em Álcool e outras Drogas no Sistema Único de Saúde - SUS (PEAD 2009-2010) e define suas diretrizes gerais, ações e metas [Internet]; 2009. [citado 2021 Fev 15]. Disponível em: bvsms.saude.gov.br/bvs/saudelegis/gm/2009/prt 1190_04_06_2009.html
bvsms.saude.gov.br/bvs/saudelegis/gm/200... ^-2929 Brasil. Portaria no 3.088, de 23 de dezembro de 2011. Institui a Rede de Atenção Psicossocial para pessoas com sofrimento ou transtorno mental e com necessidades decorrentes do uso de crack, álcool e outras drogas, no âmbito do Sistema Único de Saúde (SUS) [Internet]; 2011. [citado 2021 Fev 15]. Disponível em: bvsms.saude.gov.br/bvs/saudelegis/gm/2011/prt3088 _23_12_2011_rep.html
bvsms.saude.gov.br/bvs/saudelegis/gm/201... . However, the pressure for changes in drug policy also mobilized sectors aligned with the biomedical and legal-criminal models, culminating in paradoxes found in normative documents from 2000 to 2016⁴4 Teixeira MB, Ramôa ML, Engstrom E, Ribeiro JM. Tensões paradigmáticas nas políticas públicas sobre drogas: análise da legislação brasileira no período de 2000 a 2016. Cien Saude Colet 2017; 22(5):1455-1466.^,3030 Silva MB, Delduque MC. Patologização e penalização do uso de drogas: uma análise socioantropológica de proposições legislativas (2007-2010). Physis 2015; 25(1):231-250.. In this context, the anti-reform movement gets stronger from 2010 onwards and becomes more explicit from 2017 onwards, culminating in the pre-eminence of sectors aligned with the remanicomialization of mental health in Brazil at the federal level in the current situation²2 Guimarães TAA, Rosa LCS. A remanicomialização do cuidado em saúde mental no Brasil no período de 2010-2019: análise de uma conjuntura antirreformista. O Social em Questão 2019; 22(44):111-138..

In face of this scenario, this study aims to analyze the key elements evidenced from the study of the Law No. 13.840/2019 from the perspective of the Critical Discourse Analysis.

Methodology

This is a documentary research³¹31 Gil AC. Como elaborar projetos de pesquisa. São Paulo: Atlas; 2018. with a qualitative approach, which starts from the premise that the discourse presents a dialectical relationship with the social structure³²32 Bosi MLM, Macedo MA. Anotações sobre a análise crítica de discurso em pesquisas qualitativas no campo da saúde. Rev Bras Saude Matern Infant 2014; 14(4):423-432.. In this way, the discourse is influenced by the social structure as it also builds it, being able to reproduce or transform it³³33 Fairclough N. Discurso e mudança social. Brasília: Universidade de Brasília; 2016.^,3434 Fairclough N. A dialética do discurso. Rev Teias 2010; 11(22):225-234.. Thus, it can be understood that drug policies and conceptions about drug use are constructed from discourses that encompass complex mechanisms of power relations and ideological clashes, from which emerges the hegemony of certain discourses on other positions of resistance.

Drug use itself can be considered a socio-historical phenomenon, with implications for politics, the economy and health, as well as the different aspects of prohibitionism³⁵35 Minayo MCS, Deslandes SF. A complexidade das relações entre drogas, álcool e violência. Cad Saude Publica 1998; 14(1):35-42.

36 Carneiro H. Drogas: a história do proibicionismo. São Paulo: Autonomia Literária; 2018.^-3737 Carneiro H. Transformações do significado da palavra "droga": das especiarias coloniais ao proibicionismo contemporâneo. In: Venâncio RP, Carneiro H, organizadores. Álcool e drogas na história do Brasil. São Paulo: Alameda; 2005. p. 11-28.. Similarly, the therapeutic perspectives for people with needs by the use of alcohol and other drugs are also historical-social constructions, permeated by moralistic, judicializing, medicalizing, asylum-related, prohibitionist, anti-prohibitionist and psychosocial conceptions³3 Vargas AFM, Campos MM. A trajetória das políticas de saúde mental e de álcool e outras drogas no século XX. Cien Saude Colet 2019; 24(3):1041-1050.^,88 Santos GA, Queiroz IS. Internação psiquiátrica compulsória de usuários abusivos de drogas: uma falência ao SUS e um desuso da Política de Redução de Danos. Gerais Rev Saúde Pública do SUS/MG 2016; 4(1):59-69.

9 Bolonheis-Ramos RCM, Boarini ML. Comunidades terapêuticas: "novas" perspectivas e propostas higienistas. Hist Cienc Saude - Manguinhos 2015; 22(4):1231-1248.^-1010 Costa JF. História da psiquiatria no Brasil: um corte ideológico. Rio de Janeiro: Garamond; 2006.^,2222 Fiore M. A medicalização da questão do uso de drogas no Brasil: reflexões acerca de debates institucionais e jurídicos. In: Venâncio RP, Carneiro H, organizadores. Álcool e drogas na história do Brasil. São Paulo: Alameda; 2005. p. 257-290.^,3030 Silva MB, Delduque MC. Patologização e penalização do uso de drogas: uma análise socioantropológica de proposições legislativas (2007-2010). Physis 2015; 25(1):231-250.^,3838 Azevedo AO, Souza TP. Internação compulsória de pessoas em uso de drogas e a contrarreforma psiquiátrica brasileira. Physis 2017; 27(3):491-510.

39 Vargas D, Bittencourt MN, Rocha FM, Oliveira MAF. Representação social de enfermeiros de Centros de Atenção Psicossocial em Álcool e Drogas (CAPS AD) sobre o dependente químico. Esc Anna Nery 2013; 17(2):242-248.

40 Lacerda CB, Fuentes-Rojas M. Significados e sentidos atribuídos ao Centro de Atenção Psicossocial Álcool e outras Drogas (CAPS AD) por seus usuários: um estudo de caso. Interface (Botucatu) 2017; 21(61):363-72.

41 Perrone PAK. A comunidade terapêutica para recuperação da dependência do álcool e outras drogas no Brasil: mão ou contramão da reforma psiquiátrica? Cien Saude Colet 2014; 19(2):569-580.

42 Medeiros R. Construção social das drogas e do crack e as respostas institucionais e terapêuticas instituídas. Saude Soc 2014; 23(1):105-117.^-4343 Rezende MM. Modelos de análise do uso de drogas e de intervenção terapêutica: algumas considerações. Rev Biocienc 2008; 6(1):49-55..

We have chosen to analyze Law No. 13.840 because it changes several provisions of other drug policies in a context of change in the national political scenario. Furthermore, it inserts provisions that express a discontinuity in the scope of drug policies after the PRMB and AAM. The legal provisions analyzed in this article refer to the treatment of people with needs by the abusive use of alcohol and other drugs.

We start from Fairclough’s three-dimensional framework³³33 Fairclough N. Discurso e mudança social. Brasília: Universidade de Brasília; 2016., which belongs to the field of social science and critical research⁴⁴44 Chouliaraki L, Fairclough N. Discourse in late modernity: rethinking critical discourse analysis. Edinburgh: Edinburgh University Press; 1999. and complies with the Critical Discourse Analysis (CDA) from the understanding of the constructive effect of the discourse, which is shaped by the relations of power and ideologies⁴⁵45 Magalhães I. Introdução: a análise de discurso crítica. DELTA Doc Estud em Linguística Teórica e Apl 2005; 21(spe):1-9.. For this reason, the discourse is able to build: a) social identities and the position of subjects (identity function); b) social relationships between people (relational function); and c) belief and knowledge systems (ideational function). The dimensions analyzed are the following: text (vocabulary, grammar, cohesion and textual structure); discourse practice (force, coherence and intertextuality); and social practice (ideology and hegemony). There is no fixed procedure for carrying out the analysis, and it is possible that one of the dimensions or categories will be highlighted depending on the discourse genre.

In this study, the Law No. 13.840/2019 was read and the most relevant legal provisions were transcribed for the study of the discourse change incited by the document, namely: clauses 23-A, 23-B and 26-A. The text referring to the legal provisions was transcribed and read exhaustively. The statements were highlighted with different colors, whether they represented a discourse change or not, having as reference the drug policies after the PRMB and MAA. Relevant expressions were also highlighted when representing a discourse change.

The text analysis took into account the meaning of the words and the textual structure, that is, the way the legal provisions were grouped. As noted, several legal provisions analyzed are gathered in the same chapter, whose theme encompasses prevention, care and social reintegration of drug users and dependents.

As for the analysis of the meaning of the words, their use in other drug policies or normative health documents was taken into account. This continuity in normative documents concerns a characteristic of the discourse practice. We chose to use quotation marks to highlight words and/or expressions cited ipsi litteris in the document analyzed, since this is a relevant element for the method of analysis used.

The dimension of the discourse practice involves the production, distribution and consumption mechanisms of the texts, which vary according to the discourse genre of the material analyzed. The categories included in this dimension are force, coherence and intertextuality³³33 Fairclough N. Discurso e mudança social. Brasília: Universidade de Brasília; 2016.. We took into consideration the compliance of the Law No. 13.840 with other normative documents that are part of the drug policy, including continuities and ruptures (manifest intertextuality). However, we also sought to identify the veiled relationship between the discourse produced in the document and other discursive orders (interdiscursivity). Thus, it becomes necessary to analyze for whom the devices make sense, with their continuities and ruptures (coherence). Furthermore, the Law No. 13.840 was taken into account as it is a normative document, calls for compliance with its provisions as a rule, and is therefore essentially imperative (force).

The analysis of social practice encompasses the broader dimension of the discourse. We started from the premise that every discourse is ideological, as it produces a way to conceive reality. In this sense, discourses are produced through the negotiation of alliances (hegemony). Thus, the context in which the Law No. 13,840 emerged was taken into account. As it is a normative document, it is subject to approval at different levels, in this case, in the Legislative (Chamber and Senate) and Executive powers (Federal Government). This process takes place in a specific context, including alliances and modifications in view of the approval of the document.

This study does not require approval by the Research Ethics Committee, according to the Resolution CNS/MS No. 466/12, since it does not involve human beings and because the documents used are available in the public domain.

Results

The textual structure of the Law No. 13,840 gathers the legal provisions which refer to the involuntary hospitalization of “drug addicts”, the Individual Care Plan and the “welcoming” in the “Reception Therapeutic Community”, respectively, in Sections IV, V and VI of Chapter II of Title III, which addresses the prevention, care and social reintegration of drug users and dependents.

Another element of the text that stands out is the vocabulary. The words used can generate insecurity in the execution of the policy, as they give rise to different interpretations by the players who are in the assistance services, be they managers or professionals.

Item II of paragraph no. 5, Section 23-A, for example, states that involuntary hospitalization “will be indicated after the evaluation of the type of drug used, the pattern of use and in the proven hypothesis of the impossibility of using other therapeutic alternatives provided for in the health care system”. It is stated in the paragraph six of the same section, that “Admission, in any of its modalities, will only be indicated when extra hospital resources prove to be insufficient”. However, how to define precisely what is a “proven hypothesis” that other strategies in the psychosocial care system can be used, or that “extra hospital resources” are insufficient?

It can be considered that the document itself offers an answer to the previous question in item II of Section 23-A by stating that the treatment should “be guided by predefined technical protocols, based on scientific evidence, offering individualized care to the user or dependent of drugs through a preventive approach and, whenever indicated, through ambulatory care”. However, it can be said that this is a rhetorical appropriation of scientific evidence, considering that the document, in general, is opposed to community mental health care practices and acknowledgement of harm reduction strategies.

Section 23-B provides for the Individual Service Plan (ISP), which must be prepared based on a “prior evaluation by a multidisciplinary and multisectoral technical team”. The ISP shall consider “the objectives stated by the patient”; provide for “social integration or professional training activities”; “contemplate the participation of family members or guardians”, through “integration activities and family support” and “forms of family participation for effective compliance with the individual plan”; and establish “specific measures for the patient’s health care”. It is possible to observe successive references to an “individual plan”, “individualized therapeutic project”, “individualized care” or “individualized follow-up”, throughout the sections chosen for this analysis. Thus, it is possible to call into question whether such nomenclature is timely for the field of health care that advocates territorially-based network care⁴⁶46 Brasil. Saúde mental no SUS: os centros de atenção psicossocial. Brasília: Ministério da Saúde; 2004..

The characterization of the ISP, throughout the Law no. 13.840, shows similarities to what is conceived as a Singular Therapeutic Project (STP). A semantic shift can be observed as it seeks to establish a relationship of similarity between the two concepts whereas they are not similar. For this reason, it is necessary to critically ponder on the implicit intention when choosing a term different from the usual one in the literature and in the construction of policies within the scope of the UHS. Therefore, it becomes mandatory to highlight the distinction between a singular care proposition built collectively with the participation of users, professionals and family members, from another that proposes to be individual or individualized⁴⁷47 Pinto DM, Jorge MSB, Pinto AGA, Vasconcelos MGF, Cavalcante CM, Flores AZT, Andrade AS. Projeto terapêutico singular na produção do cuidado integral: uma construção coletiva. Texto Context Enferm 2011; 20(3):493-502..

Still within the scope of vocabulary analysis, Section 26-A, which legislates in relation to “welcoming” in the “Reception Therapeutic Community”, is characterized by a euphemism by using several words to soften the treatment in the Therapeutic Community (TC). Thus, the TC is described as “welcoming”, in which any form of “hospitalization” and “physical isolation” is prohibited, and it is stated that “adherence and permanence” must be voluntary, only with “prior medical evaluation” in a “residential environment” of “welcoming” and “conducive to the formation of bonds” as a “transitory stage”, aiming at “social reintegration”.

The construction of the TC identity is observed as a welcoming environment whose type of assistance provided is different from hospitalization. However, there is a great deal of evidence that refute this representation.⁹9 Bolonheis-Ramos RCM, Boarini ML. Comunidades terapêuticas: "novas" perspectivas e propostas higienistas. Hist Cienc Saude - Manguinhos 2015; 22(4):1231-1248.^,4848 IPEA. Nota técnica no 21: o perfil das comunidades terapêuticas brasileiras [Internet]; 2017. [citado 2021 Fev 15]. Disponível em: http://www.ipea.gov.br/portal/images/stories/PDFs/nota_tecnica/20170418_nt21.pdf
http://www.ipea.gov.br/portal/images/sto... . The care provided by the TC is anchored in a prohibitionist paradigm with emphasis on a moral approach, which reproduces elements of treatment combined with spirituality and individual and/or group psychotherapeutic approaches⁹9 Bolonheis-Ramos RCM, Boarini ML. Comunidades terapêuticas: "novas" perspectivas e propostas higienistas. Hist Cienc Saude - Manguinhos 2015; 22(4):1231-1248.^,4848 IPEA. Nota técnica no 21: o perfil das comunidades terapêuticas brasileiras [Internet]; 2017. [citado 2021 Fev 15]. Disponível em: http://www.ipea.gov.br/portal/images/stories/PDFs/nota_tecnica/20170418_nt21.pdf
http://www.ipea.gov.br/portal/images/sto... . Many question the effects of TC on the subjectivity of hospitalized people and their ability to achieve their objective: abstinence⁴⁹49 Pacheco LA, Scisleski A. Vivências em uma comunidade terapêutica. Rev Psicol Saude 2013; 5(2):165-173.^,5050 Raupp LM, Milnitisky-Sapiro C. A "reeducação" de adolescentes em uma comunidade terapêutica: o tratamento da drogadição em uma instituição religiosa. Psicol Teor e Pesq 2008; 24(3):361-368.. It is also pointed out the violation of human rights within the TC⁵¹51 CFP. Relatório da inspeção nacional em Comunidades Terapêuticas [Internet]; 2017. [citado 2021 Fev 15]. Disponível em: http://dx.doi.org/10.1016/j.tws.2012.02.007
http://dx.doi.org/10.1016/j.tws.2012.02.... .

The need for greater inspection, professionalization and scientific research in the TC is acknowledged even in studies that claim that this treatment model is not irreconcilable with public health policies and the assumptions of the PRMB and AAM⁴¹41 Perrone PAK. A comunidade terapêutica para recuperação da dependência do álcool e outras drogas no Brasil: mão ou contramão da reforma psiquiátrica? Cien Saude Colet 2014; 19(2):569-580.^,5252 Scaduto AA, Barbieri V, Santos MA. Adesão aos princípios da comunidade terapêutica e processo de mudança ao longo do tratamento. Psicol Cienc Prof 2015; 35(3):781-796.. The literature points out that the expansion of the TCs occurred due to the insufficiency of equipment bound for the UHS to deal with the care of people with needs by the use of alcohol and other drugs⁵³53 Ribeiro FML, Minayo MCS. As Comunidades Terapêuticas religiosas na recuperação de dependentes de drogas: o caso de Manguinhos, RJ, Brasil. Interface (Botucatu) 2015; 19(54):515-526.^,5454 Damas FB. Comunidades Terapêuticas no Brasil: expansão, institucionalização e relevância social. Rev Saude Publica St Catarina 2013; 6(1):50-65.. However, it is necessary to analyze this problem from the point of view of power disputes within the scope of drug policies. The investment in TC is already higher than that destined to the expansion of Psychosocial Care Centers for Alcohol and Other Drugs (CAPSad), reversing a recent trend of greater financing of territorial services instead of hospitals focused on mental health⁶6 Nunes MO, Lima Júnior JM, Portugal CM, Torrenté M. Reforma e contrarreforma psiquiátrica: análise de uma crise sociopolítica e sanitária a nível nacional e regional. Cien Saude Colet 2019; 24(12):4489-4498..

Although the operational logics of the CAPSad and TCs are different, the characteristics of temporary residential service for people with needs due to use of alcohol and other drugs assigned by Law No. 13.840/2019 to “reception therapeutic communities” are similar to those of the Reception Units proposition⁵⁵55 Brasil. Portaria no 121, de 25 de janeiro de 2012. Institui a Unidade de Acolhimento para pessoas com necessidades decorrentes do uso de crack, álcool e outras drogas (Unidade de Acolhimento), no componente de atenção residencial de caráter transitório da Rede de Atenção Psicossocial [Internet]; 2012. [citado 2021 Fev 15]. Disponível em:. http://bvsms.saude.gov.br/bvs/saudelegis/gm/2011/prt3088_23_12_2011_rep.html
http://bvsms.saude.gov.br/bvs/saudelegis... . Hence, the division of public resources between similar equipment is a complete nonsense. The practical repercussion of the emphasis on the TC in the document studied is that this still controversial modality will be privileged over a public policy built in line with the PRMB achievements.

As for the discourse practice, considering that the Law No. 13,840 is a normative document that guides the assistance to people with needs by the use of alcohol and other drugs, its provisions have an imperative character which, in turn, generates insecurities regarding its practical effects since it contradicts other documents that are part of the drug policy. Thus, it is convenient to explore the intertextuality of that law with other documents that are part of the drug policy.

The provisions referring to the involuntary hospitalization of “drug addicts”, the Individual Care Plan and the “welcoming” in the “Reception Therapeutic Community” are made up of elements from other drug policies and portray consensus and dissensus. Thus, the description of voluntary and involuntary hospitalization of “drug addicts” is similar to that used in the Psychiatric Reform Law, which provides for the rights of people with mental disorders and modifies the model of mental health care¹⁷17 Brasil. Lei no 10.216, de 6 de abril de 2001. Dispõe sobre a proteção e os direitos das pessoas portadoras de transtornos mentais e redireciona o modelo assistencial em saúde mental [Internet]; 2001. [citado 2021 Fev 15]. Disponível em: www.planalto.gov.br/ccivil_03/leis/leis_2001/l10216.htm
www.planalto.gov.br/ccivil_03/leis/leis_... .

However, when compared with the Ordinance No. 2,197²⁴24 Brasil. Portaria no 2.197, de 14 de outubro de 2004. Redefine e amplia a atenção integral para usuários de álcool e outras drogas, no âmbito do Sistema Único de Saúde - SUS, e dá outras providências [Internet]; 2004. [citado 2021 Fev 15]. Disponível em: bvsms.saude.gov.br/bvs/saudelegis/gm/2004/prt2197_14_10_2004.html
bvsms.saude.gov.br/bvs/saudelegis/gm/200... , which establishes the Comprehensive CarePolicy forusersofalcoholandother drugs (CCPUAD), it is noted that the maximum length of hospital stay for detoxification increased from 15 days to 90 days in the new document. The interchangeable use between the terms “drug user” and “drug dependent” in the article referring to the reception in TC contrasts with the principle of treating users, abusers, addicts and drug dealers²³23 Brasil. Decreto no 4.345, de 26 de agosto de 2002. Institui a Política Nacional Antidrogas e dá outras providências [Internet]; 2002. [citado 2021 Fev 15]. Disponível em: www.planalto.gov.br/ccivil_03/decreto/2002/D4345impressao.htm
www.planalto.gov.br/ccivil_03/decreto/20... in a different way²³23 Brasil. Decreto no 4.345, de 26 de agosto de 2002. Institui a Política Nacional Antidrogas e dá outras providências [Internet]; 2002. [citado 2021 Fev 15]. Disponível em: www.planalto.gov.br/ccivil_03/decreto/2002/D4345impressao.htm
www.planalto.gov.br/ccivil_03/decreto/20... , which was maintained in a subsequent document⁵⁶56 Brasil. Decreto no 9.761, de 11 de abril de 2019. Aprova a Política Nacional sobre Drogas [Internet]; 2019. [citado 2021 Fev 15]. Disponível em: www.planalto.gov.br/ccivil_03/_Ato2019-2022/2019/Decreto/D9761.htm#art4
www.planalto.gov.br/ccivil_03/_Ato2019-2... .

Furthermore, the STP, previously understood as the central axis of the logic of care²⁹29 Brasil. Portaria no 3.088, de 23 de dezembro de 2011. Institui a Rede de Atenção Psicossocial para pessoas com sofrimento ou transtorno mental e com necessidades decorrentes do uso de crack, álcool e outras drogas, no âmbito do Sistema Único de Saúde (SUS) [Internet]; 2011. [citado 2021 Fev 15]. Disponível em: bvsms.saude.gov.br/bvs/saudelegis/gm/2011/prt3088 _23_12_2011_rep.html
bvsms.saude.gov.br/bvs/saudelegis/gm/201... , was replaced by the ISP, similarly to what happens between the Reception Units²⁹29 Brasil. Portaria no 3.088, de 23 de dezembro de 2011. Institui a Rede de Atenção Psicossocial para pessoas com sofrimento ou transtorno mental e com necessidades decorrentes do uso de crack, álcool e outras drogas, no âmbito do Sistema Único de Saúde (SUS) [Internet]; 2011. [citado 2021 Fev 15]. Disponível em: bvsms.saude.gov.br/bvs/saudelegis/gm/2011/prt3088 _23_12_2011_rep.html
bvsms.saude.gov.br/bvs/saudelegis/gm/201... ^,5555 Brasil. Portaria no 121, de 25 de janeiro de 2012. Institui a Unidade de Acolhimento para pessoas com necessidades decorrentes do uso de crack, álcool e outras drogas (Unidade de Acolhimento), no componente de atenção residencial de caráter transitório da Rede de Atenção Psicossocial [Internet]; 2012. [citado 2021 Fev 15]. Disponível em:. http://bvsms.saude.gov.br/bvs/saudelegis/gm/2011/prt3088_23_12_2011_rep.html
http://bvsms.saude.gov.br/bvs/saudelegis... as a transitory residential service for people with needs by the use of alcohol and other drugs, and by “welcoming” TCs, and, eventually, abstinence is highlighted as a therapeutic objective over harm reduction²³23 Brasil. Decreto no 4.345, de 26 de agosto de 2002. Institui a Política Nacional Antidrogas e dá outras providências [Internet]; 2002. [citado 2021 Fev 15]. Disponível em: www.planalto.gov.br/ccivil_03/decreto/2002/D4345impressao.htm
www.planalto.gov.br/ccivil_03/decreto/20...

24 Brasil. Portaria no 2.197, de 14 de outubro de 2004. Redefine e amplia a atenção integral para usuários de álcool e outras drogas, no âmbito do Sistema Único de Saúde - SUS, e dá outras providências [Internet]; 2004. [citado 2021 Fev 15]. Disponível em: bvsms.saude.gov.br/bvs/saudelegis/gm/2004/prt2197_14_10_2004.html
bvsms.saude.gov.br/bvs/saudelegis/gm/200...

25 Brasil. Portaria no 1.028, de 1o de julho de 2005. Determina que as ações que visam à redução de danos sociais e à saúde, decorrentes do uso de produtos, substâncias ou drogas que causem dependência, sejam reguladas por esta Portaria [Internet]; 2005. [citado 2021 Fev 15]. Disponível em: bvsms.saude.gov.br/bvs/saudelegis/gm/2005/prt1028_01_07_2005.html
bvsms.saude.gov.br/bvs/saudelegis/gm/200...

26 Brasil. Lei no 11.343, de 23 de agosto de 2006. Institui o Sistema Nacional de Políticas Públicas sobre Drogas - Sisnad; prescreve medidas para prevenção do uso indevido, atenção e reinserção social de usuários e dependentes de drogas; estabelece normas para repressão à produção não autorizada e ao tráfico ilícito de drogas; define crimes e dá outras providências [Internet]; 2006. [citado 2021 Fev 15]. Disponível em: www.planalto.gov.br/ccivil_03/_ato2004-2006/2006/lei/l11343.htm
www.planalto.gov.br/ccivil_03/_ato2004-2...

27 Brasil. Decreto no 6.117, de 22 de maio de 2007. Aprova a Política Nacional sobre o Álcool, dispõe sobre as medidas para redução do uso indevido de álcool e sua associação com a violência e criminalidade, e dá outras providências [Internet]; 2007. [citado 2021 Fev 15]. Disponível em: www.planalto.gov.br/ccivil_03/_ato2007-2010/2007/decreto/d6117.htm
www.planalto.gov.br/ccivil_03/_ato2007-2...

28 Brasil. Portaria no 1.190, de 4 de junho de 2009. Institui o Plano Emergencial de Ampliação do Acesso ao Tratamento e Prevenção em Álcool e outras Drogas no Sistema Único de Saúde - SUS (PEAD 2009-2010) e define suas diretrizes gerais, ações e metas [Internet]; 2009. [citado 2021 Fev 15]. Disponível em: bvsms.saude.gov.br/bvs/saudelegis/gm/2009/prt 1190_04_06_2009.html
bvsms.saude.gov.br/bvs/saudelegis/gm/200... ^-2929 Brasil. Portaria no 3.088, de 23 de dezembro de 2011. Institui a Rede de Atenção Psicossocial para pessoas com sofrimento ou transtorno mental e com necessidades decorrentes do uso de crack, álcool e outras drogas, no âmbito do Sistema Único de Saúde (SUS) [Internet]; 2011. [citado 2021 Fev 15]. Disponível em: bvsms.saude.gov.br/bvs/saudelegis/gm/2011/prt3088 _23_12_2011_rep.html
bvsms.saude.gov.br/bvs/saudelegis/gm/201... .

Contradictions in drug policies are not exclusive to the Law No. 13,840. The dispute between the prohibitionist and anti-prohibitionist paradigms had already permeated the construction of drug policies between 2000 and 2016⁴4 Teixeira MB, Ramôa ML, Engstrom E, Ribeiro JM. Tensões paradigmáticas nas políticas públicas sobre drogas: análise da legislação brasileira no período de 2000 a 2016. Cien Saude Colet 2017; 22(5):1455-1466.. In addition, there are tensions, for example, between actions taken by the Ministry of Health and the National Department for Drug Policies at the time of the CCPUAD implementation¹1 Silva MAB, Abrahão AL. Política de atenção integral aos usuários de álcool e outras drogas: uma análise guiada por narrativas. Interface (Botucatu) 2020; 24:e190080.. Thus, the contradictions of the Law 13.840 manifested in its provisions make sense to the opponents of the PRMB and AAM²2 Guimarães TAA, Rosa LCS. A remanicomialização do cuidado em saúde mental no Brasil no período de 2010-2019: análise de uma conjuntura antirreformista. O Social em Questão 2019; 22(44):111-138. achievements, which reinforce the prohibitionist and asylum paradigm. The discourse constructed in the Law No. 13,840 is aimed at groups that benefit from the emphasis on an outpatient, hospital or TC treatment guided by a prohibitionist paradigm, since the document discourse is coherent for that audience.

The social practice of the studied document consists of a reproduction of forms of domination and control, as it echoes ideological elements aligned with those practices to the detriment of the psychosocial logic, such as involuntary hospitalization and the encouragement of having TCs as an instrument of control and domination¹⁹19 Costa-Rosa A. O modo psicossocial: um paradigma das práticas substitutivas ao modo asilar. In: Amarante P, organizador. Ensaios: subjetividade, saúde mental, sociedade. Rio de Janeiro: Fiocruz; 2000. p. 141-168.. Such resonance only became possible considering the current national political situation since the document was filed with the Chamber as the Bill of Law (BL) No. 7663 in 2010 and sent to the Senate as the House Bill (HB) No. 37 in 2013. Hence, it is understood that the emergence of the Law No. 13.840/2019 became possible in an anti-reform scenario that gained strength from 2010 onwards²2 Guimarães TAA, Rosa LCS. A remanicomialização do cuidado em saúde mental no Brasil no período de 2010-2019: análise de uma conjuntura antirreformista. O Social em Questão 2019; 22(44):111-138..

The discursive change as noted in the Law No. 13.840/2019 can be represented as the strengthening of the asylum and prohibitionist paradigm to the detriment of the PRMB and MAA achievements made positive in mental health and drug policies from 2001 onwards⁵⁷57 Montenegro YFL, Paixão AKR, Sales NCM, Brilhante AVM, Brasil CCP. A análise de discurso crítica no estudo de políticas públicas de saúde: exemplo a partir de mudanças na política sobre drogas no Brasil. NTQR 2020; 3:678-690.. The opening to the logic of HR, especially after the change in the political scenario in 2002²²22 Fiore M. A medicalização da questão do uso de drogas no Brasil: reflexões acerca de debates institucionais e jurídicos. In: Venâncio RP, Carneiro H, organizadores. Álcool e drogas na história do Brasil. São Paulo: Alameda; 2005. p. 257-290. and to the psychosocial care model has been constantly sabotaged by the counter-reformist opposition. We can highlight the gradual inclusion of TCs in public policies, the creation of moderate complexity outpatient care teams unrelated to territorial care, the expansion of funding for TCs and inpatient beds, including in psychiatric hospitals, the registration reduction in Psychosocial Care Centers - Alcohol and Drugs (CAPSad) and the disapproval regarding the HR²2 Guimarães TAA, Rosa LCS. A remanicomialização do cuidado em saúde mental no Brasil no período de 2010-2019: análise de uma conjuntura antirreformista. O Social em Questão 2019; 22(44):111-138.^,44 Teixeira MB, Ramôa ML, Engstrom E, Ribeiro JM. Tensões paradigmáticas nas políticas públicas sobre drogas: análise da legislação brasileira no período de 2000 a 2016. Cien Saude Colet 2017; 22(5):1455-1466.

5 Delgado PG. Reforma psiquiátrica: estratégias para resistir ao desmonte. Trab Educ e Saúde 2019;17(2):1-4.^-66 Nunes MO, Lima Júnior JM, Portugal CM, Torrenté M. Reforma e contrarreforma psiquiátrica: análise de uma crise sociopolítica e sanitária a nível nacional e regional. Cien Saude Colet 2019; 24(12):4489-4498.. The emphasis on pathologizing and moralizing models to the detriment of the psychosocial one is remarkable.

The Law No. 13.840/2019 emphasizes the treatment of alcohol and drug users in institutions such as hospitals or TCs in order to achieve abstinence at the expense of the CAPSad’s community and territorial treatment, the welcoming in Reception Units and the harm reduction under the premise of adopting measures based on scientific evidence instead of ideological and philosophical positions.

Comments as from Foucault

Considering the identity, relational and ideational functions of discourse³³33 Fairclough N. Discurso e mudança social. Brasília: Universidade de Brasília; 2016., we would like to discuss how power is manifested in the analyzed document, as well as its contribution to the production of knowledge and subjects. Therefore, we start from Foucault’s work, which describes different technologies of power that affect the production of knowledge, the disciplining of bodies (disciplinary power), the production of subjectivities (normalization) and life management and population control (biopower)¹⁵15 Candiotto C. Cuidado da vida e dispositivos de segurança: a atualidade da biopolítica. In: Branco GC, Veiga-Neto A, organizadores. Foucault: filosofia & política. São Paulo: Autêntica; 2011. p. 81-96.^,5858 Branco GC. Apresentação 1 - os nexos entre subjetividade e política. In: Branco GC, Veiga-Neto A, organizadores. Foucault: filosofia & política. São Paulo: Autêntica; 2011. p. 9-12.

59 Noguera-Ramírez CE. A governamentalidade nos cursos do professor Foucault. In: Branco GC, Veiga-Neto A, organizadores. Foucault: filosofia & política. São Paulo: Autêntica; 2011. p. 71-80.^-6060 Ferreirinha IMN, Raitz TR. As relações de poder em Michel Foucault: reflexões teóricas. Rev Adm Publica 2010; 44(2):367-383..

The Law No. 13,840 emphasizes the role of hospitals, through hospitalization, and of TCs, in the treatment of people with needs by the use of alcohol and other drugs. Both institutions are recognized as favorable places for the action of power over the bodies and subjectivity of individuals¹¹11 Amarante P. O homem e a serpente: outras histórias para a loucura e a psiquiatria. Rio de Janeiro: Fiocruz; 1996.^,4949 Pacheco LA, Scisleski A. Vivências em uma comunidade terapêutica. Rev Psicol Saude 2013; 5(2):165-173.^,6161 Fossi LB, Guareschi NMF. O modelo de tratamento das comunidades terapêuticas: práticas confessionais na conformação dos sujeitos. Estud Pesqui Psicol 2015; 15(1):94-115.. However, the reproduction of psychiatric knowledge is also observed in substitute services after the psychiatric reform ¹²12 Caponi S. Michel Foucault e a persistência do poder psiquiátrico. Cien Saude Colet 2009; 14(1):95-103.^,6262 Barbosa VFB, Martinhago F, Hoepfner AMS, Daré PK, Caponi SNC. O cuidado em saúde mental no Brasil: uma leitura a partir dos dispositivos de biopoder e biopolítica. Saude Debate 2016; 40(108):178-189.. In this context, power takes on broader contours and acts on a population which, according to the Foucaultian understanding on the matter, here refers to users of alcohol and other drugs, dependents or non-dependents. It acts, for example, in the pathologization of behaviors categorized as deviant¹³13 Rauter C, Peixoto PTC. Psiquiatria, saúde mental e biopoder: vida, controle e modulação no contemporâneo. Psicol em Estud 2009; 14(2):267-275.^,1414 Caponi S. Biopolítica e medicalização dos anormais. Physis 2009; 19(2):529-549., in the removal of homeless people, in the bureaucratization of care and in the segregation of care for people with needs by the use of alcohol and other drugs in specific facilities of the health care network, which contributes to their institutionalization⁶³63 Wandekoken K, Quintanilha B, Dalbello-Araujo M. Biopolítica na assistência aos usuários de álcool e outras drogas. Rev Subjetividades 2015; 15(3):389-397..

The impact of biopower on the population is based on the premise of survival. Hence, life management occurs through the State security devices in view of making live, which entails a dark side: letting die¹⁵15 Candiotto C. Cuidado da vida e dispositivos de segurança: a atualidade da biopolítica. In: Branco GC, Veiga-Neto A, organizadores. Foucault: filosofia & política. São Paulo: Autêntica; 2011. p. 81-96.. This means that some subjects are stripped of their rights and, consequently, excluded because they represent a threat to the survival of others. Thus, from the articulation of biopower with the theory of degeneration¹⁴14 Caponi S. Biopolítica e medicalização dos anormais. Physis 2009; 19(2):529-549., which is relevant to the constitution of psychiatric hospitals as a locus of psychiatric knowledge and an instrument of exclusion¹¹11 Amarante P. O homem e a serpente: outras histórias para a loucura e a psiquiatria. Rio de Janeiro: Fiocruz; 1996., it is possible to understand how the Law No. 13.840 favors the discrimination of people with needs by the use of alcohol and other drugs. It is somehow possible to consider that there is discrimination among the people with needs by the use of alcohol and other drugs themselves, making live those who desire and achieve abstinence and letting die those who would benefit from HR.

The provisions of the Law No. 13,840 analyzed here show a discursive shift in opposition to the PRMB. Thus, they interrupt a path constructed in view of the recognition of new subjects, their citizenship and autonomy, instead of being confined to disciplinary institutions or excluded from social life in favor of others⁶⁴64 Amarante P. Novos sujeitos, novos direitos: o debate em torno da reforma psiquiátrica. Cad Saude Publica 1995; 11(3):491-494.. Such shift becomes even more sensitive because the clashes in the execution of public policies did not allow for a consolidation of the psychiatric reform. Consider, for example, decision-making based on stereotypes produced from the conjunction of legal and psychiatric knowledge, associating treatment with disciplinary institutions and total abstinence even after the psychiatric reform⁶⁵65 Rosa PO, Pinto GSS. Quando a experiência é capturada pela representação: governamentalização das drogas na saúde e no sistema de justiça criminal. Interface (Botucatu) 2019; 23:e180103..

It can be observed how the discursive change has already been present in social practices from initiatives aimed at the hospitalization of people with needs by drug use without their consent⁶⁶66 Frazão F. Rio de Janeiro terá internação involuntária de usuários de drogas. R7 [Internet]; 2019. [citado 2021 Fev 15]. Disponível em: https://noticias.r7.com/rio-de-janeiro/rio-de-janeiro-tera-internacao-involuntaria-de-usuarios-de-drogas-09082019
https://noticias.r7.com/rio-de-janeiro/r...

67 G1 Rio. Perguntas e respostas sobre a internação de moradores de rua e dependentes químicos pela Prefeitura do Rio. Portal G1 [Internet]; 2019. [citado 2021 Fev 15]. Disponível em: https://g1.globo.com/rj/rio-de-janeiro/noticia/2019/08/05/perguntas-e-respostas-sobre-a-internacao-de-moradores-de-rua-e-dependentes-quimicos-pela-prefeitura-do-rio.ghtml
https://g1.globo.com/rj/rio-de-janeiro/n... ^-6868 Stochero PT. Após nova lei de drogas, prefeitura de SP avalia internação involuntária de dependentes químicos. Portal G1 [Internet]; 2019. [citado 2021 Fev 15]. Disponível em: https://g1.globo.com/sp/sao-paulo/noticia/2019/06/06/apos-nova-lei-de-drogas-prefeitura-de-sp-avalia-internacao-involuntaria-de-dependentes-quimicos.ghtml
https://g1.globo.com/sp/sao-paulo/notici... . Therefore, it is worth considering that the opening to the involuntary hospitalization of “drug addicts” strengthens practices that deprive these people of making decisions about their own life, under the justification that “they lost control over themselves”, in order to make another population live.

Final considerations

The results show how the discourses of the Law No. 13.840/2019 are in line with the hygienist paradigm and reproduce paradigmatic disputes within the scope of drug policies and normalizing the trend towards re-institutionalization of mental health care. It is noteworthy that the provisions related to involuntary hospitalization and reception in therapeutic communities threaten the achievements of the PRMB, such as the consideration for human rights and citizenship of the population assisted in the context of mental health policies.

It should be noted that this study does not intend to analyze the Law No. 13.840 in its entirety, nor to condemn the document itself. The analysis of devices that point to social control in limiting social participation in the structure of the drug council, for example, will be carried out at another time.

References

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History