Redução de danos no cuidado às pessoas em situação de rua na atenção primária: potencialidades e desafios

Abstract

Harm Reduction is a set of policies and practices whose objective is to mitigate biopsychosocial damage associated with the use of psychoactive substances in people who do not want, cannot or do not provide for their use. Among its competencies, this strategy is used to guide care for the homeless population, through practices that aim to minimize the risks and damages related to drug consumption, respecting the principles of subject autonomy and considering social, cultural determinants and economic beyond consumption. This study aims to identify the potentialities and challenges for the care of homeless people from the perspective of Harm Reduction in the Street Clinic teams, with the guiding question being “What are the potentialities and challenges for the care of homeless people? from the perspective of Harm Reduction?”. This is an exploratory-descriptive and comprehensive research with a qualitative approach. The study setting was the capital of Alagoas, Maceió. 21 professionals from Street Clinic participated in this research. The information was produced using the focus group technique. The treatment and interpretation of information were developed with reference to the thematic analysis method proposed by Minayo. The study was submitted to the Research Ethics Committee of the Federal University of Alagoas and approved with opinion number 5.501.153. The results were organized and systematized into two thematic categories, namely: Potentials of work from a Harm Reduction perspective and Challenges for implementing care from a Harm Reduction perspective. Among the potentialities, soft technologies emerged, mostly, such as bonding and therapeutic embracement and subject autonomy. Harm Reduction was also cited as promoting quality of life by reducing use and abuse, creating new possibilities and life perspectives. In soft technologies, guidance, conversation, listening and exchange of knowledge stand out, workshops, lectures, conversation circles and art, and finally, the use of hard technologies such as water and honey. The challenges are: lack of permanent education, lack of inputs and training, difficulties in accepting and preparing professionals to recognize and implement Harm Reduction actions, high demand and overload of services, weakened public policies and lack of intersectoral articulation. Carrying out this study made it possible to understand the topic of Harm Reduction from the perspective of Street Clinic professionals. The concepts and knowledge articulated here elucidate how the ethical-clinical-political paradigm of Harm Reduction is associated with the perspective of “Living Work”, evolving the hegemony of light technologies in the technical composition of work. The study has the potential to contribute to health services in favor of work processes that focus on caring for the person, providing subsidies that enable the appropriation of work for humanized practice, promoting bonding and autonomy to the subject, as recommended by the National Humanization Policy.