Cuidados tecidos por mulheres que usam drogas: experiências e práticas sob um olhar feminista decolonial.

Abstract

Comprehensive care for people who use drugs involves several aspects, such as the history of use of a population, vulnerabilities that can produce this use, or arise from this use, and also the strategies formulated to deal with the issues raised by such use which can become a problem. In a systematic review carried out on treatment for drug use by women, results were found that point to the influence of social stigmas, judgmental attitudes of professionals and families and the importance of considering social and health needs through unique care. However, few studies highlight the fact that these women live in sexist societies and how gender, race and class influence drug use and treatment. Thus, the research that led to this thesis aimed to analyze the care experiences of women attended by a Psychosocial Care Center for users of alcohol and other drugs and the care practices accessed by them from a decolonial feminist perspective. To this end, ethnographic research was carried out, using the Life History method in combination with photographic records and Participant Observation, as well as a participatory method inspired by Enrique Pichon-Rivière's operative groups. In studying the experiences of the interlocutors, it was possible to observe that the care practices implemented were related to the family context, formal education, issues involving work and income, coexistence and sociability networks, religious institutions and health services. In relation to health services, we find a “CAPS centrality”, where the Psychosocial Care Centers (CAPS) appeared as the health service that centralizes care practices. By analyzing these practices and the life trajectories of the interlocutors, it was possible to see how gender, race and class, as well as other social markers related to sexual orientation, education and age, demarcated limits and possibilities in the construction of this care. Even in the face of such delimitations, it was possible to observe that the interlocutors build a kind of bricolage, where care practices with health professionals are articulated with other care practices that are built alongside their informal support networks. This combination of care practices has enabled interlocutors to manage their daily challenges with less suffering, reducing the need to resort to drug use as an anesthetic for life. Such results point to the importance of implementing and valuing decolonial practices in health services, such as promoting empowerment and building coalitions through mutual recognition, supporting the free exercise of religions, as well as the joint construction of other activities that take into account the matrices of oppression that permeate the lives of women, especially black women, and the need to produce autonomy with freedom and equity, against the coloniality of gender. Finally, I highlight the importance of building knowledge regarding the use of black and decolonial feminism perspectives within the field of Public Health. Such construction of knowledge is fundamental for mental health care, for the Brazilian Psychiatric Reform and for strengthening a struggle that can become anti-manicolonial.