Meanings constructed by family members about coerced treatment for alcohol and drug use in Brazil

International Journal of Drug Policy(2022)

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摘要
Background: In Brazil, regarding drug and alcohol treatment, there is an emphasis on financing long-term resi-dential treatment and a lack of community-based approaches, leading to a burden on families. Therefore, family members increasingly seek coerced treatment even though there are reports of human rights violations in this context. This study aims to describe the meanings constructed by family members regarding coerced treatment of people who use alcohol and other drugs. Methods: We conducted 15 interviews with the family members of people who use alcohol and other drugs and had requested coerced treatment. The interviews were recorded, transcribed and analyzed using reflexive thematic analysis. Results: Through analysis, five major themes regarding the use of coerced treatment were constructed: (1) as protection for people from the dangers related to the use of alcohol and other drugs; (2) as punishment, aiming to prevent the return to drug use; (3) as a guarantee of abstinence; (4) as a consequence of the loss of autonomy to decide what was best for themselves; and (5) as time for the reorganization of the family members' lives. The lack of emotional support in relation to their concerns regarding the health and safety of the person using drugs, the prohibitionist discourse and the emphasis on abstinence shared in the decision to seek coerced treatment, and the lack of knowledge about voluntary treatments contributed to family members requesting coerced treatment more than once. Conclusion: This study highlights the importance of the need for public policies that expand evidence-based volun-tary approaches, especially community-based services, and promote the disclosure of these services to eliminate coerced treatment. Health care providers should support the feelings of family members and provide guidelines related to other treatment options, making families feel genuinely included as partners in the care of people who use drugs.
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关键词
Substance-related disorders,Involuntary treatment,Involuntary commitment,Family,Qualitative research,Brazil
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