FROM OBJECT TO SUBJECT: ETHICS AND POLITICS IN CARE FOR DRUG USERS

Abstract

This article aims to analyze Brazil’s care policy for users of alcohol and other drugs, articulating the ethics of psychoanalysis and Harm Reduction (HR) strategies to understand the advances and setbacks of public policies in recent decades. By revisiting the history of the Psychiatric Reform and the establishment of the Psychosocial Care Network (RAPS), it demonstrates how the rise of Therapeutic Communities (TCs)—marked by moralizing, religious, and punitive practices—represents a return to the asylum-based model, with serious human rights violations supported by prohibitionist policies and State funding. In contrast, Harm Reduction, like psychoanalysis, proposes a non-universalizing approach, guided by case-by-case analysis and by the subject’s implication in their treatment, considering their choice of use, misuse, or abstinence. Thus, the article argues that any mental health, alcohol, and drug care must be guided by a commitment to listening to singularity, respecting human rights, and fostering territorial and community-based care. As a “not-all” policy, this perspective must be capable of including different modes of jouissance within the complexity of each subject’s relationship with drugs and their uses.

DOI: https://doi.org/10.56238/sevened2025.036-085