Harmful Use of Alcohol and Other Drugs: A Challenge for Brazilian Society
The harmful use of alcohol and other drugs is a topic that Brazilian society frequently discusses, but due to its breadth and complexity, it is also a subject that returns to the debate due to the depth of its causes and the severity of its effects, in addition to requiring a systematic and continuous approach.
Brazilian legislation deals with the issue of drugs, proposing actions of prevention, treatment and social reintegration that are required of federated entities whose execution requires social and community support. Such actions must be carried out by organizations in the areas of health, education, work, social assistance, social security, housing, culture, sports and leisure in order to prevent the use of drugs, attention and social reintegration of users or dependents of these substances. The dimension of the problem requires government leaders to promote efforts so that drug consumption is faced by all, but with respect for the fundamental rights of the human person, especially regarding their autonomy and freedom, observing the other principles of the National Drug System of Public Policies on Drugs (SISNAD), dealt with by article 4 of Law No. 11,343/2006, legislation whose text was amended by Law No. 13,840/2019.
If, on the one hand, drug use can and should be focused on by the government and society, on the other hand, when it comes to seeing the costs and specific effects of alcohol abuse, the drug with the highest prevalence of consumption compared to the others, the State and Brazilian society need to develop strategies and, mainly, to take effective actions to deal with this situation.
When dealing with the abusive use of alcohol and the health problems generated by it, it is usually thought sufficient to provide the population with medical and hospital resources, which are necessary to take care of the serious conditions of physical and mental health impairment that the problematic use of alcohol is capable of causing.
However, what will be discussed in these brief lines is how Brazilian society can face the problem of alcohol abuse before the situation triggers deleterious effects in the individual, family and social fields that demand specialized intervention from the health area, highlighting the need to control abuse and prevent the harmful use of alcohol.
To support this idea, there is scientific evidence extracted from a long-term study that dealt with alcohol consumption and effects in 195 countries, called "Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016 (1)". This study pointed out that alcohol control policies need to be reviewed worldwide, suggesting efforts to reduce the level of general consumption of this substance by the population.
For this, it is necessary to consider as a starting point that alcohol consumption in Brazil is a public health problem with repercussions on the lives of people and families. In addition to health, there are several other services and entities impacted. Professionals in the area of social assistance, public security and justice can generally describe situations known to them during the work that generated deaths, serious injuries and various losses whose determining factor or at least supporting factor for such occurrences was linked to the harmful use of alcohol.
In the field of health and observing the effects caused by alcohol on victims, a position in a litigation that anyone can occupy, under the coordination of the physician specialized in spinal cord trauma Júlia Maria D'Andréa (2) and funded by FAPESP, Brazil developed research pointing out that alcohol, a licit and cheap substance, increases the number of cases of violence in general. considering traumas and deaths in accidents and assaults. This study analyzed visits to the Emergency Room of the Hospital das Clínicas of the Medical School of the University of São Paulo and presented significant data that can serve as a basis for the adoption of public policies and strategies for alcohol control, indicating that 46% of the victims of aggression were under the influence of excessive doses of alcohol, as well as 24% of traffic victims and 20% of fall victims, also pointing out that 14% of those injured or assaulted had used marijuana, cocaine or amphetamines a few hours before the event.
It is common for the harmful results influenced by alcohol to be considered as unfortunate misfortunes, although they could be avoided if consistent environmental prevention practices were adopted for the harmful use of this substance by public agencies, at the various federal, state, district and municipal levels, driven by the pressure of society. These practices, in addition to preventing alcohol abuse, require regulating the supply and supervising consumption in public environments and open to the public in which alcohol is offered. Prohibiting the improper delivery of alcohol to children and adolescents and also educating, discouraging and making cases of excessive consumption of this substance among young people and adults responsible for the risks and possible damages, are desirable practices of environmental prevention.
Offering alcohol at points of sale located in places where consumption is risky, as occurs when it is tolerated to sell alcoholic beverages at gas stations and other environments frequented by drivers, such as parking lots and car repair shops, encourages drivers to leave these places under the influence of alcohol, regardless of whether they may be inspected for excessive drinking and driving. Because it is not imaginable that for every driver who passes through a place of this type and consumes alcohol there is an inspector ready to catch him.
Allowing or tolerating the sale of alcohol in areas with intense movement and agglomeration of people, such as soccer stadiums or environments where large open popular gatherings take place, such as the places where legitimate democratic demonstrations are held, can also be as harmful as tolerating that a driver incapacitated by alcohol abuse drives his vehicle on busy roads.
Developing strategies to implement environmental prevention actions requires a conscious and mobilized society that demands from those who have the power to regulate the creation of rules for this purpose, from maintaining and supervising the prohibition of alcohol for children and adolescents, to the allocation of sufficient budgetary resources for inspection to act regularly and effectively in risk environments, promoting respect for the rules.
Professor and researcher Zila Sanchez (3), from Unifesp, says that the strategies once employed to prevent tobacco in Brazil, such as not selling to minors, controlling sales and taxing rigorously, controlling advertising in the media and at points of sale, among others, would be very welcome to reduce the harmful effects of alcohol.
Who holds power is the authority and this authority is disseminated in society, in the exercise of private and public activity, and can be observed in love relationships involving parents and children, in the professional contact between employers and employees and in the respectful treatment between elected officials and citizens. Those who own and exploit the alcohol market cannot decide alone to whom, in what way and in which place they will sell their product only considering that the consumer can pay the price, but must always observe the rules and respect the legal limits. Free enterprise must be tirelessly preserved, however, in favor of the common good, the State must establish a minimum and clear regulation so that the distribution and sale of alcohol, which is a drug that causes known damage to health, obeys criteria and standards compatible with the risk of its consumption, maintaining a healthy environment.
There are encouraging examples in the world, as is the case in Russia (4). Considered one of the nations that consumes the most alcohol in the world, there was a success story to be followed by the use of long-term strategies, with the use of rigorous political reforms in the field of alcohol production and individual consumption that were able to reverse the devastating effects of this substance in this country, so much so that in 2018 the life expectancy of the Russian people reached a historic peak, reaching almost 68 years of age for men and 78 years for women, according to a WHO report that examined the effects of alcohol control measures on mortality and life expectancy in Russia.
Brazil is repeatedly cited as one of the countries in which inequality and social exclusion are intense and it is known that to reduce these ills it is necessary to offer quality education and generate means to produce income, but as a government and society they strive to achieve these goals that allow the inclusion of the entire Brazilian population from north to south of the country in movements that expand education and work generating well-being, The nation must organize and use environmental prevention strategies to face the challenge of alcohol and other drug abuse.
Text - Dr. Mário Sérgio Sobrinho
Mário Sérgio Sobrinho is a speaker and partner of the Freemind Mobilization, prosecutor of the MP-SP and member of the Movement of the Democratic Public Prosecutor's Office (MPD).
Source: https://www.conjur.com.br/2020-jan-20/mp-debate-uso-nocivo-alcool-outras-drogas-desafio-sociedade
[1] Available: <https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31310-2/fulltext>. Accessed on 14 Dec 2019.
[2] Available: <https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=2ahUKEwiEmIagnrXmAhV-JrkGHfvODsIQFjAAegQIAhAB&url=http%3A%2F%2Fses.sp.bvs.br%2Flildbi%2Fdocsonline%2Fget.php%3Fid%3D5089&usg=AOvVaw0dJ2KuXHpASFRTQPBBzCy3>. Accessed on 14 Dec. 2019
[3] Available: <https://www1.folha.uol.com.br/cotidiano/2017/07/1899157-mal-feita-prevencao-a-droga-pode-incentivar-o-consumo-diz-especialista.shtml>. Accessed on 14 Dec. 2019.
[4] "Russia's alcohol policy: a continuing success story." Available: <https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32265-2/fulltext>. Accessed on 14 Dec. 2019
