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

• Published in: The International journal of drug policy 2022-01, Vol.99, p.103466-103466, Article 103466
• Main Authors: Araujo, C.N.P., Corradi-Webster, Clarissa Mendonça
• Format: Article
• Language: English
• Subjects: Abstinence; Alcohol; Alcohol use; Autonomy; Brazil; Community-based programs; Drug abuse; Drug policy; Drug use; Drugs; Emotional support; Families & family life; Family; Health care; Health care industry; Human rights; Human rights violations; Humans; Interviews; Involuntary commitment; Involuntary treatment; Meaning; Medical personnel; Pharmaceutical Preparations; Punishment; Qualitative research; Relatives; Reorganization; Residential treatment; Substance abuse; Substance abuse treatment; Substance-Related Disorders; Treatment programs; Violations
• ISSN: 0955-3959; 1873-4758
• DOI: 10.1016/j.drugpo.2021.103466

In Brazil, regarding drug and alcohol treatment, there is an emphasis on financing long-term residential 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. 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. 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. This study highlights the importance of the need for public policies that expand evidence-based voluntary 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.