what they do and why they are in the sights of PSOL

Therapeutic communities for the treatment of chemical dependents are in the sights of left-wing movements, such as PSOL, the party that made up the coalition of president-elect Luiz Inácio Lula da Silva (PT). A report produced by the party and suggestions from the transition team recommended the suspension of around 200 norms produced by the government of President Jair Bolsonaro (PL) that benefit these organizations.

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Among the norms that would be modified or abolished is the decree on the National Policy on Drugs (Decree n. 9,761, of April 11, 2019) of the Bolsonaro government, which favors drug abstinence strategies as one of the ways to reduce social problems , economic and health. This guideline is in line with the actions of therapeutic communities and against the policies of leftist parties in relation to drugs.

For PSOL, support for abstinence and rehabilitation communities would be a “remarkable disservice to the population”, even more so with the presence of religious in some of these organizations in the fight against drugs. The party also accuses these organizations of violating human rights, since, for the socialist party, labor therapy would be “overexploitation of the work of the user population”.

The PSOL, like representatives of other leftist parties, has already positioned itself in favor of the legalization of marijuana, not only for medicinal use, but also for recreational use.

What are therapeutic communities

Therapeutic communities (TCs) are private, non-profit entities that welcome people with chemical dependence or other addictions, in a transitory residential regime and on a voluntary basis. The reception period can vary from 3 to 12 months, depending on the methodology of each project. CTs are not part of the Unified Health System (SUS) and the Unified Social Assistance System (SUAS).

One of the characteristics of TCs is to make the chemical dependent completely interrupt the consumption of alcohol and other drugs, that is, the abstinence model. And it is this form of work that is the target of left-wing movements. On the other hand, in general, leftists defend the harm reduction model, with the attempt to minimize the damage caused by drugs, or even to reduce their consumption, but without necessarily ceasing to use them.

According to the Executive Director of the Brazilian Federation of Therapeutic Communities (Febract), Ricardo Valente, it is estimated that there are around 5,000 therapeutic communities in Brazil. He explained that these institutions began to emerge in the 1950s as a proposal to transform the hospital model into a residential one, where dependents could take care of themselves, maintain a healthy environment and live with other people.

Of these entities, many are linked to some religious movement. Ricardo recalls that this characteristic is not decisive for evaluating public policy: the essential thing is to analyze the effectiveness of the program adopted and that every person is respected regardless of the religion he or she professes. “Spirituality is a support tool. Faith is always good, but drug addiction is not a religious problem. It must be understood from a biopsychosocial point of view”.

One of the communities that uses Christian values ​​to help drug addicts is Fazenda da Esperança. This community has been operating for 40 years and was founded by Friar Hans Stapel. Today there are 160 halfway houses spread across 25 countries with a total of 4,000 people being served. In the houses there are also the medical team and volunteers who help the organization.

The community’s method of action is work, spirituality and fraternal life. The host proposal is for a maximum of one year. “The person decides to go, knows the methodology beforehand and accepts it. This is the differential of the therapeutic community. The person freely decides to live the proposal of the house”, explained the general president of Fazenda da Esperança, Father José Luiz de Menezes. The organization welcomes drug addicts, alcohol addicts, gambling addicts and people with depression.

After the person has voluntarily decided to go through the addiction recovery process in the community, the addict must follow the entity’s routine. This routine has a time to wake up, meals, prayers, sport, work and moments of sharing. For Father José Luiz, spirituality “rescues the meaning of life”. On the other hand, “work takes away from idleness and rescues the dignity of feeling useful”. “One of the consequences of addiction is the disruption of family and community bonds. So living together rebuilds the family bond and fraternal life,” he said.

The person responsible for the formation of another entity, the Bethânia Community, Daniel Amaral, stressed that another characteristic of therapeutic communities, in general, is that they do not serve so many people simultaneously, which makes it possible to offer personalized and individual treatment. “It’s a pedagogical way of tracking people’s time. A person’s experience is unique and unrepeatable, and it is necessary to look at each one individually”.

Criticism and challenges from communities

Despite success stories with drug addicts, the methodology of therapeutic communities is questioned not only by PSOL, but also by entities such as the Federal Council of Psychology. In 2017, the entity published the National Inspection Report on Therapeutic Communities, produced in partnership with the Federal Public Ministry. A group of 100 professionals carried out inspections in 28 establishments in the states of Goiás, Mato Grosso, Minas Gerais, Pará, Paraíba, Pernambuco, Rio de Janeiro, Rio Grande do Norte, Rondônia, Santa Catarina and São Paulo, in addition to the Federal District.

The text points out failures in therapeutic communities such as technical weaknesses of multidisciplinary teams, irregularities involving hospitalizations, alleged violations of religious freedom, evidence of professional ethical violations, absence or lack of infrastructure and problems in financial management.

Febract’s executive director, Ricardo Valente, says that some notes in the 2017 report are justified, but not all of them and do not occur in most institutions. For him, it is important to close entities that are not prepared, but to value those that bring tangible results. “You cannot, based on this report, think that every therapeutic community works that way (…) not all of them work that way,” he said.

Valente also pointed out that the federation is aware of these problems and that it tries to monitor them. The large number of institutions and problems in the legislation, according to him, make this work difficult.

“The legislation already has guidelines, but these guidelines leave gaps so that certain situations of disrespect for human rights and individual freedoms end up happening”, said Valente. “But the governments have made progress in trying to supervise and the Public Ministry has been working to close those places where there is no structure. But it is a challenge”, commented Valente.

Bolsonaro government and future PT

According to Ricardo Valente, during the Bolsonaro government, there was a significant increase in vacancies in therapeutic communities. “We invested a lot, it was an important public policy”. Before the Bolsonaro government, he reports, there were not so many investments in these entities. “The first vacancies came from the government of former President Dilma Rousseff, but with Bolsonaro this funding gained other formats”, he revealed.

Now, communities fear that, for ideological reasons, Lula’s government will harm all institutions, without separating the “wheat from the chaff” – and give up on the idea of ​​abstention, which contributes to the recovery of many drug addicts.

For Roselene Amora, founder of Comunidade Fonte de Misericórdia, many judge and criticize the work of therapeutic communities without knowing these organizations. According to her, the government cannot help all drug addicts and that the communities help to serve more people.

Daniel from Bethânia Community also highlighted the relevance of these organizations, even knowing that many people will not recover in these entities and will need clinics. “There are people who will not be able to do it alone, they will need a community to be able to recover. What public policy cannot do, therapeutic communities can help,” he said.

The director of Febract also stressed that these entities are not for everyone. Some methodologies – such as the abstinence method, criticized by PSOL – are for a specific audience. “But this is one device in a huge network of devices [para dependentes químicos]. The greater the offer of help, the more users benefit”.

For the next government, Valente hopes that public funding will continue for therapeutic communities, but not just with the distribution of resources. “We hope that they offer qualification programs for attention and care for the individual. And that they make a financing program with planning, execution and evaluation so that the institutions work with an ethical and technical structure. So that the result can occur in a dignified and respectful way, ”he highlighted.