Social Centers for People Who Use Drugs a Tantalizing Prospect in Brazil

May 18, 2023

On May 16, the Brazilian National Council of Human Rights (CNDH) issued an important recommendation—to the country’s ministries of Human Rights and Citizenship; Justice and Public Security; Health; Women; Racial Equality; and Social Development—with transformative potential for people who use drugs in Brazil.

Evoking the UN Declaration of Human Rights, the National Constitution of 1988, and a series of policies and laws enacted since the 1990s, the CNDH, a government collegial body, recommended the implementation and regulation of social centers (Centros de Convivência, which translates as Centers of Coexistence) aimed specifically at supporting people who use drugs.

If the ministries put the recommendation into practice, it will mark a decisive break from the previous governmnt’s policy.

Considering the status and political links of the CNDH, there is a reasonable chance that the recommendation will be carried forward with the support of the Ministry of Justice—or at least, without that ministry sabotaging its implementation.

If the ministries put the recommendation into practice, it will mark a decisive break from the previous governmnt’s policy—one that promoted commitment, including involuntary commitment in hospitals, for people who use drugs, breaching their human rights and seeking to impose total abstinence.

Social centers, instituted in 2009 and run by municipalities with support from the federal government, are cornerstones of Brazil’s Universal System of Social Assistance. They tend to be concentrated in urban areas, but are widespread. In the State of São Paulo, for instance, according to the latest numbers, there are over 2,500 Centros de Convivência. But not all are adequately funded.

In these centers, people in need—vulnerable families, unhoused people, and older citizens, for example—have access to social workers and other professionals who support them in accessing social benefits, offer advice on how to claim and access their rights, and refer them to services provided by other governmental institutions.

As the Portuguese name for them suggests, they are also coexistence spaces, where people who are going through or have experienced difficult situations can find support and advice from peers. Many of these centers promote community engagement activities and conversation sessions with peers and professionals.

Besides strengthening social bonds, and promoting well-being by providing nonjudgemental support and counseling, many of these centers also offer a range of courses for people to learn or develop skills that might help them to find jobs.

Such spaces, if dedicated to supporting people who use drugs—whether for enjoyment, self-medication or related to substance use disorder—have vast potential. They could work to promote harm reduction practices through education, dismantle stigmatization of drug use, foster positive social engagement, and empower people to make informed choices about their options, whether that looks like treatment or other paths.

Part of their strength is that they don’t focus just on drug use per se, but more broadly on bringing together community members.

Recognition of social centers’ ability to help people who use drugs is not new, even if successive governments’ policies have failed to realize the potential.

An ordinance issued by the Ministry of Health in 2011, in the first year of President Dilma Rousseff’s (Workers Party) tenure, highlighted how social centers can already, in practice, play a crucial role in promoting social inclusion for people who use substances like crack cocaine and alcohol. Part of their strength is that they don’t focus just on drug use per se, but more broadly on bringing together community members to socialize and embrace their differences.

Despite the prevalence of commitment for people who use drugs, the official national policy for people with mental health or substance use issues is grounded in deinstitutionalization and psychosocial care. Social centers play—or should play—a central role in the deinstitutionalization process. Signed during Rouseff’s presidency, it should be noted that this is a national policy rather than a party policy, and has been solidified through four national conferences on mental health. Social centers have seen widespread participation and won recognition from the Unified Health System (SUS)—something that the CNDH’s recommendation emphasized.

The implementation of social centers that explicitly welcome people who use drugs could be a game changer for vulnerable people neglected by the state and routinely victimized by law enforcement. It could pave the way for decriminalizing these citizens, addressing the root causes of problematic drug use, depathologizing it, and removing the involvement of the criminal-legal system.

This recommendation is startlingly welcome in the current political context, where the federal government sends ambiguous messages about its stance on, and commitment to, transforming policy and legislation in the wake of mass incarceration fueled by failed drug policies and laws.

By doing this, the federal government would finally be sending an unambiguous message that it wishes to treat people who use drugs as people.

That ambiguity has been typified, for instance, by the government reinstating the civil society presence on the national drug policy council—just a few months after granting institutional space for rehab entrepreneurs involved in the business of forced “treatment,” widely known for human rights violations.

Now, the expectation should be that in following CNDH’s recommendation, the current legislature revisits its position and ends the legitimacy of abusive “therapeutic communities,” which receive government funding and became synonymous with drug treatment in Brazil under far-right President Bolsonaro.

A bonus in making that move would be that it would free up federal funds—which could then be diverted to municipalities to implement the kind of social centers that would make so much difference for people who use drugs.

By doing so, the federal government would finally be sending an unambiguous message that it wishes to treat people who use drugs as people.

 


 

Photograph by Marco Verch Professional Photographer via Flickr/Creative Commons 2.0

Felipe Neis Araujo

Felipe is a Brazilian anthropologist. He's a criminology lecturer at the University of Manchester, where he researches drug policy, state violence, structural racism and reparations for historical inequalities. He lives in London.

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