The first Brazilian public policies directed at people who make use of alcohol and other drugs focused on criminalization and punishment. In 1932, medicine and its strategies of governmentality began to work within this field. The Penal Code of 1941 brought the ideal of abstinence to the Brazilian public arena, which was then broadly disseminated by the legislation up until 2006, when a new mental health policy began to be implemented for this population. In this chapter, we analyze the tensions between models that focus on care and those that have a safety perspective in programs for users of alcohol and other drugs in the central region of the city of São Paulo. We analyzed public domain documents: documentary material on the legal landmarks of policies; revision of literature; and news in Brazilian media about governmental actions in this area. Results of the analysis indicate that the tension between harm reduction models and the abstinence model persisted in governmental actions over the years. Regarding the central region, there was a diversification in the offer of treatment models and approaches. But these models took form as a market dispute: for sellable goods, employability of professionals, and the interests of the pharmaceutical industry.
Part of the book: Public Health