“(Des)capsula” AI! Tecendo a Gestão Autônoma da Medicação (GAM) em um Centro de Atenção Psicossocial Álcool e outras Drogas (CAPS AD) em Belém do Pará

Abstract

The Autonomous Medication Management (GAM) is a mental health care device that arrived in Brazil in 2009, through a multicenter research study among four public universities that joined forces to adapt, translate, study, and improve it, involving workers, families, and especially users of the mental health network in Brazil. GAM originated in one of the provinces of Canada, in Quebec, in 1990, through a participatory and collective process. Studying GAM in the Brazilian context for the first time, in an Amazonian region, highlights the importance of discussing a cabano territory that resonates in every person from Pará, experiencing and being affected in different ways. The objective of this Dissertation research was to implement the discussion of the Guide to Autonomous Medication Management for the first time in the North Region, with the State of Pará being the first state in the North to discuss this care device within the Psychosocial Care Network (RAPS). The research took place at a Type II Psychosocial Care Center for Alcohol and Other Drugs (CAPS AD II), located in the municipality of Belém, which has activities aimed at people who have problematic use of alcohol and other drugs, having the philosophy and practice of care based on the Harm Reduction policy. In the research, we used the methodological design of intervention research and, with collective mental health as a guide, we implemented this device collectively, with users, family members, workers, and management, using theoretical-conceptual tools such as field diary, observations, group work, and implication analysis, given that in the CAPS I held the position of worker and researcher. One of the analyses we brought to the field was the formulation of two theoretical categories: capsular and (de)capsular, which seemed important to us, as it implicated the theoretical knowledge field of the pharmaceutical being. The research was submitted to the Ethics and Research Committee and approved, with ethical opinion 80522524.0.0000.001. The intervention with the GAM guide device took place from May 2022 until the end of the research in July 2024, and divisions between user x worker x management x system were observed. In the results, we borrowed the song Princípia from Brazilian RAP artist Emicida to discuss the findings. The selected verses were "everything we have is us," "God, why is life so bitter in the land of sugarcane?", "silence the exhaustion, redo the bond, and offer a warm hug," "Peace is not built with bullets but I aim, facing my fragility," "the link is no longer lost, love is the secret to everything and I paint everything in yellow." We expanded the discussion of the GAM Guide to other social markers such as gender, race/color, sex, and territory, while discussing the effects of Necropolitics and the results of the 'war on drugs'.The pioneering work of GAM for the first time in the Amazon Region and in a territory 'outside asylums' was to legalize care in freedom. With GAM, we re-established the bond and (de)capsulated the system.