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Sustainable Development Goals
03 Saúde e Bem-EstarCollections
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THE QUEST TO EXTEND HEALTH SERVICES TO VULNERABLE SUBSTANCE USERS IN RIO DE JANEIRO, BRAZIL IN THE CONTEXT OF AN UNFOLDING ECONOMIC CRISIS
Substance abuse services
Universal health
Crack-cocaine
Mental health services
Affilliation
Johns Hopkins Bloomberg School of Public Health. Department of Mental Health. Baltimore, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Mental Health. Baltimore, USA.
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Johns Hopkins Bloomberg School of Public Health. Department of Mental Health. Baltimore, USA.
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Abstract
Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation’s most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care.
Keywords
Marginalized groupsSubstance abuse services
Universal health
Crack-cocaine
Mental health services
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