A randomized controlled trial was conducted in 2014 with 7th and 8th grade students from 72 public schools in 6 Brazilian cities. This trial aimed to evaluate the effects of an adapted European school-based drug prevention program Unplugged, called #Tamojunto in Brazil, which was implemented by the Ministry of Health as part of public policy. The experimental group (n = 3340) attended 12 classes in the #Tamojunto program, and the control group (n = 3318) did not receive a school prevention program. Baseline data were collected prior to program implementation, and follow-up data were collected 9 months later, allowing a matching of 4213 adolescents in both waves. The substances examined were alcohol, tobacco, marijuana, inhalants, cocaine, and crack. Multilevel analyses were used to evaluate the changes in consumption of each drug between time points and between groups. The intervention and control groups had similar baseline characteristics. The mean age of the adolescents was 12.5 ± 0.7 years, and 51.3% were female. The program seemed to increase alcohol use initiation (first alcohol use); students in the experimental group had a 30% increased risk of initiating alcohol use during the 9-month follow-up (aRR = 1.30, 95% confidence interval (95%CI) 1.13-1.49, p < 0.001) compared to the control group. The opposite was found for the first inhalant use: the risk of using inhalants for the first time after baseline was lower in the experimental group (aRR = 0.78, 95%CI 0.63-0.96, p = 0.021) than the control group. The results of the #Tamojunto program suggest that the content and lessons regarding alcohol may enhance curiosity about its use among adolescents. We suggest a re-evaluation of the expansion of the #Tamojunto program in schools while analyzing why the program's effects were inconsistent with those of previous European studies.

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This article refers to the research discussion based on methodology of content analysis, which aims at making explicit the horizon of rationality of the services provided for alcohol users and other drugs in the Great Florianópolis region, to contribute to the establishment of qualitative parameters in the evaluation of health services. It was verified that there is a hegemonic conception about the drugs dependence phenomenon as well as the way to intervene in this phenomenon, synthesis of different and, sometimes, contradictory rationalities. The model of this conception is based on the notion of disease, on the pursue for abstinence, on the struggle to control de addiction, operating medical-therapeutic and moral apparatus. On the basis of this conception, there is a subjectivist, moralist and psychopathologizing perspective, constituting a historical and not very critical view of the social production around the use of drugs, grounded on a rationality of metaphysical predominance, even when blended with other rationalities such as the scientific. In this article we will discuss the importance of correlating the "horizon of rationality" in the health services with the problematic of effectiveness and efficiency of treatments on the area of drugs dependency.

O momento é emblemático para as políticas públicas em saúde no Brasil, pois os novos modelos de atenção, que rompem com a lógica da psiquiatria tradicional, já estão implementados, mas sua legitimação e consistência teórico-metodológica precisam ainda ser consolidadas na práxis coletiva. Dessa forma, o objetivo deste estudo é estabelecer reflexões sobre as práticas nos novos dispositivos de atenção à saúde, como os CAPS - Álcool e Drogas e sua relação com as políticas realizadas pelo Ministério da Saúde. Sustentado em estudo do tipo exploratório descritivo, baseado na análise de 1122 prontuários do CAPSad da cidade de Blumenau-SC, nos anos de 2005 e 2007, o presente trabalho traçou o perfil dos usuários desse serviço. Utilizaram-se análises estatísticas univariadas e bivariadas. Estabeleceram-se discussões entre os dados obtidos e as proposições da Reforma Psiquiátrica.

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