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SÃO PAULO – State prosecutors are investigating the involuntary hospitalization of crack addicts by São Paulo’s municipal government. The policy, implemented in April, has been criticized by members of the clergy who work with the homeless in Brazil’s largest city.
At least 28 people have been hospitalized without their consent over the past two months, ever since mayor Ricardo Nunes decided to apply a 2019 federal law which allows such measures. The forced treatment, which involves a full detox for 90 days at a city hospital, must be previously authorized by family members or by a government health care agent.
The program has been one of Nunes’s plans to deal with “Crackland,” an area in the central part of the city where hundreds of drug addicts spend days and nights doing drugs. Over the past three decades, city officials have tried a number of different approaches to tackle the problem, from police repression to harm reduction policies. None have succeeded.
Nunes’s strategy also includes police operations. Since April, when the Crackland addicts suddenly moved from their historical location to a nearby square, city police have used force to keep them from wandering across a larger area.
On several occasions, addicts were attacked by policemen and forced to leave an area – as they escaped, they would rob passersby, break windows, and invade shops. During one such chaotic scene in May, a drug addict was shot dead by unknown men.
The violence and general disturbances connected to Crackland since its formation in the 1990s has led many of São Paulo’s citizens to support harsh policies against crack addicts. Indeed, part of the local media has celebrated Nunes’s involuntary hospitalization program as a promising way of solving the longtime problem. But those who work with the addicts have been criticizing the plan.
“It’s unethical and inhumane,” said Father Júlio Lancellotti, the Archdiocese of São Paulo’s vicar for the homeless and a longtime human rights advocate.
People who have been involuntarily hospitalized have often discussed their experience with Lancellotti in his parish, where he serves hundreds of hot meals every day for the homeless.
“They tell me horrible things about the drugs administered at the hospital and their effects. A person once said: ‘I used to be addicted to one illicit substance and now I am addicted to eight legal drugs’,” the priest told Crux.
Lancellotti said that people feel powerless with the sedatives they are forced to take – and some called them a kind of “chemical handcuff.”
“They lose their will and discernment, defecate and urinate in their clothes, and lose libido. All kinds of side effects emerge,” he said.
After the treatment, most of the patients get back to the streets and to crack, “and its effects become even worse,” Lancellotti added.
“That is not an opinion based on ideology or religious values. I heard many of them telling me those things. They would say things like: ‘Our pains are many. Medicines will not solve some of them’,” he said.
Lancellotti said that a much more humane way of dealing with such a complex situation has been advocated by Missão Belém (Mission Bethlehem), a Catholic group founded in São Paulo by Italian-born Father Gianpietro Carrara in 2005.
“It is a totally different concept, one that does not involve medicines nor involuntary hospitalization,” he said.
With the goal of “being a family for the ones who do not have one,” Mission Bethlehem welcomes about 50 drug addicts every day.
“They come spontaneously to us. Over 17 years, we have welcomed 130,000 people. Nobody has ever joined us in a compulsory way. That would not be possible, because we propose a spiritual experience, and not a medical-therapeutic one,” Carrara told Crux.
The drug users are sent to one of the Mission’s 180 houses and are accompanied by former addicts. They have a chance to rebuild their lives with the community’s support and constant prayer. No medicines are given to them during the process.
Carrara acknowledges that there are complex cases that may need extra care.
“Since 2005, we have taken 500 children out of the streets. But there was a 10-year-old kid who was completely dominated by crack. We could not help him. What should we do in a situation like that?”
He said that “the involuntary hospitalization of drug addicts is a very sensible issue which requires serious research and documentation” and should not be the object of spectacular media coverage.
“Crackland is the symbol of a society without values and spirituality. One needs to ask if our youth has the necessary ‘fuel’ to live, if our society is healthy and generates healthy people,” Carrara said.
Lancellotti said the way the city government deals with the issue “only holds accountable the drug users and fails to attack the deeper causes of the problem.”
“Those policies are established to please part of the public opinion. But they do not solve anything,” he said.