E-health, psychoactive drugs and attention psychosocial the perspective of users

In the last decade there has been an expansion in the number of people who use online social networks as well as in the number of people who abuse psychoactive drugs. Given this, the article aims to identify the difficulties encountered by users of psychoactive drugs to start the treatment of addiction and to evaluate the use of online social networks as a tool to attract users. The theme of the study reveals the importance of the internet and social networks when the objective is to reach the patient in his natural environment and to promote tools capable of motivating him to actions capable of improving his life and well-being.

pointed out that 8.9% of the disease burden results from the abusive consumption of psychoactive substances (Medeiros, 2013(.This contributes so that it can be defined as a public health problem, which culminates in the need to develop health policies focused on the treatment of users. The use of psychoactive drugs has existed since the beginning of human history, in practically all cultures and social classes1, although it is not known for sure when it was first used.The dependence on these psychoactive drugs can be understood as a change in brain function when there is prolonged use on the human organism (WHO, 2002).Some of the reasons encourage or restrict drug use, as some commonly cited: curiosity; the desire for transcendence; the search for immortality, for pleasure, for wisdom; family habits; the culture, rituals and customs of the community (Soares 2020).
In the last decade, it was possible to observe a major change in the modalities of care for mental health patients, this change was called psychiatric reform.
From the psychiatric reform, it was possible to observe the insertion of psychoactive drug users as mental health patients, and their treatment is now carried out by specific Psychosocial Care Centers (CAPS-ad).
Another important event in the last decade has been the growth in the use of social networks by individuals in different age groups and social classes (Body, 2015).
The reasons that lead people to look for social networks are several, such as: entertainment, social support, communication, claiming their rights, obtaining information related to health and well-being and support for health issues (Tisott, 2019).
Online social networks, since their appearance, have attracted millions of people who integrate them in their daily activities.According to Boyd & Ellison (2015), online social networks can be defined as systems that allow to build an identity (personal profile), interact and promote public exposure.Since the popularization of so-called smartphones, it has become even easier for individuals to adhere to the use of the most diverse social networks existing today.As examples, we can mention: Facebook, Twitter and Instagram.
In view of the above, the article aims to identify the difficulties encountered by users of psychoactive drugs to start the treatment of addiction and evaluate the use of online social networks as a tool to attract users.

Methodology
This is a descriptive study, with a qualitative approach.Considering the role of the internet and its social networks, as important vehicles for the dissemination of information, which can be used as mechanisms for tele-education in health (del Castilho, 2020), the scenario of the study was a group created by the authors on the social network Facebook entitled Ficar Livre das Drogas (FLD).The social network Facebook was chosen because it is the online social network that has the largest number of users since the beginning of the 21st century (Benevuto, 2012).
The study subjects were users of psychoactive drugs participating in the basic project for this study, residents of the city of Rio de Janeiro, who have access to the internet and sought help voluntarily, accessing the FLD page.When requesting his participation in the group (via social network -FLD page), he receives information about the research and is informed that by accepting his inclusion in the group, he agrees to participate in the research and with the information contained in the Free and Informed Consent Form (IC).
The inclusion criteria adopted were: psychoactive drug users, residing in the city of Rio de Janeiro, who have access to the internet and sought help voluntarily, accessing the Ficar Livre das Drogas (FLD) social network page.
Data collection was carried out through a semi-structured questionnaire adapted from the McGill MINI Narrative of Illness, this is a questionnaire model used in research of meaning and ways of narrating the experience of illness.This instrument was translated into Portuguese and used in the Brazilian context for patients with psychiatric problems and cancer (Lean, 2016).
The flow of recruiting users to carry out the interviews was done at random, as they entered the FLD group in order to request assistance to start their treatment and participation in the study occurred in 4 stages, namely: Stage 1 -User searches for treatment for psychoactive drugs on the social network facebook, locates the page and requests to participate in it.In this stage the Informed Consent Form is also available.Step 2 -Contact of the researcher with the user to pass on information about the study, as well as regarding the treatment modalities and the places available for treatment.Step 3 -The user chooses the CAPS-ad to start his treatment and then he is given the necessary information so that he can start the treatment.
After data collection, the interviews were organized in tables and, subsequently, were grouped according to the existing similarities in order to form categories to analyze their contents.
The research was submitted to and approved by the Research Ethics Committee under registration CAAE 43137815.0.0000.5282,and follows the required ethical principles.

Results and Discussion
The total of 20 patients who returned the interview in a period of four months.Of these, three were male and 17 female.These data are in line with the publication released by the Ministry of Health.This clarifies that women are more concerned with issues related to their health and well-being (Quittkat, 2019), which culminates in the greatest number of women in the health units.
The floating and group readings carried out to analyze the narratives, it was possible to observe the existence of nuclei of meanings and divergences.Thus, it was possible to identify the following categories, namely: When we analyze the gender of the subjects participating in the study in relation to the consumption of psychoactive drugs, we realize that the data collected go against the Brazilian Report on Drugs, released in 2021 by the National Drug Policy Secretariat.This describes that men have greater use and greater dependence on psychoactive drugs than women in all age groups (Brasil, 2021), trying to keep in mind that in our study the number of women asking for help is greater than the number of men.However, even men with a higher consumption of substances, their presence in treatment programs is still less than women, as can be seen in our study and in other health programs offered by MS.Thus, it is clear that women are more concerned with issues related to their health and well-being, while for many men, care is not seen as a routine practice.
Furthermore, in many of the cases in the case of male patients, the recognition of the need for health assistance may reflect a negative impact on their masculinity (Quittkat, 2019).

Category 1 -Difficulties encountered in welcoming
The interviews showed that patients are volatile, that is, they want treatment one time and not the next.It is noteworthy that this is a common characteristic presented by users of CAPS-ad, a unit specialized in the treatment of users with disorders resulting from the use of psychoactive drugs.However, through fluctuating reading and group discussions about the responses of the interviewees, we realized that in the speech of many of them, we can observe the difficulty found in the CAPS-ad units to perform the welcoming.
Most of our interviewees had their reception performed differently than recommended.Many of them reported that when they entered the unit, they were attended by professionals who, instead of prioritizing understanding what was happening to the person, made the appointment to start treatment on another day and time, without clarifying this procedure, as we can see in the speak below.
Interviewee 6 -"I was attended by the receptionist, I was even a little disappointed, because I thought I would be attended on the same day."Interviewee 11 -"As soon as I arrived at the hospital that you indicated to me, I was attended by the girl at the reception who repeated all the information you gave and then marked the day of my appointment with the doctor".
Interviewee 12 -"The hospital receptionist who attended me and made my appointment for the next Wednesday".
It is also interesting to highlight that it was possible to observe the difficulty that the interviewees presented in identifying the category of the professional who performed their initial care.However, the speeches suggest that the reception was performed at the reception, and may even have been performed by a professional from the administrative sector.
Interviewee 3 -"Who answered me was the lady who was at the door, working on the computer." What is important for the patient is the identification of the professional who is assisting him, thus transforming the more humanized care, which can facilitate the link between patient and service, according to the Ministry of Health, at

Humaniza SUS [Official Public Health System]:
The patient's right to be identified by name, to know who is attending him, what are the procedures to which he will be submitted.To be informed about their health status, about the diagnostic and therapeutic actions, what can result from them, the duration of the treatment, the location of their pathology, if there is a need for anesthesia, which instruments are to be used and which regions of the body will be affected by the procedures.To consent or refuse procedures or treatments (Brazil, 2010).Thus, we understand that identification is not only intended to strengthen the bonds between professional and patient, but is also a right achieved by patients and guaranteed by Brazilian legislation.It should also be noted that this policy values the right to listen and to dialogue, issues that did not seem to occur in the aforementioned cases.

Category 2 -Credibility in the service and treatment offered
The Brazilian mental health policy is relatively new, its creation dates back to 2001, after the psychiatric reform.
However, this assistance model has been integrated into SUS since 1990, with the creation of the SUS Organic Law (LEI 8080/90) (Brazil, 1990).In a report presented by the Ministry of Health regarding the opinion of Brazilians about SUS, they point out that health is the problem most experienced by Brazilians (Brazil, 2003).
These data are reinforced in our research that showed that many patients are still unaware that disorders resulting from the abuse of psychoactive drugs as a public health problem, and what are the treatment modalities offered by the CAPS-ad.
Statements 7 and 13 represent this reality:

Interviewee 7 -I don't know the treatment, so I don't know if it can work. Interviewee 13 -It is very difficult to answer this question, how can I know if the treatment will work, if at least I know what type of treatment it is.
However, users, even though they are unaware of the treatments provided by the CAPS-ad, believe in the treatment patterns offered by SUS.Research, Society and Development, v. 12, n. 5, e2812541408, 2023 (CC BY 4.0)  Some users link the success of the treatment not only to the existence of SUS and its services offered, but also to the existence of an inner or superior force that collaborates to improve the presented picture.Therefore, the ability to seek treatment can also be supported by the spirituality of each individual.This is confirmed by Oliveira (2020) who point out that spirituality involves the human search for the meaning of life.Research shows that when patients are heard and can demonstrate how their abusive consumption of psychoactive drugs has affected their lives, this contributes to the link with the service established by the emergence of a spiritual link.
Interviewee 1 -Yes, because all treatments offered by hospitals, work even more when the person forces you.
Interviewee 6 -I have faith that the treatment will work.
This increase in inner strength, in the individual's spirituality, is pointed out by Backes (2012), as an essential and extremely important factor for the treatment of addiction to illicit psychoactive drugs, as they have a great aggregating, encouraging, and dynamic, capable factor to support the individual throughout treatment.It is noted that the professional's respect for the patient's belief represents a respect for diversity and the legality of belonging to a secular country, as constitutionally recommended.
Another important factor observed in our study related to credibility in the service and / or the treatment offered, is that in addition to being linked to the individual's spirituality, it can also be linked to their social networks, and how members of their group answered similar questions previously experienced.
Interviewee 3 -I think the treatment will work well, I know some friends who have done the treatment elsewhere and are doing well The individual's social networks are structures capable of increasing their relationship with others and facilitating the sharing of values and objectives.Thus, the existence of a member in the group who has previously been successful in some treatment for drug addiction, will facilitate the adherence of other members of the group to treatments with the same objective, considering that it was possible to observe success and improvement in people that are around you (Tracy, 2016).
Category 3 -Communication and information Law 8080 of 1990, which provides for the creation and functioning of SUS in its Chapter II, article 7, deals with 13 principles and guidelines of SUS, among which we can highlight: VI -disclosure of information regarding the potential of health services and their use by the user (Brazil, 1990).
The disclosure of information to the user becomes important, since it makes the user aware of the services and treatment modalities offered by the various health institutions present in the SUS and consequently helps to improve the situation presented.
In a publication made by Pense SUS of the Oswaldo Cruz Foundation (FIOCRUZ) in 2015, it states that access to health information is a fundamental factor to reduce inequities and promote social transformations necessary for the quality of life and more democratic well-being of the populations (Fiocruz, 2015).Also according to FioCruz (2015) communicating is not only communicating through the media what is good in the system, as well as not just assembling and offering a database.Communicate in health and provide devices to strengthen the relationship in three dimensions: patient, health professional and health institutions.Research, Society and Development, v. 12, n. 5, e2812541408, 2023 (CC BY 4.0)  The statements described above make us think that difficulties in communication are factors capable of making it difficult for patients to get started with treatment, since many are unaware of the existence of the service.
Improving health information and communication should be seen as a way to improve the public health system and improve the participation of citizens in that system.

Final Considerations
The theme of the study reveals the importance of Internet and online social networks when the objective is to reach the patient in his natural environment and to promote tools capable of motivating him to actions capable of improving his life and well-being, such as the psychoactive drug users mentioned in the study, since these, after the information given by the FLD group, visited the CAPS-ad chosen to start the treatment.
The analysis of the data shows that the number of women that the number of women who seek help through social networks is higher than the number of men, which makes us think about the need to intensify the measures aimed at men's health, in order to increase your participation in issues related to your health.
The difficulties encountered by patients in the reception performed at the CAPS-ad were described, and how these difficulties impact the uptake of patients using psychoactive drugs to initiate treatment.Improving the form of reception, that is, offering the assistance of the health professional right on the first visit, could contribute to increase the rate of adherence to anti-drug therapies.
Another important element observed in the study is communication and health information, this becomes important, since it has the power to narrow the patients, health team and health institutions, so that they collaborate so that the patient is aware of the treatment modalities offered by the different health units.
The study made us realize that the individual's social networks and his "inner strength" are important factors regarding his search and adherence in treatment programs for abusive consumption and psychoactive drugs.
The limitations of the study are based on the fact that the study subjects are limited to only those who have access to Internet and social networks, because in this way, subjects who do not have access to the Internet and who are not familiar with online social networks are excluded, in order to make it difficult to locate the page created.
We consider the study to be relevant, due to the impact it may have on the practice of health professionals in the CAPS-ad and on the daily lives of patients, especially in the transformation of their lives.
| ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v12i5.414086 However, it is still possible to observe the existence of barriers in communication, which can be evidenced in the statements below: Interviewee 7 -I don't know the treatment, so I don't know if it can work.