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Health actions in the area of psychoactive substances remain a challenge for health workers. In Brazil, they face serious obstacles, and particularly resistance from users, who are entrenched behind pathogenic defensive systems—which becomes a source of suffering for these workers. Based on the clinical method in the psychodynamics of work, this paper analyzes the role of alcohol as a defensive ideology and seeks to reveal the Brazilian working dramaturgy, in which addiction to alcohol is not just a syndrome or an illness, but also a symptom and form of resistance. And if its syntax is not considered by a diagnosis that differentiates this form of resistance and alcoholism, followed by an action that is able to let the symptom speak, it will become very hard to overcome the retreat of our health policies.