San Patrignano is a residential drug rehabilitation centre located in the northern part of Italy, just a few kilometres from Rimini and the tiny republic of San Marino. It began as the vision of one man, my father Vincenzo, who suddenly changed his life and decided to commit himself in the fight against the rising drug addiction in our local community. He started by welcoming a young drug addict into our family and home; at present, our community is the largest drug rehabilitation centre in Europe with its 1,800 guests. Since its foundation in 1978, it has taken in over 18,000 young people, rehabilitating and reintegrating them into society in absolutely drug-free conditions. During these 25 years, the community has grown constantly and currently occupies an area of almost 620 acres. It has all the on-site services and structures necessary for the life of a small town with a population of almost 2,000. From a medical-health centre specializing in the treatment of pathologies connected with drug addiction and in research on HIV infection, to 50 job training sectors in which each and every one of the young people in the community can learn the professional skills necessary for their return to society and normal life. To a kindergarten and structures for the education of the approximately 150 sons and daughters of San Patrignano's guests and staff, to sports and leisure time facilities. There's also a village with 60 cottages at the disposal of families - parents and children - who've gone through drug addiction. In fact, the community also takes in addicted couples with children, offering them the opportunity of reconstructing their family life during the rehabilitation period. The majority of the approximately 180 staff and volunteers working in our centre, of whom 90 have left drug addiction behind them, live in the community, thus ensuring their constant presence 24 hours a day all year round. Since 1978, our mission has been taking in and recovering marginalized people and drug addicts without any discrimination of a social, political or religious nature, nor as far as nationality and geographical origin are concerned.

Hundreds of our guests come from jail and more than 3,000 "prison years" have been avoided and turned into recovery programs as an alternative to prison, giving them a possibility of social reintegration. We don't have any selection procedure with the admission requests we receive. The only condition we lay down to whoever asks us for help is a real desire to face and overcome drug addiction. We don't have a preset therapeutic scheme that people have to adapt to. We believe that in the DNA of life, each and every life, even the most desperate and difficult, there's a code of singularity or diversity. Taking in a new guest means establishing a relationship considering the singularity of the person's lifestyle. Drug addiction is the result of a gap in the growth of someone's character and behaviour, something which can be different for every single individual and which needs a specific care case to case. This is why our programme, which is ranged between three and four years, doesn't foresee rigid therapeutic steps or those with precise deadlines.

We have always offered all these services completely free of charge. Nobody pays at San Patrignano. Neither young people nor their families nor public institutions. Thanks to the productive activities of its three social cooperatives - with a workforce of approximately 200 - the community itself procures approximately 50% of the financial resources necessary to support community life. These resources are integrated by a further 50% from private donations. From this point of view, I think our community is a model of social service which doesn't weigh on society or on private finances, but which rather becomes the protagonist of a virtuous circle in which, on one hand gives a free service to whoever needs it and, on the other, produces goods and economic resources whose results extend beyond the limits of the community, involving society as a whole. I think this is an important aspect, since in the Western world some of the models of welfare society we've used until now are in crisis and we have to face the enormous problem of how to set up social services in numerous parts of the world that are combating every day with conditions of absolute poverty or lack of resources. Precisely for this attention to what's happening around us, not only in Europe, and because we are convinced that drug addiction is a global problem regarding the whole planet, we've always interacted closely with rehabilitation workers throughout the world. In 1995, San Patrignano was one of the founders of the Rainbow International Association Against Drugs, a network that includes hundreds of communities and private associations worldwide. An association which enabled us to widen our perspective, allowed us to get to know other public and private rehabilitation organizations, acquire important experiences, verify the validity of our rehabilitation proposal and, above all, keep up to date and improve the quality of our work. Of course, this also enables us to make ourselves known to others. The staff of some of these communities has come on training courses to San Patrignano to study our approach and our methods.

Regarding this, by the end of the year, we'll publish a replication manual of the essential features of San Patrignano's proposal for rehabilitation. This publication is the result of a survey we underwent by Milan's Bocconi University, which analyzed our procedure and our therapeutic and practical logic with the aim of verifying the possibility of repeating our treatment's characteristics in situations outside Italy. In the last 15 years the community has also been subjected to other surveys, including the one we believe to be the most important: a serious follow-up research on the results of treatment at San Patrignano, carried out by the University of Bologna.
This project was carried out in 1993, enabling the researchers to examine a sample of 711 ex-guests of the community - a sample believed at that time to be representative of the universe of people who had passed through the community and had spent a continuous period of at least 14 months at San Patrignano. A minimum period necessary, according to the researchers, in order for people to be able to introject at least part of the community's therapeutic treatment and find a cause and effect link between the change in their lifestyle (a drug-free existence) with their stay at San Patrignano. No less than 72.6% of these people, met in 54 different towns after having left the community for at least 3 year, had a house, a job, a family and were no longer addicted to any substance.

Scientifically evaluated and validated results should constitute the basis of any serious consideration on the treatment of drug addiction and also help us to reply to another question: what drug addiction in fact is. In these years, thousands of people have arrived in San Patrignano having been diagnosed as being unrecoverable drug addicts. A diagnosis which turned out to be wrong: 25 years' hands-on experience has taught us that drug addiction isn't an illness, particularly a chronic recidivistic illness. We're not looking at a deviation or a genetic predisposition, an infection or a pathology that can be treated with medicine: we're dealing with the expression, the social and human evidence of personal difficulties. Drug addiction is the result of a break, an empty point in young people's formative and educational process, in which drugs enter, disrupting and stopping it. Having care of a drug addict should mean therefore to start this process off again, or often to start it from scratch. A long term residential drug free treatment centre is the most effective tool to face the problem of addiction, if and when, it turns to be an educational environment in which each young boy or girl picks up the maturity and growth process that drugs had interrupted.

On this matter, it is clear that treatment using pharmacological means fails if it's not used to overcome abstinence or as a medical tool with a view to starting a drug-free rehabilitation process, but as an instrument for containing the addiction and its social implications on a long term basis. Regarding this aspect, from the seventies through to the present day, medical science has periodically proposed new drugs for the treatment of heroin addiction. We went from morphine to physeptone, methadone, subotex and many other synthetic substances, each presented as the ultimate cure for opiate addiction. However, their use in my own country, in Europe and elsewhere in the world produced the same result: drug addiction was turned into a chronic condition. And chronic drug addiction undermines health and life. Replacing one addiction with another often means closing the door on future prospects and personal motivation, factors that are essential to bring about change. In this context, the absurd situation was reached when heroin controlled prescription programmes were introduced in order to fight heroine addiction! The results speak for themselves: none of the addicts enrolled in the programme decided to stop heroin use; in terms of successful rehabilitation, these programmes have produced the worst results, practically zero, since drug-addiction recovery studies began. Furthermore, drug abusers show an increase in the use of other mood-altering substances, drugs and alcohol. The only so-called positive outcome is the very high retention rates enjoyed by these programmes. In other words, we have discovered that if you give a heroin addict his daily dose of heroin, he will come back day after day, month after month, year after year. And most importantly, he will never ask you to stop giving him drugs, to help him learn to live without drugs. It is a result that I think needs no further comment.

It must be clear that, if we want to understand which are the most effective interventions and treatments against drug addiction, first of all we must consider the objective and the goals that the drug policies intend to achieve.
In some countries, particularly in Europe, the main objective of these policies is not a drug free lifestyle, and in this case it is clear that the alternative aim will only be the social control of the phenomenon and the chronicity of the addict.
But, as we believe, the objective must be the person's complete rehabilitation, we must understand which are the treatments to adopt, where and which are the best practices, therefore the highest numbers of recoveries and the lowest of relapses. Unfortunately, not many follow-up surveys have been carried out worldwide, specially in Europe. But everything that has been produced shows that full rehabilitation is possible and that long-term social/educational programmes are the most effective answers. Of course, the costs might be high.

Drug addiction's social costs are enormous. Every single drug addict involves his family in his or her drama. For each person taking drugs, we loose an inestimable wealth of participation and presence in our collective life. The costs for the health and welfare systems, already hard pressed throughout the world by the current economic situation, are increasing. At great expense, we're filling prisons with people who'll be unable to find any opportunity for freeing themselves from drugs there. And the latest synthetic drugs have worsened what was already a difficult scenario. As you know and according to most authoritative researches, MDMA and Ecstasy cause direct damage to people's nervous systems, preventing the production of dopamine and serotonin and causing psychiatric illnesses that are probably irreversible, facing us with the prospect of finding ourselves in the very near future with hundreds of thousands of young people that will have to be treated and assisted for life. And we can quantify the economic costs the society must face because of drug addiction. Chronic drug addicts will always have to be treated for life. Private and public services will spend thousands of euros for each person to maintain them in this situation, with a few possibilities of change. Long-term residential programs, even with extremely high quality standards in health and psychological care and educational and vocational training, cost an average of ten thousand euros per person per year, and after two, three or four treatment years, an average 30 to 73% of these people return to a drug-free life. Many of the addicts are kept uselessly in prison, costing the whole community hundreds of euros per day. On the contrary, implementing the possibility to introduce them to recovery programs as an alternative to prison, means financial savings for the whole community and, above all, gives freedom back to these people who lost it with drugs.

I'm talking about this challenging situation because we increasingly frequently receive urgent requests for help from all over the world, in particular from many Eastern European countries, also asking for indications on what to do when faced with the spread of drug addiction and how to help young people stop taking drugs.
We consider it our duty to offer our experience to whoever believes it could be put to use, and we must do this in a concrete effective manner, deciding together which is the most useful action for the people and the community. ECAD and similar organizations can play an extraordinarily important role in this process: coordinating and forming a network with the various countries' experience. And if, as I'm convinced, the objective should be drug addicts' complete rehabilitation, it is necessary to set up and monitor serious research programmes to find the best practices in drug rehabilitation and, above all, make them freely available to those countries that have an urgent need now. I've said on numerous occasions that our aim must be a person's complete rehabilitation and we are ready to commit our entire life to give more young people more opportunities to live a drug-free enjoyable life, no matter how long and hard the struggle will be.

Thank you!

 
 
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