Drugs, in Italy from SanPa to today everything has changed: only politics has remained immobile

The times of SanPa are far away, those of chains, of consumption in the light of the sun, of the overdose count (1600 in 1996, 373 in 2019). That time in which the figure of the father-master, who in the absence of the state, was incarnated in Vincenzo Muccioli, founder of San Patrignano, was the only solution to “save those boys”. After forty years, the success of the Netflix series, directed by Cosima Spender and conceived by Gianluca Neri, demonstrates that there was an untold piece of Italian history that needed to be investigated and expiated, but which today seems to have disappeared from public discourse .

Sanpa, the hero and the heroine

«We should write a Bible on the epochal changes of the last twenty years: they concern traffic, production, consumption, approach. Everything has been trivialized: if you say that marijuana is as bad as heroin, the kids just understand that then heroin is not so bad. The first thing to say, and that it worked in the 90s, is that drugs are not all the same “, says Salvatore Giancane, thirty years of experience in the public service, who tried to” summarize “the theme in over 400 pages (Heroin, Opioid Disease in the Digital Age, 2014). It refers to the law that regulates drugs today, the “Fini-Giovanardi” of 2006 which, having put soft and hard drugs on the same level and tightened penalties for simple consumers, caused an overcrowding of prisons, filled more with consumers than of drug traffickers.

“Most of the inmates have been drug addicts for thirty years now. It is convenient to treat them as drug dealers, but they are people who first started using and then selling », adds Giancane. Suffice it to say that the drug addicted inmates present in prison at the end of 2019 were 16,934, equal to 28% of the prison population. The “war on drugs”, as Don Gallo said, often turns into a war on people.

The shortcomings of politics
The world of drugs is a world that changes quickly and should be monitored continuously. For this, by law, a National Conference on Drugs is foreseen which should meet every three years, but which has not been convened for twelve. The last important meeting was held in Genoa in 2000, it launched innovations especially on new drugs and the world of the night. On that occasion the then Minister of Health, Sandro Veronesi, had proposed to experiment with the legalization of cannabis. It remained unheard.

Vincenzo Muccioli, the prophet of populism

Without the will of politics to take steps forward, the road is tortuous: “On the left it is a divisive argument, on the right everything is summed up with a” no to drugs “which means everything and nothing: the question is no longer whether drugs they do good or bad, but how to regulate the interventions ”, explains Claudio Cippitelli, sociologist, former president of the National Coordination of New Drugs (CNND) and founding member of the Parsec Association of Rome. «We need a joint participation: health care environment and services, but also police and justice forces. Drugs cannot be eradicated, but the health and social pathologies associated with them can be tackled ”, he adds.

The absence of a common political line creates large territorial distinctions: alongside virtuous regions, where excellence is often given by the will of those at the head of that service, there are others where abandonment and confusion reign: ” If heroin addicts are no longer seen, it is because there is a great deal of work in the services, but the responsibilities of politics are enormous ”, explains Giancane. Title V, with health in the hands of the regions, then gave the final blow: «The SerT had their power in responding to a Ministry. Today some regions have inserted the SerTs in the Department of Psychiatry, which has nothing to do with it, others in primary care, while some have an Addiction Department. Harm reduction is in Lea (essential assistance recognized by SSN, ed), but little is done and it is written only to make a good impression ».

There are 562 public services for addiction, located in 603 outpatient locations. There are 6,624 operators, for each of which almost 21 users are in charge. To these are added private social, associations and voluntary work. 64% are in primary use of heroin and 21% of cocaine.

The heroin survivors
Consumption has changed since Muccioli’s time: young people today are often multi-consumers and less problematic, unlike heroin veterans, who make up the majority of those assisted by public services. In 2019 there were 136,320 users in charge of the SerT, the average age of users is 41 years, progressively aging: 58% are over 39 years old, compared to 11% in 1999.

“Everything has changed since the 1990s, especially for the health of consumers”, recalls Lorenzo Camoletto, in the Abele group since ’94, in the highlight of heroin, when dozens died of HIV in the communities: “In Europe, heroin users he is 42 years old on average. He was once much younger and it was unthinkable to turn 50. Now there are many “survivors” to that wave. We mostly follow the over 50s ». What is missing is a specific response for this age group, where the demand is now more health-related than linked to inclusion in the community.

Most of the veterans of that time are immunosuppressed, HIV positive, with hepatitis or problems related to decades of consumption. “Let’s stop saying that everyone can heal. There are chronic toxicants, that is, long-lasting: if a person has 25 years of use, continuous relapses, five years of community: what do we call it?”, Giancane relaunches. And there is a debate on the situation of the communities: «There are 18-19 thousand places available, but less than half are occupied – explains Camoletto – The truth is that the access thresholds have been lowered, despite this the communities are empty. It is a model to be completely revised. Harm reduction is applicable to everyone, but drug free, as SanPa wanted, does not necessarily have to be the main objective “.

The “junkie” today
The approach to new consumers also requires new rules. Heroin is no longer, at least not as before, a substance that bends those who use it and pushes the margins of society. It has settled and found a home in the lives of people, who manage their own consumption, alternate substances, or change their use according to the situation. Today the drug is often recreational: heroin is used at the end of raves, to lower the effect of exciters, but also performance at work, such as smoked heroin. To think of dealing with these differences with the methods of SanPa, without distinction, would be a failure.

“You graduate your use according to need: methamphetamines, for example, collapsed with covid, in the absence of raves – explains Cippitelli – The societal diffusion of cocaine, on the other hand, is so vast that we need to think about more approaches, not to a single answer. We must keep in mind: “a person, a substance, a context” ». For this reason, the distinction between drugs is fundamental, it allows us to admit that the “drug addict” does not exist as a granite figure to be treated with a single method.

«We need to get out of the stigma of the drug addict: a being stripped of personality, who has no identity, if not that of the user. This has created the wrong culture of generalizing about drugs ”, explains Alessio Guidotti, president of ItaNPUD, the Italian network of people who use drugs. «SanPa illustrated this vision well: the addict as a moral evil that had to be treated, that vice of“ saving our children ”, still present today in many communities. But what other disease is tolerated that is treated in this way? Franco Basaglia has managed to overturn the vision of mental illness, with substances it seems impossible ».

For this reason, many consumers would like to be part of the discussion around drugs and have their say on dedicated services which, they complain, with the excuse of anonymity, do not take into account people’s feedback: for this reason the ItaNPUD has drawn up “Nothing about us, without us”, a charter of the rights of people who use substances, supported by many associations and SerT.

Chambers of consumption and legalization
And as often happens, one looks abroad, where the consumption rooms are a historical reality in many countries: «They are an urgency, but they are blocked only by ideology. In Zurich they are located in the city center, among the rich banks, we prefer the basement, the degradation », Cippitelli says. In Turin, “the little room of Collegno”, an innovative experiment in this sense, has been closed.

“Thanks to the rooms, relationships are opened between consumers and health workers: perhaps you want to change consumption, decrease it or suspend it for a short period”. In these places, substance analysis is also done: to study the market and the ways in which drugs are cut, which can sometimes be lethal. “It would guarantee a right to health for all, which does not mean encouraging use”. Like therapeutic heroin in Switzerland, given in special cases to avoid marginalization and discomfort.

On the other hand, a discourse on the complete liberalization of drugs seems impossible. Many service operators would agree, albeit with the certainty of finding themselves with new problems to face. “International conventions prevent a speech of complete liberalization in Europe and Italy, but we must push for total decriminalization: anything that can put the consumer in a position to go to jail must be eliminated”.

Another theme is that of the liberalization of cannabis, a discourse often relaunched on our pages. Today the use of marijuana is allowed in Canada, Spain and in some states in the US, while the speech in Italy is at a standstill in Parliament. The draft law for recreational use, carried out by the Radicals, is also supported by the president of the National Anti-corruption Authority, Raffaele Cantone, who sees it as a solution to remove trafficking from organized crime. Studies show that where consumption is allowed, there is no exponential increase in use.

«Legalizing soft drugs would take away space for the mafias. The rules are out of date “

“How do we explain to the boys the absolute tolerance to alcohol and then the grim war on cannabis?”, Adds Cippitelli who deals with this, but has no freedom to talk about liberalization in his meetings with young people: “It could be done better prevention, distinguishing cannabis from the rest. The pusher sells both hemp, amphetamine and cocaine, and we know that most of the overdoses concern young people. ‘ In 2019, only 50% of higher education institutions implemented specific prevention interventions on psychoactive consumption.

Source: L'Espresso – News, inchieste e approfondimenti Espresso by espresso.repubblica.it.

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