DRUG POLICY AND IDEOLOGY

AN ITALIAN CASE

Giancarlo Arnao

THE SAN PATRIGNANO COMMUNITY

On September 20,1995 the main event for the Italian mass media was the death of Vincenzo Muccioli, founder and leader of San Patrignano, a therapeutic community (TC) for drug addicts. The main features of the San Patrignano community are.

• Between 2000 and 2500 inmates, and considered the biggest in Europe.
• Addicts are taken straight from the street, even during the withdrawal syndrome.
• Inmates under strict surveillance, i.e. physical barriers, guard dogs, night patrols, severe discipline.
• A hierarchical centralised structure, based on the 'charismatic authority' of the leader, Mr Muccioli.
• Inmates work in a very well-organised industrial system, which gives seemingly very good financial results.
• The turn over of the inmates is very slow; most of them stay in the community for more than 3 years.
• The success rate is unknown; a rough evaluation gives a rate not over 35%.
• It has never been monitored by health authorities.

Mr Muccioli was always an outspoken supporter of the hard-core prohibitionist approach. In fact, he intervened publicly not only in defence of his own 'model' of community, but also supporting any kind of repressive drug policy. The basic ideology of San Patrignano is that all drug users become addicts and all addicts die. People that go to San Patrignano are 'saved from death'; therefore, any means is permissible to save them from drugs.

The enemy number 1 of the San Patrignano ideology is methadone. In Italy methadone maintenance is practised by most of the public services (SERTs). The number of addicts assisted by SERT has increased dramatically in the last few years: from 38 000 in 1990 to 72 000 in 1994. This trend coincided with a decrease in mortality: from 1279 in 1991 to 840 in 1994 (Medico d'ltalia, 16 June 1995). The aversion of the San Patrignano model to methadone is motivated by the usual 'it's-just-another-drug'argument, but has another ideological aspect: being delivered by public services, methadone is identified with the costly and inefficient 'state' approach, compared with the efficient 'private' approach of San Patrignano. The ideology of 'privatisation' is nowadays prevalent in Italy, even among left wing politicians. The other big enemies are harm reduction and cannabis legalisation. According to the San Patrignano ideology, the main causes of the drug problems are 'permissive ideologies' of the 1960s and 1970s.

EVENTS IN 1984-95

Vincenzo Muccioli has deeply influenced Italian drug policy since the early 1980s, when Italy was ruled by a coalition of Christian Democrats and Socialists. At that time, many Italian politicians (mainly from the government, but also belonging to the opposition) publicly praised the 'San Patrignano model'; the mass media were almost unanimous in exalting Vincenzo Muccioli, 'the man who saved many young people from the drug death' . The 'war on drugs' was an important political issue. People were afraid of drugs: many Italian parents had a son or a daughter who was or could become an addict. The politicians wanted to let the people know that they were supporting this war. As Mr Muccioli was considered the most outspoken and active 'warrior', being on his side meant a sort of warranty of serious commitment in the 'Holy War'.

The enormous popularity of Muccioli was fully displayed in 1984, when he was tried for putting some addicts in chains. On this occasion, most of the newspapers and many important politicians and government representatives publicly took up his defence; he was finally acquitted. In March 1989, two inmates committed and a third attempted suicide on the same day within the Community. These episodes were reported by the media, but were not followed by a critical debate about the Community.

In the late 1980s, the Italian Government decided to issue a new drug law, based on the principle of sanctioning drug users. Within this task, Mr Muccioli was frequently consulted by politicians. In fact, the whole philosophy of the new law was based on the assumption that a resort to an authoritarian therapeutic community is the only answer to the problems of drug addiction, and the allegedly high effectiveness of the 'San Patrignano model' was considered as the unquestionable proof of this assumption. The law was approved by Parliament in June 1990.

In April 1989, the corpse of Mr Roberto Maranzano, inmate of the San Patrignano TC, was found in a garbage disposal near Naples (600 km south of the community); he had apparently been killed and his death was attributed to a drug market dispute. But 4 years later ( March 1993) some former inmates of the community confessed that Mr Maranzano had been killed in a punishment section of the community by another inmate, a 'guard'; the victim had been tortured and beaten to death for 2 days, and his corpse was carried away in a community-owned car; moreover, the medical examiner stated that Mr Maranzano had been injected with heroin while he was still alive. Mr Muccioli initially pretended to ignore the fact, then he admitted that he knew about the crime, but he didn't inform the police because he didn't want to scare the inmates of the community.

In the meantime, the Italian political scene changed abruptly. The general elections held in March 1994 were won by a coalition between the extreme right AN (Alleanza Naziormle), the moderate Lega Nord (federalist group), Forza Italia (new group headed by TV tycoon Silvio Berlusconi), and other parties, including the Marco Pannella Movement, a small group headed by Marco Pannella, who launched the anti prohibitionist movement in Italy in the early 1970s.

In October 1994 Muccioli was tried for the murder of Maranzano. During the trial many San Patrignano inmates or former inmates testified that the Community was ruled with a high level of violence. Moreover, it turned out that another inmate of the TC had committed suicide in 1992. In November 1994, Muccioli was found not guilty of murder but guilty of complicity in hiding the corpse of Maranzano, and was given a very light suspended sentence of 8 months in jail. During and after the trial, the CORA (anti prohibitionist organisation strictly bound to the Pannella Movement) issued a number of press releases, where it exposed the violent systems adopted by the staff of the community on the inmates, and requested the Government to dismiss Mr Muccioli immediately from the management of the community; it also complained that the San Patrignano inmates were forced to give their vote to politicians who were pleasing to Muccioli.

Nevertheless, the Vlth Annual CORA Conference took place at the premises of San Patrignano Community from 26 to 29 January 1995. During the Conference, Mr Pannella made a number of statements about the trial: he said that the death of Maranzano was a trivial accident, which could happen in any other therapeutic community, moreover, he denied that the San Patrignano community was based on violence- The behaviour of Mr Pannella was understandable, in the light of the general political situation.

Although, before the trial, the media were 95% favourable towards Muccioli, after the trial public opinion was politically split: the Right Wing parties (AN, Forza Italia, CDC) maintained that Muccioli had been victim of a 'judicial persecution'; the opposition parties (the so-called 'progressive group') criticised the San Patrignano model. And most of the newspapers took a more cautious and reflective attitude on the subject. Nevertheless, serious debate about the question never took off. And the media were soon busy with other political issues.

In the summer of 1995, Muccioli was hospitalised. The family maintained that he was stressed by the 'judicial persecution', and they openly accused the judges of being responsible for his illness. No official diagnosis of his sickness was ever made. Muccioli died on 20 September 1995. His death was treated as a national event by the TV and most newspapers, including those newspapers devoted exclusively to sport. The prohibitionists launched a new campaign against the judges who condemned Muccioli. The press almost unanimously exalted the memory of Mr Muccioli; the criticism written a few months before, during the Maranzano trial, was for gotten: in a few days - Muccioli became a national myth.

In June 1995, Left Wing MPs presented a new law about cannabis legalisation to Parliament. This law was opposed by most of the Right Wing parties, particularly by AN and CDC. In August 1995, some activists of the Pannella Movement (including Mr Pannella himself) offered publicly some joints to bystanders in a Roman flea market, as a protest against cannabis prohibition.

In October 1995, the San Patrignano Community hosted a large prohibitionist Conference organised by the Stockholm Resolution. The Conference was attended by most important Italian politicians, and was supported by President Scalfaro and the WHO Secretary General Boutros Galhi. The leaders of the Centre Right Parties, including Silvio Berlusconi, signed a document against cannabis legalisation. The new manager of the Community, Andrea Muccioli (son of Vincenzo), declared: 'our aim is to fight against any idea of drug legalisation, and also the distinction between hard and soft drugs. Drugs are always Evil' (Avvenumenti, 1995).

THE DRUG POLICY ISSUE

Why was Muccioli so popular? Why did the 'San Patrignano model' become so popular in Italy? In fact, the 'war on drugs' ideology has always been popular in many other Western countries, for a number of historical reasons, which most of our readers already know. But in Italy the prohibitionist ideology found something that one can hardly see in other countries: an exceptionally effective leadership. In other countries the 'war on drugs' is publicly supported by politicians, journalists, personalities in different fields people who have a large ideological authority, but not a practical involvement with the drug issue.

In Italy, Vincenzo Muccioli had a wide practical activity, as the manager of 'the biggest TC in Europe'. Within the drug debate, he sided with the prohibitionist ideology, but he could also display a pragmatic attitude: he 'made things', and the things he made were a practical example of what could be done in order to solve the problems. On the other side, the anti prohibitionists were considered as people who relied only on 'theories' and were never confronted with reality, people who 'never soiled their hands', never got in touch with the abrasive reality of drug addiction. The leadership of Mr Muccioli, combining ideology with pragmatism, gave reassurance to public opinion, and credibility to the politicians who sided with him.

As for the dramatic episodes (the suicides in 1989, the Maranzano homicide) that happened in the Community, people seem to believe that they are the inevitable costs of a difficult and successful enterprise, like the rescue of thousands of young addicts deemed to death. In this regard, the most remarkable fact is that the practical results of San Patrignano have never been questioned. As far as I remember, no journalist ever raised the simple question: how many successful cases were there at San Patrignano? The attitude of most of the mass media towards San Patrignano was similar to the one towards Lourdes: the 'news' are the people who come back healed, but nobody cares about other people who went there and had no results. Nobody ever questioned whether the practical results of San Patrignano were really better than the ones of the other TCs in Italy (which treat altogether more than 15 000 inmates), and whether the San Patrignano model could fit the 200 000 Italian drug addicts. We don't know very much about the practical results of San Patrignano. There is no doubt that the Community has been very useful for many young addicts; but it is not clear how many other cases were a failure.

In June 1994 (during the Maranzano trial) two researchers from Bologna University (who were out spoken supporters of San Patrignano) issued a study about a group of former San Patrignano inmates (Guidicini and Pieretti,1994). Out of 5800 inmates who came out of San Patrignano in the years 1979-94, the study found out that only 2300 left after staying in the TC at least 14 months (i.e. for a period enough long to get some therapeutic value) . Of these 2300, 479 could not be traced, 151 were dead, 105 were in prison or in other communities, 807 refused or interrupted the contact with the researchers, and a final (non-randomised) sample of 711 were interviewed. They all gave replies that implicitly meant a condition of 'successful outcome'.

On the admission of the researchers, this study was not supposed to be an 'evaluation' of the Community's results, because the sample was not representative of the San Patrignano inmate population. Nevertheless, public opinion was given the impression that this study was the scientific evidence that, in San Patrignano, most of addicts (70%) had been 'healed'. The results of this research were officially presented at a press conference in Rome. According to a document issued by the San Patrignano staff, the study proved that addicts can be 'healed' and therefore a 'harm-reduction' strategy is pointless. In other words, the study was used as a political argument in favour of a strict prohibitionist policy; the press conference was attended by Minister of Health Mr Costa, who proposed to make a more restrictive drug law (Corsera,1 July 1994) .

In fact, the study proved that the rate of success of the San Patrignano Community is no higher than the average for other Italian therapeutic communities. But this evaluation was never reported by the major newspapers. Most Italians still believe that the 'San Patrignano model' is the only way to solve the addiction problem. This belief is being reinforced after recent events helped the creation of a myth around this Community.

In summary, this story shows how a mixture of political interests, mass media conformism, and an exasperated and misinformed public opinion brought about a situation that can be a big obstacle to drug policy reforms.

Dr Giancarlo Arnao, 16 Via Gaetano Sacchi, 1-00153 Rome, Italy (Tel.: (0)6-5818362 (work); (0)6-5812419 (home).

REFERENCES

Avvenimenti ( 1995). 25 October
Corsera, 1 July, Corriere della Sera ( 1994) .
Guidicini P, Pieretti P ( 1994). San Patrignano tra comunita e societa. University of Bologna.
Medica d'ltalia (1995). 16 June.