SanPa. Where did we leave off? Where are we now?

SanPa. Where did we leave off? Where are we now?

In  Italy the documentary on San Patrignano community has started a wide debate on drugs. A lot has changed from the ’80’s and ’90’s: the fight for de-crimininalization of drug use has won support, harm reduction is now part of the public drug policies, a significant part of Italians agree on cannabis legalization. But the current debate shows also that there is a “long shadow” of those years: drug use paradigm, PWUD stigma and human rights violation didn’t change in public opinion, and in political and mass media discourse.

I waited for some time before beginning to write this article. I would have been too emotional, but not because of some incredible discovery: I know everything about the story and the practices of Muccioli and of San Patrignano. I always knew everything from when I began to learn something about drugs via my activism and my profession. I have always fought against that culture, that paradigm, and those practices while trying, along with tens of thousands of others, to think about and to propose alternative practices. The Netflix series Sanpa however does not only provide information (which in itself is important for those who know nothing, for those who weren’t there, and for those who were there but were asleep), but it tells the stories, with the voices, the uncertainties, the pain and the anger, from both the sides of the barricade. It once again gives that culture and that paradigm bodies, faces, emotions and thoughts. To me, as someone who has fought for thirty years my own battle for non moralistic based respect and care, my immediate emotion remains that of great anger and the sensation of an endless prolonged “scandal”. It is the lack of this feeling of “scandal” that strikes me: the lack at the time when all this occurred, when the media circus and the politics of the time were the manifest examples, all of which is well represented in the film. And also the lack today,  in the multiple reactions one can read on social media and in the newspapers (apart from the actual community of San Patrignano which obviously is defending itself). The reactions from those who know nothing about drug use, or worse know something, and state they wish to “suspend judgment”, or  say “who knows?.. it’s complicated”; or, “it was a dramatic time in Italy” and they don’t know enough to comment. Who knows?? Suspend judgment?? I don’t know enough about it?? In the face of coercion, forced labour, humiliation, violence, kidnapping, homicide, the absolute exercise of power over others, the claim of impunity in front of the law, the absolute authority of an institution, someone can say “I don’t know enough about it”?!

 

The key question surrounding this lack of scandal and the difficulty to take a side, both yesterday and today, is not the lack of information but the exact opposite, is what many people “know” about  drugs. Many people  see drug users as “non-persons”, according to an interiorized and uncritical paradigm, perhaps in an unclear or superficial way, or without understanding much about drugs, about the people who use them and the treatment for people who use them. Gregory Bateson said people who say they have no paradigm (“I know nothing about this”) actually always do have one. It is not explicit. It is unconscious and perhaps unknowledgeable.

Would we not “know enough” about it if we are talking about the maltreatment of the elderly in nursing homes? Or of psychiatric patients tied to their beds for days? Or of small children being hit in nursery school? Or prisoners being tortured? Would it have been enough to create  a scandal? Is it enough, in these cases, to have a minimum level of democratic culture of   fundamental human rights, an idea of treatment based on respect for the person and his/her identity and liberty which is inalienable even when that person is in difficulty and ill.  Not to mention the inviolability of the body and the respect for the law which should guarantee all of this. Would it have been enough? Is it enough?  It certainly is.

But not for those who use drugs.  Not for him, not for her. Not even when faced with being chained to walls, beaten, given experimental drugs without consent, hunted in the night in the countryside, kidnapped. “I dont’ know..it’s complicated”….

 

A scandal that could enable understanding and further thinking

The central point and the interest generated by the renewed debate is not San Patrignano. It is the paradigm and how drug use is seen along with the social stigma heaped upon people who use drugs (illegal drugs, as legal drugs are fortunately accompanied by a social culture that has solid roots and are therefore absolved). The person is disputed between a moral judgment (the user is a deviant) and a pathological judgment (the person is ill). This alliance is a living hell for people who use drugs.

It is this line of thought that I feel we should take up again and re-propose, also thanks  to this film.

If for some time an individual thought it was better to be defined as ill rather than criminal, in actual fact they soon discovered that this was not a saving factor. For people who use drugs these two dimensions are intertwined, not alternative and are a double cage. In this paradigm, even treatment risks being a detention, a control. It should be a scandal (and even elicit irony if one could laugh about it) to hear being said that a correctional context, violent and disciplinary wants to “cure”  and “save” people from prison. Everything that we have learnt from the Muccioli method, not from  detractors but from his own words, is nothing more than the verified practice of absolute institutionalization: mortification and the deconstruction of the self; humiliation and diminution; violation. Erving Goffman would call it an organized “assault on the self”. Goffman would say these are clear, evident, unequivocal dispositions with respect to which words mean nothing. The greatest pain and anger and ethical disgust I felt watching the film was not for the chains but at the humiliation of that young man, whose voice still trembles while remembering those events today as a man, when he was publicly humiliated for his writings and his intellectual dignity, which was negated and mortified. And the young girl who was captured and taken back to the community, fragile and crying and lost. They laughed about her in front of the tv cameras while Muccioli, the authoritarian patriarch, falsely embraces her as he reminds the audience of her prostitution.  Do we really “not know enough”?

 

The question of the paradigm, in fact: the “illness” that was represented by Muccioli is still very present today. It is represented as a chemical molecule entering into the body of person who is then rendered totally helpless. It dominates them, turns them into someone else and they are incapacitated.  Non-men, non-women. The citations of this assumption in the film are numerous. The judge of the appeals court said it in an exemplary way, and unsurprisingly based the absolution of Muccioli and the chains on this: the young men and women were capable of understanding but not of being responsable for their actions (it was a paradigma, in fact no individual psychiatric examination was made).

Here it is: the treatment and the support can be undertaken with total disregard to the person, the character, previous life experiences and personal freedom. Liberating them from the molecule became the absolute imperative, no matter what the complexities of their lives were. The sister molecules that cured (methadone) were also demonized and forbidden. The deconstruction of the personality was the premise for writing a new one on a blank page, according to an imposed moral, in order to “return” a man and “ return” a woman.

This is the reality that I believe we must place at the center of our reflections today. We must read the Sanpa case in filigree, as a case at the limits of  “ordinary stigma” and of an “ordinary” and diffuse paradigm. If the chains, the homicides, the suicides that are still waiting for truth, have ever caused embarrassment for someone, the stigma and the paradigm that allowed those events to occur have actually had great fortune: the authoritarian and repressive aspects of the counter-reform against  the drug law n.685/1975 – law which intended to take users out of psychiatric institutions and prisons and be given over to the competency of local public services –  which led to the law n.309/1990, which still govern today, are the products of the battle of San Patrignano (they were certainly not alone. Other friends joined along the way, including some rehab communities, and are still functioning today). Muccioli extolled the media circus (it is chilling and extraordinary watching the  arrogance and the miserable testimony of the popular dj Red Ronnie) and politicians went on pilgrimages to Sanpa,  in perfect anticipation of the wave of populism that continues today.

 

“He was all there was”.. omission is never innocent

Alongside the lack of scandal I am also struck by the lapse of memory that is part of the current debate. A lapse of memory regarding the context of the time, the battles, the conflict. Which is to say truthfully, the film Sanpa does not satisfy, and this is it’s greatest defect: those who do not have enough information or are very young, could watch this film and end up thinking that no matter what people thought about the place, “there was only him” who had an answer to a dramatic situation.

 

No, there was not only him. To begin with, in the 1970’s there was Franco Basaglia, the pyschiatrist, known all over the world,  who started  a revolution which abolished psychiatric institutions and violent and forced treatments. He was involved more with psychiatric patients than with drug addiction,  but he had definitive words to say regarding the subjectivity of those who suffered, about care and treatment, against  containment and chains, about the inalienable rights of each and everyone of us, about the concept of illness itself and about total institutions. He also had something to say about the revolution that health professionals and therapists themselves began during the 1970’s when no-one would have been allowed to say “I don’t know enough about it”, and attempt to avoid having a position (for this alone they were great times). The country was overrun by this thought and this revolution, even in the area of drugs and each one of us had the chance to make up our own minds. Some of the same arguments that we find in Sanpa are identical to those used for mechanical containment in psychiatry, and that Basaglia disputed: we do it for him/her so they won’t hurt themselves. The chains Muccioli used come from those times, from that period when this deception was radically revealed. Nobody can say there was no alternative.

 

No, there was not only him. There was a battle for the laws regarding drugs. The law n.865/1975 which recognized problematic use and the need for a response, and that provided this without punishing the user and by investing in local social health and hospital services. It was a first victory against psychiatrization and criminalization. It is true the public system started off slowly and had many faults. I can think of the law n.180, the so called “Basaglia law” which abolished  psychiatric institutions,  and how the lack of political courage, of clear strategy and operational efficiency threatened success from the beginning. However, the law n.685 and the debate and the battle it bought to Parliament changed at least in part the culture surrounding drugs and dependency, by trusting public welfare with the health rights of its citizens,  those citizens who use drugs. That law was wanted and defended at the time by many therapeutic communities, who had no need for chains then nor today. Muccioli and San Patrignano always contested them, just as they had always worked to not recognize the role and competency of public services.

 

No, there was not only him. At the end of the ’80’s and the first years of the ’90’s – at the height of the giantism and political lobbying of San Patrignano – there was an open battle, theoretical cultural and scientific, and clear alternative guidelines of work. We deconstructed that stigma and that paradigm. We concretely criticized and overturned it and cut it to bits. We gave life to other services, to other therapeutic options and other ways of caring for people and mostly, other ways of regarding drug use. We conducted a swift battle against the new  punitive law. We didn’t win but we certainly had an important impact: we won the 1993 referendum whereby Italians chose to moderate the more punitive articles of the law for users. Above all we created and organized the prospective of harm reduction which has at its base the overturning of a stigma and the portrayal of a user who is informed and capable, even if  also has fragilities, sufferance, and difficulties. A subject who does not loose his/her characteristics as such and can learn, act and change. We also demonstrated that a large part of those with problems correlated to drug use can resolve them without professional support (self-recovery). This is not to say that services are not useful (they are needed and they are a right), but that the subjectiveness of those who used drugs must be  recognized, subtracted by invisibility and salvific rhetoric.  And while the tragic parabola of San Patrignano was being consumed in the middle of the ’90’s, we were in alliance with and supported the early self organized groups of people who used drugs, born to vindicate their rights and to change the general conversation around drug use. Each one of us chooses our companions on the road.

We discovered and demonstrated that drug molecules are not enough to explain a problem. It is necessary to see the person and their context. And if you really wish to help, the last thing to do is to label people who use drugs. We promoted a relationship of treatment and support based on respect, on recognizing users’ objectives and competencies and above all their  fundamental rights. One of the slogans at that time, emblematic of a variegated movement was Educate not punish and it involved a large part of the Italian therapeutic communities. Another one, particularly dear to me for the energy and passion I gave to it for years to turn it into a concrete practice, was borrowed from Franco Basaglia: Freedom is therapeutic.

 

No, there was not only him. A lapse of memory is never innocent because it bends history for the use of someone else.

There were many of us who took other roads and each one of us took responsibility for rowing in their chosen direction. It was and is possible without chains. Without forced labour, without patriarchal bosses, without humiliation, without renouncing rights. And it was and is possible to live with drugs without dying: if the world in which we live (law, society, culture, prejudice, prohibitionism and the illegal market, services, mass media and the patriarchal bosses) do not do everything to convince us of the opposite. This is where we begin once again to break down this paradox: to help you I convince you you are incapable and your destiny is death. It is here, in this lie, that arbitrary and absolute power is nourished. Here respect ends and taking care of someone vanishes.

 

* Forum Droghe, President of the Scientific Board



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