In 2024, Robert F. Kennedy Jr. drew renewed attention to San Patrignano (SanPa), presenting it as a potential model for addressing severe substance use disorders. In his remarks, he described it as a “healing community,” in which individuals struggling with addiction are given ample time, much-needed structure, and communal responsibility to regain a sense of identity and purpose. The appeal of such a model, from his perspective, lies in its emphasis on duration, discipline, and social integration—factors often perceived as lacking in contemporary treatment systems in the United States. San Patrignano also requires abstinence, and RFK Jr has argued that effective recovery requires individuals to be removed from places where drugs are accessible.
Two years ago, RFK Jr expressed interest (go to 38:08 where he mentions SanPa) in expanding such residential models in the United States, yet such proposals have generated significant political and institutional resistance. Some commentators describe large-scale “wellness farm” concepts as incompatible with legal and constitutional norms, invoking historical parallels to earlier institutional systems associated with coercion or “eugenic” ideology: a system of improving society through selective breeding.
The historical backdrop to these critiques is not trivial. Early 20th-century state institutions—such as Gracewood in Georgia—often began with good-intended missions of education and vocational training for individuals labeled “feeble-minded” - a broad categorization for those who had learning disorders, psychiatric disorders or behavioral problems. Over time, many of these institutions expanded too quickly, became overcrowded and increasingly custodial in function. In other words, they were institutions that separated and controlled the mentally unfit, they weren’t places with a purpose to heal. In many cases, however, the scientific belief at the time was that many behaviors were hereditary and unchangeable. Therefore the solution wasn’t to change people, but to segregate them, manage them and in some cases, sterilize them.
This criticism applied directly at SanPa as well. In a 2020 Netflix documentary titled: SanPa - Sins of the Savior, Vincenzo Muccioli, the founder of SanPa was exposed for among other things, forced confinement and mandated labor of the residents.
Given the negative publicity of SanPa as well as the sordid history of long-term institutions, it’s not surprising such programs have yet to be adopted.
Yet I am confounded that today’s approaches—“Housing First” and “Harm Reduction”—are deemed acceptable. These approaches emphasize stabilization and risk reduction without requiring immediate abstinence or structured moral transformation as a precondition for assistance. In other words, free housing and medication supplies with no conditions. Despite the limited evidence of success, these approaches have been formalized in federal public health strategy in recent years, especially under President Biden’s drug prevention strategy, and are now embedded in national overdose prevention frameworks.
I wrote extensively about my thoughts on these approaches in my piece: San Patrignano confronts suffering honestly. In that piece, I also wrote about why we need more institutions like SanPa here in the United States.
Recently, I had the pleasure of speaking with Monica Barzanti, head of international relations at SanPa. She talks about how the center started, its successes and its challenges.
You can learn more about Monica Barzanti on her profile page and San Patrignano here: https://www.sanpatrignano.org/en/
Interview coverage:
2:47 - From resident at San Patrignano to head of international relations.
3:59 - The philosophical difference between San Patrignano’s approach of long-term, drug-free recovery vs the view that drug disorders and mental health issues are brain diseases. “The brain disease model of addiction explains a situation when the substance use disorder is already well-advanced.”
6:44 – It takes time and space to find a new purpose in life and to dismiss the personality of addict that was assumed.
8:39 - In 80’s and 90’s, there was a proliferation of antidepressants: 1% on antidepressants decades ago vs 15% today. But in Italy, Prozac fever didn’t spread the way it did in the United States.
11:01 - In order to make a diagnosis, you have to have a person without drugs for a period of time in order to better understand their condition. Substance use disorder is a problem of education.
12:52 - How long does a person abstain from drug usage to get a good diagnosis?
15:00 - The origins and philosophy behind San Patrigano. Tenets of the program are similar to the Christian tenets of redemption, transformation through sacrifice, dignity and responsibility.
17:39 – The stigma taken away and the stigma added. Culture equates compassion with not blaming a person or making them feel guilty for their actions because it stigmatizes them. Yet this causes the person to take on another stigma of being a dangerous and an unpredictable person without medications.
22:13 - Why working is a pillar of the program.
24:18 – The lie that is telling someone that substance disorder is a chronic disease. Telling someone the truth about their loss of self-esteem isn’t judging them. But telling them they have to take buprenorphine for the rest of their life is defeating.
26:37 – The stigma created when a person is labeled a dangerous person who can’t recover on their own, or someone who cannot be trusted but needs medications to be stable, is a worse stigma than a person struggling with self-esteem or life in general.
28:44 - How San Patrignano started by founder Vincenzo Muccioli, who used his property to start the program.
30:57 - San Patrignano is a social enterprise with 65% of its budget sourced through its production of goods (crafts, wine, baked goods) and services (hair styling). The rest comes from donations.
33:00 - Residents also learn how to spend their spare time engaging in sports, music and art.
36:00 - The process of internship or apprenticeship, and the peer support infrastructure.
38:20 – The social enterprise explained in more detail, such as bread sold to Burger King and other neighborhood restaurants.
42:00 - The required time to stay at SanPa because it is a therapeutic necessity and the time needed to learn a trade. According to neurobiologists, the brain takes at least five years to get back to its natural functioning.
44:00 – Responding to the Netflix documentary - Sins of our Fathers – accusations of abuse, including chaining of residents or coercive discipline and ethical concerns around unpaid labor. Importantly, residents attend SanPa on a voluntary basis.
48:00 – Around 600 enter the program every year. Difficult to gauge how many apply because there are hundreds of inquiries, and many who drop out early due to the commitment required.
51:00 – RFK Jr wants to develop healing farms across the United States, pointing to SanPa as a model. But there are similar models in the United States. Those include Trosa in North Carolina as well as The Other Side Academy in Salt Lake City, Utah, and Delancey Street Foundation.
