I modelli culturali delle tossicodipendenze in Italia (Cultural models of drug addiction in Italy)

This report describes the issues addressed during the third national conference on drug addiction held in Genoa between 28 and 30 November 2000 and the cultural models on drug addiction that emerged from the content analysis of the interventions of the conference participants. The main themes were: the decarcerisation, the evaluation of the implemented interventions and the reference models with respect to the affirmation in Italy of a cultural orientation towards quality and the management reorganization of services, the freedom and autonomy of choice of the "patient-user -citizen" with respect to the spread of a new culture of the centrality of the patient in the relationship with the doctor, the new phenomena of abuse and the renewed need for knowledge of the youth universe, the need for coordination at national and European level on strategies of fight against drugs, the realization of a network integration model among territorial structures, the issue of comorbidity and the relationship between drug addiction services and psychiatry, the need for an adequate approach to alcoholism problems and smoking, the specific nature of the interventions aimed at drug addict mothers and their children, with a view to supporting parenthood, the problems of correct application of Article 75 of Law 309 of 1990 in relation to the awareness of young people regarding the new forms of drugs, the situation on the functionality of the C.I.C. (information and counselling centers) within schools, the evaluation of interventions based on the use of methadone, the harm reduction policy, the problems associated with strategies to promote job placement for drug addicts, the need to study new phenomena to find new models of reading and intervention through the training of operators and the reorganization of territorial services for drug addiction, the new forms of addiction such as gambling and other addictions linked to compulsive behaviors. The cultural models that emerged from the analysis of the contents of the interventions at the conference can be summarized as follows: 1) the culture of the public body that helps drug addicts, or of the "Public", which tends in general to medicalize the phenomenon of drug addiction, proposing the idea of the drug addict as a sick person to be “cured and restored to society”; 2) the culture of recovery communities of drug addicts, with a strong religious connotation, which argues with medicalization, focusing everything on the "recovery" of the meaning of life, the development of a life project self-determined by the drug addict through psychosocial and long-term rehabilitation treatments and not on the use of "other drugs" (substitute drugs); 3) the culture of the drug addict as a person capable of understanding and willing, bearer of a clear vision of himself and of his situation and of a request for intervention often in contrast with the operators' ideas regarding diagnosis and treatment, as opposed to a more consolidated social representation of the drug addict, almost as a person capable of understanding but not willing, which at times justifies and has justified even harmful forms of compulsory treatment