Open critical nodes, between the legal and the clinical, in the field of addiction

Issue 4/2019

Abstract. The first element that jumps out from the first approach to the subject is that we are moving within a phenomenon in constant and rapid change with an available regulatory (T.U. 309/90) which, with very few modifications, is that of almost 30 years ago and is rooted in the debate of the late 80s amongst the so-called advocates of the “modest quantity” (to reiterate a speech famous at the time Bettino Craxi, returning – infatuated by the Reagan “war on drugs– from the USA) and those who instead believed that a “right dose of escapades” was essential to persuade even the most riotous to embark on a path of redemption from the use of psychotropic substances.
It is a little as if the now chaotic traffic of New York in the 1920s had been regulated by a highway code of the velocipedes’ era.
Most of the current scientific knowledge on the neurobiological mechanisms underlying the different clinical forms of addiction were acquired in the years following 1990; specifically, the unitary nature of the addiction phenomena is totally ignored , beyond the phenomenal aspects of the consumption of each single addictive object.

SUMMARY: 1. The evolution of the regulatory system in the 70s and 80s of the twentieth century. – 2. The almost mandatory health treatment, the TSqO of drug addiction. – 2.1. The first round. – 2.2. The second round: treatment as a penalty, the Community as a prison. – 2.2.1. Suspension of pre-trial detention in prison. – 2.2.2. Suspension of the execution of the sentence. – 2.2.3. Probationary custody in special cases. – 2.3. The third penitential round (again, take care of the people who use it…). – 2.4. The last round. – 3. The three mirrors of blindnesses of law and medical science – 3.1. The blindness of the law, the “acute” reading of a chronic phenomenon, the scotomization of individual addictive behaviours – 3.2. The shared blindness between the law and medical science: the existence of grading in consumption, from sporadic to the most frequent and controlled use, to the loss of control and the possible return to controlled use. – 3.3. The blindness of neuroscience, a modern mechanistic reductionism: the mind is much more than the brain. – 4. The laborious struggle of the organisational health response. – 5. One last word: a policy that does not make “policies” but that pursues the moods of the “people”.

To read the Reflection, click on “open file”.