RFK Jr. says it's the model for addiction treatment. Experts disagree

0:00It's Consider This, where every day we go deep on one big news story. Today, Health and Human Services Secretary Robert F. Kennedy Jr. and his plan to revolutionize addiction treatment in the United States. I've seen this beautiful model that they have in Italy called San Patriciano, where there are 2 ,000 kids who work on a large farm. That's Kennedy speaking to News Nation in 2024. He's talking about a drug treatment community in rural Italy. The facility focuses on hard work, a regimented schedule, and community. They don't offer therapy or medical care. When he was campaigning for president in 2024, Kennedy used the Italian facility as an inspiration for his proposal to open government-run farms and work camps, adding they would be places where American children could be reparented.

0:50Many critics have a lot of questions about that approach. We know that abstinence-based programs fail over and over again. often very quickly, your likelihood of dying was 70 % higher than if you weren't in treatment at all. Consider this. HHS Secretary RFK Jr. thinks he has the answer to addiction treatment. The experts say otherwise. From NPR, I'm Scott Detrow.

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2:03It's Consider This from NPR. Health and Human Services Secretary Robert F. Kennedy Jr. thinks he has cracked the code for addiction treatment. Kennedy used heroin for more than a decade, believing wellness, work-focused treatment, and abstinence, like the methods practiced in a rural Italian facility, are the keys to sobriety. But Kennedy is facing new criticism over his proposal to open government-run farm and work camps. NPR addiction correspondent Brian Mann has the story. When Kennedy campaigned for president in 2024, one of his signature policy ideas was building a network of wellness farms and addiction treatment camps in rural communities across the U.S.

2:41I've seen this beautiful model that they have in Italy called San Patriciano, where there are 2 ,000 kids who work on a large farm. That's Kennedy speaking on the network NewsNation in 2024. As health secretary, Kennedy's vision of wellness farms, especially those he proposed for children, is under scrutiny, with Senator Angela Alsobrooks, a Democrat from Maryland, questioning him during a combative Senate hearing last week. You said every black kid can get reparented on a wellness farm. Can you admit that you said that? During the heated exchange that followed, Alsobrooks described Kennedy's concept as dangerous and irresponsible.

3:20Kennedy pushed back. I have no memory of saying anything like that. Kennedy later added, quote, if I said it, I apologize. In fact, Kennedy did speak at length about reparenting American children on U.S. government run farms during at least two different podcast appearances when he was campaigning. At times, Kennedy described it as a way to help a wide range of kids harmed by addiction and what he described as overprescription of anxiety and depression medications. But during an interview on a podcast called High Level Conversations, Kennedy spoke specifically about his vision for black children.

3:54And those kids are going to have a chance to go somewhere and get reparented, to live in a community. NPR asked repeatedly to interview Kennedy about his views. The Department of Health and Human Services sent an emailed statement acknowledging Kennedy used the reparenting term, but said his comments about black children had been taken out of context. The HHS statement said Kennedy used the reparenting term in reference to psychotherapy treatment. But during the podcast interview, Kennedy made clear his inspiration was the Italian farm camp. The model for this is a community that I had direct contact with because of families.

4:31HHS officials told NPR Kennedy would have no further comment about his interest in San Petronano. But we were able to visit the community east of Florence on Italy's Adriatic coast, where we interviewed numerous residents and employees about the program created in the 1970s. Leaders at San Patronano told us they were surprised and confused by Kennedy's enthusiasm. They have no record of him ever visiting or contacting them to learn about their program. Monica Barzanti, San Patronano's spokeswoman, said she only learned about Kennedy's vision for copying their model through the media. Yeah, I read the interview because someone forwarded me.

5:09It is the only thing I know about this project. Perhaps as a result of this lack of contact, Kennedy has talked about San Patronano as a solution for the U.S. addiction crisis while frequently getting basic facts about the community wrong. We found San Patronano is much smaller and has fewer residents than Kennedy suggests. He's also described it as a place that primarily serves children. In fact, the vast majority of residents are adult men. San Patronano does have a farm and vineyards and textile workshops like this one, where we met Liliana Moretti, who's 28. She said her addiction began after she was put up for adoption as a child.

5:47I had scars that I never healed or healed not well, not enough, that I patch up with alcohol, with, you know, cocaine, with food mostly. Moretti has lived in California and Italy, and she's been at San Patronano for eight months. The day we met, she was weaving on a loom. I'm putting the thread around the wheel. I have to follow a sequence of three orange threads. Roughly 850 people live here. Most, like Moretti, don't receive formal therapy or medical care. Instead, the program focuses on hard work, a highly regimented schedule, and a deep focus on community. This place has humanity, has compassion.

6:27It has those little things that help you see hope in yourself and in others. Kennedy used heroin for more than a decade, starting when he was a teenager. He said wellness and work-focused ideas like those at San Patrick Dano that promote abstinence from drug use helped him recover. But long before last week's Senate hearing, Kennedy's embrace of San Patrick Dano and the community's approach to addiction care was sparking alarm among many doctors, researchers and drug policy experts in the U.S. Critics point to the fact that San Patricdano's program rejects use of scientifically proven medications like buprenorphine and methadone, long considered the gold standard for treating opioids like fentanyl, heroin, and pain pills, which are the biggest causes of overdose deaths in the U.S.

7:13Dr. Robert Heimer studies the effectiveness of addiction therapies at Yale University's School of Public Health. He says pivoting the U.S. response to the fentanyl crisis away from a focus on medications toward an abstinence-centered model like San Patrignano would be dangerous. This is very hard to answer without getting angry. We know that abstinence-based programs fail over and over again, often very quickly. Hymer is one of many researchers who found that opioid users who enter abstinence programs like San Patrignano quickly lose their tolerance for opioids. Their bodies become more vulnerable, then they relapse at high rates, often with catastrophic results.

7:52Your likelihood of dying was 70 % higher than if you weren't in treatment at all. During our visit, even many of San Patrognano's most ardent advocates voiced doubts about whether their program could be effective in the U.S. For one thing, San Patrognano's leaders say their program isn't equipped to deal with the kind of severe addiction and illness caused by street drugs like fentanyl, methamphetamines, and xylazine that are widespread in the U.S. In Italy, the most common street drug is cocaine. San Patrognano's medical director, Dr. Antonio Boschini, also told NPR it would be impossible for their small grassroots model of addiction care to be safely scaled up into the kind of national program Kennedy has described.

8:37Boschini says San Patrognano tried to expand in the 1990s, and the effort was a disaster. There were too much people out of control, and one person was killed in the community. During that era, San Patrignano was rocked by scandals portrayed in a Netflix documentary series in 2020 that drew national attention across Italy. The community recovered by downsizing and making sweeping reforms. NPR could find no instances where Kennedy talked publicly about those controversies. Again, he didn't respond to our inquiries. Kennedy's views matter. As health secretary, he may be the most influential leader in the U.S.

9:15shaping addiction policy. and he's promised big changes. Earlier this year, when he unveiled the White House's new $100 million addiction effort called the Great American Recovery Initiative, his focus wasn't on health care or medication, but on work, faith, and abstinence. That's how you precipitate a spiritual revitalization, a spiritual renaissance. Reaching out to addicts on the street and then giving them stable lives. But public health experts point out street drug deaths in the U.S. have actually been dropping fast for years, with doctors and researchers saying much of the improvement has come through wider access to addiction treatment medications.

9:56Brian Mann, NPR News. This episode was produced by Kai McDamee and Tyler Bartlom. It was edited by Andrea DeLeon and Courtney Dorning. Our executive producer is Sammy Yannigan. It's Consider This from NPR. I'm Scott Detrow.

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