During a Senate hearing, Sen. Angela Alsobrooks pressed U.S. Health Secretary Robert F. Kennedy Jr. about his proposal for national “wellness farms” — rural, work-based communities he has described as places to “reparent” young people. Kennedy denied recalling the specific phrasing and apologized if he had used it, but he has repeatedly praised the model publicly while running for president and since, citing San Patrignano, an Italian therapeutic community, as a template.
Kennedy has discussed sending people — including youth he says are harmed by street drugs and by prescription anxiety and depression medications — to farm or work camps where they would live in a structured community, do supervised work, and undergo a form of reparenting. HHS told NPR that Kennedy used the psychotherapy term “reparenting” prior to his time as secretary and that his comments were taken out of context.
San Patrignano, founded in 1978 near Coriano, Italy, spreads across roughly 700 acres and houses about 850 people in recovery. Residents live and work in the community, attending school and workshops and following regimented schedules focused on work, responsibility, and abstinence. Residents and staff describe a humane, compassionate environment that has helped many people rebuild their lives; NPR reporters and others who visited found residents praising the sense of community and steady routine.
But San Patrignano’s model is controversial. It emphasizes total abstinence and rejects medications commonly used to treat opioid and alcohol dependence, such as methadone and buprenorphine. That rejection is central to critics’ concerns. San Patrignano leaders defend their approach, arguing that “no drugs can cure drugs” and that rebuilding a life through work and community is the only path to recovery. They say past scandals have prompted reforms.
Medical researchers, public health officials, and drug policy experts in the U.S. warn that an abstinence-centered model that excludes medication-assisted treatment (MAT) would be dangerous here, particularly given the U.S. opioid crisis driven by fentanyl, heroin, and prescription opioids. Studies show that people addicted to opioids who stop using street drugs without medications typically relapse quickly; because relapse after reduced tolerance carries a high overdose risk, experts say medications that reduce cravings and stabilize patients are lifesaving and the standard of care.
Dr. Robert Heimer of Yale, who researches addiction therapies, said abstinence-based programs “fail over and over” and that treating opioid addiction without medication can leave people at enormous risk when they relapse. The CDC and other health agencies advocate expanding access to opioid-addiction medications to reduce deaths.
San Patrignano’s history includes scandals and legal entanglements. When the community attempted to expand in the 1990s, problems arose that nearly destroyed the program; a Netflix documentary and reporting have highlighted episodes where residents were held against their will and other abuses occurred. The community’s founder, Vincenzo Muccioli, was later convicted in connection with covering up the murder of one resident; he died in 1995 while his case was on appeal. Current leaders acknowledge past mistakes and say they have implemented reforms intended to improve transparency and safety.
San Patrignano’s current medical director told NPR it would be “impossible” to safely scale the community’s model into a nationwide program like the one Kennedy envisions. San Patrignano also differs from how Kennedy has described it: it serves far fewer people than he has suggested, and most residents are adults rather than children. The community’s spokesperson said they had no record of communicating with Kennedy or HHS and first learned of his interest through the media.
Kennedy has given mixed statements about medications for addiction. At times he has called them “practical and pragmatic” when used alongside faith-based approaches, while at other times he has voiced skepticism, saying he would not endorse using drugs to “fix what’s wrong inside of you.” When announcing a federal initiative called the Great American Recovery Initiative, Kennedy emphasized faith, work, and abstinence-centered programs as central to his vision.
Critics caution that transplanting San Patrignano-style communities to the U.S. without integrating evidence-based medical treatments would risk worsening overdose deaths here. They stress that while therapeutic communities and structured work can be valuable elements of recovery, they should complement, not replace, medically supported treatments, especially for opioid use disorder. San Patrignano’s approach may be less risky in Italy where alcohol and cocaine dominate and overdose rates are lower, but experts say the U.S. context — dominated by lethal synthetic opioids — requires broad access to medications that reduce overdose risk.
NPR sought interviews and detailed answers from Kennedy and HHS about his emphasis on San Patrignano and concerns raised by experts and lawmakers; HHS declined further comment and Kennedy did not provide an interview. San Patrignano residents and staff described lives transformed by the community’s routines and relationships, while leaders and outside experts alike warned that the community’s history, insistence on abstinence-only care, and limited scale make it a problematic direct model for national policy in the United States.
