A deportation machine

Foreigners awaiting repatriation to their country of origin due to their irregular status on Italian territory are detained in the CPRs, which Matteo calls a "deportation machine," where "the human being disappears, and only money remains." Giorgia Meloni's far-right government seems unlikely to change the system, he says. Detention in a CPR can last up to a maximum of 90 days (which can be extended by a further 30 days in special cases). Only a minority of migrants detained in CPRs are actually repatriated, while others are eventually released.

Nine CPRs are already in operation, although the "Brunelleschi" center in Turin was temporarily closed in March 2023 after protesting inmates set fire to the premises, rendering the rooms unfit for use.

In the latest finance law, an additional €42.5 million have been earmarked for the expansion of the current network by 2025. Plus, a new decree on immigration adopted in March 2023 simplified Italian procedures for the construction of new expulsion centers, with the aim of building at least one per region.

This is in anticipation of more migrants being expelled after arriving in Italy, as Tunisia has recently overtaken Libya in migrant departure numbers. According to an Italian agency, 24,383 people arrived at the southern Italian island of Lampedusa since the start of the year, compared with 2,201 the year before.

By August 2022, Tunisians accounted for 65% of all detainees in Italian CPRs. Between 2021 and 2022, they made up at least 27%.

An "inhumane" system

Youssef knows all about this abusive system. Originally from Gafsa, Tunisia, the young man in his thirties spent 10 years looking for a way to thrive without having to leave Tunisia, to no avail. "I do odd jobs to survive, with no follow-through," he says. "I thought I'd be able to find a job after my studies, but there's nothing ... I haven't been able to find a stable job for over ten years now."

For Youssef, the only solution would be to leave and find a job in Europe legally, instead of risking his life at sea. But with the increasing difficulty of obtaining a Schengen visa, that is not an option. In Nov. 2020, at the height of the COVID-19 pandemic, he decided to set sail from the port of Sfax, Tunisia, sharing a large eight-meter boat with "around 10 young Tunisians and 50 Sub-Saharans," he says. Twelve hours later, they were in Lampedusa. His story echoes that of many young Tunisians who have left for Italy, then passed through a CPR before returning to the point of departure, deported to their country of origin.

Once in Italy, he didn't even have time to look for a job before being sent through several CPRs: "I felt like I was in prison," he says.

In the midst of the COVID-19 crisis, the young man found himself locked up with six other people. Youssef recounts seeing psychotropic drugs being passed around the CPR, including "a lot of Tramadol and especially Tavor, a drug used extensively to help people sleep, given the conditions."

The memories linked to the CPR in Turin, now closed, are the most painful: "I witnessed a suicide attempt by a young Tunisian who sprayed himself with disinfectant gel and tried to light himself on fire [out of] despair. The thought of death is always present, and that's why drugs are consumed in large quantities."

After being expelled from Italy, Youssef had no choice but to return to Gafsa. But his violent experience of administrative detention and then repatriation did not deter him, and he insists that once he has saved enough money, he will try again.

Psychotropic drugs, given without consent

Youssef and Matteo's testimonies are backed up by data obtained by Altreconomia, in collaboration with Inkyfada. A large proportion of the drugs purchased at the CPRs are psychotropic drugs: they account for at least 10% of expenditure at each center, and as much as 44% at the Rome center.

Meanwhile, the Immigrant Health Center (ISI) in Vercelli, at a similar size, uses only 0.6% of its total health budget expenditure on psychotropic drugs. That is 70 times less than Rome, that has three times fewer patients.

But the CPR's budget is far from the only problem. The type of medication used is also concerning. "Unlike prisons, health care in CPRs is not entrusted to doctors or specialists working for the national health system, but to staff hired by [hands-off] CPR managers,” said Nicola Cocco, a doctor and expert in administrative detention. In Milan, half of the psychotropic drugs purchased in the CPR between Oct. 2021 and Feb. 2022 were Rivotril tablets - a prescription drug authorized as an anti-epileptic, but widely used as a sedative.

Data shows that only eight examinations were carried out on inmates at the Milan CPR between Oct. 2021 and Dec. 2022. Furthermore, informed consent is required to administer the drug as a sedative to someone. "They asked me, a simple operator, to administer it. I always refused, because I'm neither a doctor nor a nurse. The younger people don't even know what it is. They didn't ask for consent," Matteo continues.

CPRS buy benzodiazepines, anxiolytics and antidepressants used for anxiety disorders or severe insomnia by the hundreds or thousands. "The use of psychotropic drugs in CPRs is too often arbitrary and excessive, and does not represent a form of care for detainees," said Cocco.

Misuse of these drugs can have fatal consequences. In Jan. 2023, a trial opened for the death of a migrant from Georgia, Vakhtang Enukidze, 37, in a CPR. The Italian daily Domani reported that the autopsy said the cause of death was pulmonary and cerebral edema due to a cocktail of drugs and narcotics. A few months later, on July 20, 2020, 28-year-old Orgest Turia from Albania died of a methadone overdose.

Vulnerable people

The discomfort felt in the CPRs can also be assessed by the large quantities of paracetamol, analgesics, gastroprotectors and intestinal painkillers that are purchased. In five years, Rome’s CPR purchased 154,500 Buscopan tablets for 4,200 inmates. Despite the maximum dose being 15 tablets, this averages at 36 pills per person.

This lack of consensus generates a lack of transparency.

The specialists hired by the CPR organisms are supposed to assess the detainee's health and see if they need follow-up appointments. Contracts relating to the running of Italian CPRs confirm this: "Medical examinations on entry and, where appropriate, the administration of medication are guaranteed in all cases." But the contracts do not detail how these medicines are to be administered, or who is supposed to purchase them.

As a result, each CPR adopts its own practices, depending on local health protocols — despite being a public agency bound by administration prescriptions. This lack of consensus generates a lack of transparency. In Milan, the prefecture specified that "the medicines purchased are prescribed by health staff using a National Health Service form, which covers the costs."

Local health officials argue that CPR doctors can use the regional prescription book for several purposes, but "not for prescribing medication to illegal foreign nationals," pointing out that there is an agreement with the prefecture.

Even if drugs are supplied correctly, migrants with illnesses should not be detained. Before entering CPRs, they are supposed to undergo an "examination of aptitude for life in a restricted community" by a doctor from the local health authority or hospital. According to a May 2022 directive, the examination serves to exclude "pathologies such as infectious diseases, psychiatric disorders, acute or chronic degenerative pathologies which cannot be adequately treated in community detention".

The purchase of antipsychotics, antiepileptics or ointments for treating ailments like scabies are evidence of non-compliance with these regulations. Drugs used to treat schizophrenia, bipolar disorder or addictions are also distributed in these centers.

Lack of transparency

A lack of transparency is also part of the problem. For one CPR facility located in southern Italy and run by the Engel Italia company, the local health agency says it spent just €34 on drugs in 2022, a figure that hasn't changed since 2018. No presence of psychotropic drugs or antipsychotics was recorded.

But doctors working inside that CPR reported "massive use of psychotropic drugs (Rivotril and Ansiolin) on inmates." Another CPR in north-east Italy has already been the subject of a judicial inquiry for similar circumstances.

The fatal consequences of this system, such as the deaths of Vakhtang Enukidze and Orgest Turia, confirm the urgent need to shed light on their abuse of psychotropic drugs, and to make this evidence publicly available. Indeed, it was impossible to obtain data from the CPRs based in Brindisi (Apulia), Trapani (Sicily) and Bari (Apulia).

When it comes to the authorities, this problem is far from resolved. In March 2023, when Interior Minister Matteo Piantedosi announced his umpteenth visit to Tunisia in the name of the "fight against irregular migration," the minister merely described the CPRs as "unpleasant," while announcing that the government would be building more.

Some courts, however, are beginning to take an interest in the case. In Milan in Jan. 2023, Judge Elena Klindani rejected a request to extend the detention of a 19-year-old, who had been locked up for five months, on the grounds that "each additional day of detention leads to a progressive deterioration in psychophysical health, for which no specific assistance is offered, except pharmacological therapy." According to the judge, the young man's health "is likely to deteriorate further due to the psychological state determined by the prolonged restriction of personal freedom." A far cry from the adjective "unpleasant."