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Clinical activity

Admission to the hospital

Hospitalization at the Service aims at detoxifying patients from psychoactive substances, either taken alone or together with heroin, methadone, buprenorphine, cocaine, crack, amphetamine, ecstasy, cannabinoids, benzodiazepines, GHB barbiturates, other psychotropic or pain-killing drugs, as well as severe types of nicotine poisoning which cannot be cured with a walk-in clinic treatment.

A patient is voluntarily admitted to the hospital, in accordance with the hospitalization schedule. No emergency hospitalization is provided. A post-detoxification program is necessary, involving psychotherapy, extended therapy based on the antagonist neltrexone, a substitutive treatment based on buprenorphine, a change of residence and/or employment, an extended treatment in a rehabilitation centre, a short-term stay in a rehabilitation centre (4-16 weeks), in particular with regard to stimulant-addicted patients.

The pre-hospitalization examination shall take place, indicatively, four to six weeks before hospitalization. If the patient is a Ser.T user, the doctor requiring hospitalization shall write a clinical report on the case under study. During the examination, the patient shall receive adequate information about the detoxification program he/she will undergo; a post-detoxification and rehabilitation program shall be agreed upon and the date for admission to the hospital shall be set. Patients are usually admitted to, or discharged from, the hospital on Mondays.

Detoxification aims

Detoxification is a process by which a person who is physically or psychologically addicted to a certain drug ceases to take the substance, suddenly or in stages.

In short, the aims of detoxification are the following:

  • eliminating physical addiction from a chronic use of psychoactive substances;

  • eliminating the pain and the symptoms of withdrawal;

  • personalizing and beginning an effective rehabilitation treatment, customized for each patient, in order to help the patient break his/her addiction to psychoactive substances;

  • smoothening the transition to a different level of treatment, in order to avoid drop-out;

  • diagnosing and treating concurrent medical problems;

  • educating the patient about health care and to avoid drop-outs by intervening on the issues connected to psychic addiction.

Variables affecting detoxification

A complex series of variables may affect the course of detoxification:

  • the substance from which the patient shall be detoxified: detoxification from heroine, for example, is quicker than detoxification from methadone or buprenorphine;

  • the dosage of the substances taken before hospitalization;

  • how long the patient has been taking drugs: detoxification may vary depending on whether the patient has undergone a methadone pre-detoxification treatment only for a few weeks as a stabilizing therapy or for a longer period of time as a substitutive therapy, therefore allowing him/her to be more stable and integrated into society;

  • the condition of drug abuser centres;

  • psychiatric co-morbidity;

  • detoxification during hospitalization or walk-in clinic: generally, detoxification during hospitalization has lower drop-out levels than detoxification during walk-in clinic treatment;

  • the patient’s fear of pain during detoxification, which could lead him/her to enter the hospital with some dosage of the substance, therefore affecting the course of the treatment, and implying the issue of whether to perform any body-searching procedure upon admission;

  • a number of severe organic pathologies (such as HIV or hepatitis) affecting the patient at the same time.

Anti-smoke walk-in clinic

Many smokers want to give up smoking. More than 50% of Italian smokers tried to give up smoking at least once. Such attempts are usually based on poor information and without a proper therapeutic program. The Service provides a walk-in clinic for smokers, in an internal medicine environment, in order to provide an actual answer to such problems.

The Service provides care for approximately 500 smokers a year. The anti-smoke service is the most important and leading part of the walk-in clinic.
The walk-in clinic activity obviously also addresses other problems, such as detoxification from benzodiazepine, cocaine, barbiturates, follow-up examinations of discharged patients, etc.


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