And some have become runners. Since February, a top marathon coach, Gabriele Rosa, has been training the program’s team of runners to help improve their self-confidence. The New York City Marathon is a way for the runners to pursue a dream, but there are other benefits.

“We also hope that the visibility of the N.Y.C. Marathon could make our community known and available to other people in need all over the world,” said Letizia Moratti, a longtime supporter of San Patrignano and the president of its United States affiliate, Friends of San Patrignano.

San Patrignano, which was founded in 1979 and has two smaller branches in Italy, is not like many drug rehabilitation centers. It is free, for one. Unless the newcomers need to scale down their use of methadone, residents are not given substitution medicines. They can see a therapist but are not compelled to. Social workers and former drug addicts who have seniority in the program assist those who have just arrived. If necessary, the seniors “crowd around you and talk you off the cliff,” as an American resident put it.