Editor’s note: This is the first of occasional columns on the opioid epidemic from local experts who work in the field of addiction.
On Dec. 19, Gov. Tom Wolf signed Senate Bill 446, granting authority to the Pennsylvania Department of Drug and Alcohol Programs to regulate recovery houses statewide that receive any public funds. Some say this is a long overdue necessity to guarantee and, in some cases, improve the quality of these types of establishments. Others contend that overregulation will drive out many good owners. A task force convened in 2016 created a draft of guidelines to certify homes.
Owners and operators who viewed the guidelines during the public comment session were concerned about elements regarding the physical plant and operations of the houses. For example, one of the recommendations is that all basements must have two exits, or they must remain locked and cannot be used. Another proposes that each house keeps residential records.
These expectations seem to be a bit lofty for places that are inherently nonprofessional in nature. What has been suggested will require trainings for owners and managers, possibly certification of their own, and in some cases, extensive remodeling that will likely cause many houses to close.
Many people in Washington County don’t know or understand what a recovery, three-quarter or sober living house is. Perhaps for good reason, they are viewed with a fair amount of skepticism. Let’s say you regularly see four to five guys smoking on the porch across the street from your house, and the faces seem to change more often than the seasons. Suspicion is the likely result.
These establishments are part of an unregulated adjunct to substance-use disorder (SUD) treatment. They are not treatment facilities, but rather transitional, group-style homes where residents are paying to stay and working toward the common goal of maintaining abstinence from intoxicants. Studies indicate that longer-term treatment stays and recovery support services produce better outcomes. However, many SUD sufferers don’t stay in treatment long enough for it to be effective or are unable to access funding to do so. Further, professionally delivered recovery support services are not always available in residential treatment settings. Recovery housing becomes an often-critical component of an overall continuum of care. In addition, the camaraderie that is pervasive in many recovery houses is born of the same stuff that binds survivors of other kinds of near-death experiences. This can be fertile ground for expedited healing.
In 2015, my agency, the Washington Drug and Alcohol Commission, began to offer rental assistance to SUD treatment participants whose only real obstacle to continuing treatment was having a safe place to live. This necessitated the development of a policy regarding not only the criteria an individual in need of funding would need to meet, but also the types of houses to which we could feel reasonably comfortable referring individuals. So, criteria had to be established for those residences as well.
Fortunately, in Washington, there are a few recovery houses that have been a vital part of the recovery community in Washington for over a decade and have helped untold numbers of people. The only regulation or accountability has consisted of monthly meetings attended by the owners, where they discuss shared issues and strategies to address these issues.
Among other things, the houses must have protocols regarding the use of medication, and the ability to test for the use of drugs or alcohol. They need to inform new house members of the rules upon entering the household. They must have policies that promote recovery by requiring resident participation in treatment, self-help groups and/or other recovery supports. All houses must follow local ordinances. Most importantly, they are to protect the atmosphere of recovery by having a zero-tolerance approach to any use of intoxicants. Individuals who request funding must be engaged in and regularly attending treatment, and they must also be employed or seeking employment. The Regional Recovery Housing Coordinator, employed at my agency, is responsible for tracking the progress of these folks and maintaining communication with house owners and operators.
These protocols have been in place at the local level for the past three years. We have had very few issues, and residences that were cause for concerns are no longer operational. Locally, we have a strong core of good owners with years of experience who are in it for, what I believe, are good reasons.
While I understand Harrisburg’s ambition to provide safe housing for individuals seeking to recover, my hope is that they don’t unintentionally make it impossible for good houses to stay in operation. A better approach may be to leave it up to local experts, and those holding the purse strings to public funding, to decide based on their experience with the area and owner/operators. Mandates that blanket the state to target pockets of corrupt practices often tend to throw out the baby with the bathwater.
When you see a group of men or women on the porch smoking and watch as their faces change, remember that you are not looking at bad people trying to be good, but at sick people trying to get well.
Erich Curnow is director of Clinical and Case Management Services at Washington Drug and Alcohol Commission.