A Plan to Regulate Sober/Recovery Housing

There has been all kinds of terrible news about the problems caused by sober/recovery homes in NJ, PA, FLA, OH and a number of other states. These concerns have existed for years, and they include overcrowding, a lack of expertise, workers that are using drugs, and death. These programs are neither licensed, nor regulated, and rarely supervised in any way by a true substance abuse expert. I sent this letter to the NJ State Senate Health Committee on May 13, 2017, and I am publishing a copy of it now in the effort to further the discussion and help the public.

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To the NJ State Senate Health Committee:

I am writing regarding  S-3161 (recovery housing).  Many states around the country have had problems with their sober/halfway/recovery houses. Florida created a certification that went into effect last year, but most of them have still not earned it. They are still mired in problems. Ohio created a voluntary certification (that is overseen by the industry) and the state also provided 2.5M to support the expansion of services. Because of the voluntary nature of the certification, the Ohio sober houses are still rife with problems (no curfew, people using, little to zero accountability, client brokering).

I suggest the following:

  • A state certification or license be required to own/operate a sober/recovery house
  • All staff must submit to a criminal background check
  • 24/7 staffing required, particularly overnight
  • A minimum urine screens of at least 1x a week (self reporting abstinence from substances is not effective). These can be instant tests, rather than send-away lab tests. Screens should test for at least 7 different substances and always include alcohol, marijuana, cocaine, benzodiazepines, heroin, opiates, and methamphetamine.
  • A requirement of a blackout period for the first 30 days. This means that there is a curfew for new residents during that period (10 pm to 7 am, with early morning exceptions for work).
  • At least monthly supervision of all workers by a LCADC to ensure quality control. Despite this not being a clinical setting, there should be some oversight and supervision.
  • Clients that are on medication assisted therapies cannot be denied. Many sober homes are operated by people in recovery, and they often have a bias against medication assisted therapy. Those on medication assisted therapy should be required to adhere to best practices, which mean weekly urine screens and outside counseling of at least 1 hour a week.
  • Reasonable access to 12-step meetings and treatment (with a 1 mile walk) or a van service is provided at least once a day for each.
  • An exemption from ADA compliance, as this can be too costly.
  • Penalties for violations including fines, revocation of license/certificate and possible jail time.
  • Oversight of the programs provided by some state agency.

Owners and operators of these programs will argue that because they are in recovery, that they know better than DMHAS and the state government. Please do not be swayed by arguments that regulation will force them to close. There are a few programs that exist in the state already that exceed my recommendations and they are financially well. Please do not fall prey to their arguments that they can self-regulate and that the industry will watch itself (I can’t think of an industry that does a good job regulating itself).