People recovering from drug addictions could use an intermediate step before living on their own, especially if they’re coming out of prison or a treatment program. However, the state needs to bring uniform regulations and oversight to the patchwork of inspected, self-regulating and unregulated recovery homes to make sure the clients are adequately served, not taken advantage of during a vulnerable period.
The state should establish a licensing and inspection program — much as it has done for senior care and nursing facilities — for so-called “sober living homes.” If it wants to pay the counties to handle the inspections, that would be fine, provided they can handle the extra work. The goal should be to make sure recovery homes are clean, safe and meeting clients’ needs, without imposing so many requirements that the cost of operating them becomes prohibitive or clients cannot afford to pay.
In a story Tuesday, Post-Gazette staff writers Adam Smeltz, Molly Born and Kate Giammarise reported that the number of sober living homes is on the upswing because of the opioid epidemic. The homes are supposed to be way stations on the road to wellness, places where people with addictions can work on recovery plans with the support of peers and, perhaps, the services of addiction specialists. They are sometimes called three-quarter-way houses because they offer clients more freedom than inpatient addiction treatment programs, jails, prisons or the regulated halfway houses associated with the criminal justice system.
Without a licensing system, however, neither state nor county officials know how many sober living homes are out there, how well they serve their clients or whether they’re anything more than flophouses eating up money from clients or other sources. Some homes have been accused of crowding in too many clients or offering no services. A small number of homes are subject to inspection because they operate under government contracts, but the others either seek certification through a professional association, the Pennsylvania Alliance of Recovery Residences, or operate as they see fit.
To be sure, operating a recovery house is challenging work. Some clients skip out without paying. Operating margins can be thin. Yet the state should be able to strike a balance between no regulation and too much, especially if it solicits the input of operators already holding themselves to high standards.
The alliance should continue reaching out to recovery homes and encouraging them to meet industry best practices. But this is one of those cases where the carrot pales beside the stick. The licensing and inspection of recovery homes is a natural complement to other opioid-related measures that state leaders have enacted or continue to study. If holistic care is the goal, the state has to address housing issues, too.