A New Trend in “Wet Houses” Flames Fury

By Kirk Maltais 06/06/11

Shelters that allow homeless chronic alcoholics to drink are hospices, not treatment, say critics like Dr. Drew Pinsky.

 

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A formerly homeless resident at St. Anthony. Photo via

Are some alcoholics so far gone that there’s no way to stop them from literally drinking themselves to death? And if so, should such terminal alcoholics who have fallen into homelessness be offered a shelter to protect them from the health risks associated with living on the streets—even if they continue drinking? Or should society offer them at least minimal protections, much as clean needles are provided to IV-drug users to limit their risk of contracting HIV and hepatitis C?

This quandary about homeless chronic  alcoholics is the reason that a growing number of U.S. cities are now opening so-called wet houses, which allow residents a bed, meals, medical attention coupled with alcoholism counseling, while not requiring that they stop drinking. Based on the model of harm reduction, such wet houses are an attempt to deal with the stark reality that some alcoholics may be too far gone to turn back.

Controversy has arisen due to a flood of media coverage of a wet house that opened in St. Paul, Minnesota. The St. Anthony Residence shelters some 60 late-stage alcoholics. The home, which is partly funded by the state and operated by Catholic Charities, receives taxpayer money, which residents see as monthly checks for $89—much of which they spend on booze.

Directors of the St. Anthony program argue that a wet house allows alcoholics a safer alternative to living on the streets. “These are all men who have been through treatment, numerous attempts,” St. Anthony program director Bill Hockenberger told CNN. “These are men who lost their jobs, relationships, homes due to alcohol—all family ties pretty much have really reached rock bottom.” Hockenberger says that St. Anthony not only decreases the dangers to which homelessness exposes the men but keeps hope alive by actively working with them to try to help them kick their habit. St. Anthony is one of five wet houses in Minnesota, and the model for others in cities such as Memphis and Philadelphia.

Yet some experts like TV rehab specialist Dr. Drew Pinsky argue that harm reduction is not a treatment because it allows alcoholics to continue their addiction, even if in a safer environment. “I want to know if they are actually doing more harm than good,” Pinsky wrote on a CNN blog post. “What motivates most people to change their behavior is consequences. No consequences? No behavior modification.” Pinsky called the sanctuary a hospice, where alcoholics go to die.

Proponents of the concept counter that making sobriety a condition of shelter is what had led to the large number of homeless alcoholics in the first place. If nothing else, they say, wet houses save states the costs involved in arresting and hospitalizing alcoholics who are left on the streets. According to research by the San Francisco Department of Public Health, the top 100 individuals who require emergency public services (out of the estimated 16,494 homeless in San Francisco) racked up an annual bill of $8.1 million. One such individual, a 49-year old schizophrenic with severe addiction problems, cost the city $155,453 alone.

A 2005 study of 1811 Eastlake, a wet house in Seattle, showed a 53 percent decrease in spending on services for patients over six months. While further studies of the effectiveness of these programs are ongoing, the wet houses at least appear to be cost-effective.

As more wet houses spring up nationwide, the sound and fury over whether tax dollars are in fact “enabling” these alcoholics in their disease is only likely to increase in volume and complexity. If studies show that with stable housing comes a stabilization in drinking habits, this harm reduction approach may garner more support. If not, their claim on scarce funds for a fraying social safety net may prove harder to sustain.

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Kirk Maltais is a New York-based reporter.  Find out more about him on Linkedin and Twitter.