Sober Living Homes Are Too "Clean"

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Sober Living Homes Are Too "Clean" - Page 2

By Anne M. Fletcher 07/21/13

I was heartened by Matthew Perry's openness about addiction—but then dismayed by his sober living home's backward thinking on maintenance drugs. Such policies are illegal, as well as unethical.

perry sober house.png
Matthew Perry's heart may be in the right place—but his sober living home's MAT
policies are not.

(page 2)

Anyone who works in the field of addiction treatment is aware of the growing view that serious substance use disorders should be viewed like other chronic illnesses, such as diabetes, that warrant more than just a short-term burst of treatment. Sober living facilities can help with the transition from intensive treatment back to the real world. The forthcoming “Policy Statement: The Role of Recovery Residences in Promoting Long-Term Addiction Recovery” to be published in the American Journal of Community Psychology by DePaul University’s Leonard Jason, PhD, and several other leading experts in the field concludes, “A small but growing body of research supports the effectiveness of recovery residences in sustaining abstinence and promoting gains in a variety of other domains.” 

Also, a number of experts I interviewed for my book feel the combination of going to intensive outpatient treatment while living in a well-run sober home can be a better model than residential rehab for many people. James McKay, PhD, director of the Center on the Continuum of Care in the Addictions at Philadelphia’s Treatment Research Institute said, “When a sober home works well, it’s a longer stay than in a residential program. You get six months rather than twenty-eight days for a fraction of the cost.” But again, being well-run is a “big if.”

If Perry wants to help others in an optimal way, he’ll recognize science-based treatment approaches and that there are many different paths to recovery.

So what’s up with denial of sober housing to people on Suboxone and methadone? Beth Fisher, LCSW, Executive Director of Hope Homes and past president of the National Alliance for Recovery Residences, an organization that has adopted national operating standards for sober living facilities, said that homes allowing MAT are difficult to find. (I checked with a number of experts, and they all said that there are no national data on the number of facilities that will admit clients on MAT.)

Fisher added that the argument that these medications will make clients “pee dirty” is one that can be gotten around with tests that are more sophisticated than just “peeing in a cup.” But they cost a bit more. (A glance at the Perry House website suggests that they could spring for the more expensive testing.) She also stressed the need for residences to have strict standards for MAT clients—for instance, Suboxone and methadone should be kept in a lockbox because they can be abused when taken inappropriately.

Over the course of the past few months, I’ve been helping the father of a young man with a long history of opioid addiction find quality residential treatment, which they eventually did. But afterward, they found that not one sober home in a large metropolitan area would take clients on Suboxone. With difficulty, they finally located one, but in another community. The father considered a lawsuit against some of the facilities that refused MAT clients. He said, “It’s just speculation on my part, but [the peeing dirty argument] appears to be simply an excuse to keep people on medication out.” 

Mark Willenbring, MD, director of the Alltyr treatment system in St. Paul, Minnesota, and former director of the Division of Treatment and Recovery Research at the National Institute on Alcohol Abuse and Alcoholism agreed: “It's just an indirect way of saying you don’t think people taking opioid therapy are ‘sober.’ So it's better to stay addicted and possibly die rather than ‘be dirty’ but alive, happy and productive.” Willenbring maintains that we need to see MAT as we do insulin for people with diabetes, and I agree. 

Tom Horvath, PhD, owner and director of the Practical Recovery treatment facilities in San Diego, said, “It’s extremely frustrating to individuals who have achieved stability in recovery using Suboxone when they’re told they’re ‘not really in recovery’ and therefore not eligible for a sober home. They’re faced with the choice of not having sober living or not having Suboxone.”

As a person in long-term recovery from an alcohol use disorder, I see revelations like Perry’s as bolstering the growing movement to break the silence about addiction, which hopefully will help to vanquish some of the stigma surrounding it. But if he wants to help others in an optimal way, he’ll lead the charge by recognizing science-based treatment approaches and that there are many different paths to recovery—paths that include MAT for as long as someone needs it. 

Anne M. Fletcher (@annemfletcher) is a columnist for The Fix, and the author of Inside Rehab: The Surprising Truth About Addiction Treatment—and How to Get Help That Works (Viking, Feb. 2013) and Sober for Good: New Solutions for Drinking Problems—Advice From Those Who Have Succeeded (Houghton/Harcourt, 2001).

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