©2014 Rick Macnamara LCSW
Sober Living Homes are a great idea and the vast majority of persons who have stayed in one report positive, life-changing experiences. However, consumers should exercise caution and, as with many things in the addiction treatment industry, not take claims and promises at face value. In this week’s blog, I will point out some of the problems surrounding these establishments and ways you can protect yourself and your loved ones.
Sober Living Homes have been around since at least the 1970’s when it began to be recognized that the living environment for a person recovering from addiction is vitally important to treatment outcomes. It was during this time that residential treatment centers and other inpatient facilities emerged that sought to take the addict out of her destructive living situation and place her in an environment where she could build new support systems and learn new ways of living without the use of substances.  A recent article published in the Journal of Psychoactive Drugs compiled the results of several studies of Sober Living Homes that affirmed the hypothesis that a sober living environment and social interactions with other sober individuals led to better outcomes for individuals studied over a three year period. 
Several recent articles in local newspapers around the country and reports on local TV stations, however, point out some of the systemic problems of sober living homes as they currently exist. The authors of the Journal of Psychoactive Drugs article acknowledged some of these shortcomings, as well. Taken as individual incidents, they appear to only cause local interest, but in the aggregate, they show a need for national attention.
First, there is the lack of oversight by any state or federal agencies for the majority of Sober Living Homes. In the absence of strong self-governance of a home, things can get out of control as they did in October 2013 in Rumson, New Jersey, when a 25 year old man died of a heroin overdose in a sober living group home.  The parents of the young man learned that the home, and many others like it, was not licensed by the State of New Jersey even though in some cases sober living homes are reported to receive state and federal money.
In February of 2014, Channel 7 News Miami Investigative Reporter Carmel Cafiero reported on some disturbing deaths at sober houses, which she described as ‘popping up all over” in south Florida. It was not apparent what, if any, role the sober living homes had in the deaths, but as in the New Jersey case, it raises serious questions about how safe they are and who is watching out for the rights and safety of recovering addicts. 
Most other facilities that provide a safe environment must follow licensing requirements and be subject to periodic, often unannounced, inspections. In the late 90’s, I was a Case Manager at a residence for Mentally Ill Chemically Addicted (MICA) homeless adults called the Warner House in Hackensack, New Jersey, a former single room occupancy hotel in a 150+ year old building. We were licensed under the Division of Consumer Affairs and could look forward to an inspection at any time. The three people who operated the Warner House program day to day, two case managers and a building operator, were highly motivated to provide a safe environment for our twenty two residents, but we were very aware of similar residences within a few blocks of us that cut corners and put residents at risk.
In most states, it is possible to access the inspection reports for hospitals, nursing homes, and other care facilities to see if there have been any deficiencies. These reports, many of which are freely available online, judge facilities on an array of criteria, including food, activities, safety, etc. But in nearly every state I have reviewed so far, sober living houses operate in a grey area outside of government scrutiny.
This week, five southern California cities filed a friend of the court brief to ask the Supreme Court to review restrictions on local ordinances governing sober living homes. This action was apparently prompted by local residents’ complaints of noise, cigarette smoke and a transient population at these homes. Local ordinances were over ruled as unconstitutional , but it’s important to remember that a well-run and accountable facility would not have these problems in the first place. I can sympathize with these cities, which are only reacting to the lack of uniform regulations and the negative environmental issues that rose as a result.
Also this past week, FBI and IRS agents raided a sober living condo in West Palm Beach, Florida, as part of an insurance fraud investigation. It’s not possible to draw any conclusions regarding whether better state regulations could have prevented this, but the legal vacuum surrounding regulation of these facilities could be attractive to persons looking for illicit opportunities. Reports are that local treatment centers applauded the raid on the described dilapidated condo. As a Clinical Supervisor for a large behavioral health managed care organization, I routinely heard reports from reviewers in south Florida and elsewhere about relapses that occurred in so-called sober environments.
Sober Living Homes and similar establishments have done a lot of good for a lot of recovering addicts. Most are staffed, like the Warner House where I worked, by dedicated professionals serious about the safety and wellbeing of their residents. But in light of recent revelations regarding a lack of oversight on these facilities, consumers would do well to be very careful selecting a sober home and remain vigilant while you or a loved one is living there.
 White WL. Slaying the dragon: The history of addiction treatment and recovery in America. Chestnut Health Systems; Bloomington, IL: 1998.
 J Psychoactive Drugs. Dec 2010; 42(4): 425–433.
 The Record (New Jersey): Sober House Rules September 16, 2014
 Sober House Deaths WSVN Miami/Fort Lauderdale Carmel Cafiero, Investigative Reporter February 25, 2014
 Costa Mesa supports Newport in sober-living case The Daily Pilot September 12, 2014
 FBI raid targets sober home owner in West Palm Beach The Palm Beach Post September 11, 2014