This just in: Overdose deaths in Massachusetts increased 7 percent last year. That figure is significant because the rise in deaths is slower than previous years, an indication that greater awareness and legislation are making a small dent in the epidemic. And the comprehensive opioid legislation signed by Governor Charlie Baker two months ago, including the first law in the nation establishing a seven-day supply limit on first-time opioid prescriptions, should help make a difference over time.
Still, there were nearly 1,400 lives lost statewide last year to opioid and heroin abuse, an unconscionable toll that shows there’s more to be done. Policy makers must turn their focus to what happens to addicts after they detox or get treatment, a vulnerable population in dire need of community-based, sustainable pathways to recovery. Legislative action must address the real needs for additional services or the Commonwealth risks losing addicts in an overwhelmed provider network.
A key long-term recovery support institution is the “sober home,” which provides an alcohol- and drug-free living environment. This often is the first step for addicts who have detoxed; they face an uneven, unregulated system. Joining Ohio and Florida, Massachusetts recently adopted a voluntary certification program for sober homes.
According to a recent Globe report, there are about 350 sober houses in Massachusetts. They typically charge a weekly rental fee of $160. But beyond that, information is scarce about where they are located and who runs them. The facilities, as recovery residences, aren’t considered treatment. And that’s why the state can’t license them. Additionally, federal housing rules shield them from regulation, since they essentially are group homes for disabled people with a shared concern.
Such lax governmental oversight led to abusive landlords whose sober houses were not exactly drug-free environments. Instead, they were running insurance scams and overcrowded homes until Massachusetts authorities caught up.
With the new voluntary certification program, the state expects to see the quality of sober homes rise as property owners comply. To earn the seal of approval, a sober house must meet certain physical and administrative requirements and safety standards, as well as have rules for the residents. More important, it must offer programs that support recovery. Starting this year, state agencies, drug courts, and parole and probation officers will be required to send addicts in recovery only to certified sober homes.
But the concern among advocates is that waiting lists will lengthen if not enough homes pursue the certification. “I don’t know how you could stay in business,” the president of the Massachusetts Association for Sober Housing told the Globe, indicating the mandatory referral would act as a powerful incentive for sober home owners to get certified.
Still, more can be done to ensure that recovering addicts are indeed offered a substance-free, high-quality living setting. At least five states either have passed or are considering legislation to institute basic rules for recovery residences. In Arizona, for example, the state legislature recently passed a bill allowing cities and towns to regulate sober houses where at least 25 percent of the residents are in treatment at a licensed facility. The state of Delaware provides a monetary incentive in the form of short-term rent assistance for sober homes that pursue voluntary certification.
Other legislative solutions that lawmakers should consider include increased access to medication-assisted therapy such as methadone and buprenorphine. These treatments can be an effective component of long-term recovery.
The Commonwealth has taken on the addiction crisis with a true sense of purpose. The landmark bill signed into law by Baker provides for earlier intervention, increased education to prevent addiction, expanded access to treatment services, and enhanced screening measures. But more attention needs to be paid to what happens after drug addicts walk out of a 90-day treatment program. Until the full cycle of addiction is accounted for, too many recovering addicts, who might otherwise recover, will remain at risk.