The lucrative business of so-called sober homes — where individuals recovering from substance-use disorder live in a supportive residence free of drugs and alcohol — has come under increased scrutiny across the nation.
A Globe story earlier this month focused on one unscrupulous operator, Daniel Cleggett Jr., who has seen his sober homes business boom in Massachusetts. Two people have died on his company’s watch. Cleggett’s sober home in Boston, city officials allege, had clients living in overcrowded and unsafe rooms. In another of his company’s sober homes, clients allege that nonmedical staff told them to stop taking psychiatric medications and were told to pray instead.
There is no charge that Cleggett’s company did anything illegal (a local police investigation into one of the deaths is ongoing). Yet the case shines an uncomfortable light on a budding industry that exists in a regulatory twilight zone: Operators face few legal requirements, which allows pretty much anyone to open up a sober home.
That’s not to say Massachusetts officials haven’t been paying attention. In fact, the state became a national leader in 2014, when the Legislature introduced some oversight into the sober-home industry, including voluntary certification. But there’s more the state can do.
It’s difficult to regulate sober homes, and that’s partly because of existing federal antidiscrimination rules. Residents of these houses, as a group of disabled people living together, are protected by the Americans with Disabilities Act and the Fair Housing Act. Furthermore, under state law, sober homes are not considered treatment facilities and thus are not subject to licensing requirements.
Those obstacles are why the state’s certification program, which launched in 2016, had to be optional. The certification process includes making sure that a sober home meets nationally recognized administrative and safety requirements. For instance, to be certified, a sober home must have rules and a code of ethics and provide drug screening for residents. The home needs to pass an inspection and buy enhanced property insurance.
At least 10 or so other states — including Indiana, Rhode Island, and Ohio — have laws on the books defining sober-living residences and regulating their operation in some form or another.
“Our law was enacted as a consumer protection law,” said Larissa Matzek, executive director of the Massachusetts Alliance for Sober Housing, the nonprofit designated by the state to administer the certification program. “We do feel this was a strong step towards eliminating problems that we saw prior to the law.”
To encourage certification, Massachusetts required all state agencies and vendors receiving public funds to refer individuals in recovery to only certified homes. There are currently about 180 sober homes certified in the state.
And yet there are still a significant number of sober homes operating in the dark, since plenty of folks aren’t referred through state agencies or vendors. The 180 or so that have been certified by MASH represent roughly one-third of the estimated total sober homes in the state, according to Matzek. No one knows the exact number, but that is still a pretty large group of operators without direct oversight.
David Sheridan, president of the National Alliance for Recovery Residences, a nonprofit that developed standards and training and provides resources on sober homes, lauded the state’s efforts but argued we’re “half-way there.”
“The model right now is Florida,” Sheridan said. For instance, the Sunshine State offers stronger incentives for sober homes to get certified. “Florida not only mandates all state referrals to go to certified homes, but also referrals from private agencies.” Massachusetts could also fund increased access to certified sober housing for individuals who cannot afford it, Sheridan said.
The state must also continue to educate the public on sober homes, because there is still strong stigma unjustly associated with the residences, which can make them difficult to site in communities.
Massachusetts was one of the first states to recognize that sober homes could play a significant role in the recovery process of individuals suffering from substance abuse. “For more than 30 years, most of addiction resources went into treatment,” Sheridan said. “But opioid addiction is a chronic condition, and it takes several years, and not just a 30- or 60-day treatment, to recover. Sober homes are a critical component after treatment because they provide that longer-term support.”
He’s right. While progress has been made, the state should take extra steps to ensure safe and healthy environments that support residents in their recovery from substance-use disorders.
Correction: An earlier version of this editorial misspelled the name of Daniel Cleggett Jr.