Pubdate: Sun, 08 May 2016
Source: Boston Globe (MA)
Copyright: 2016 Globe Newspaper Company


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.
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MAP posted-by: Jay Bergstrom