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31 Health Law. 24 (2018-2019)
Addressing the Opioid Crisis through Quality Recovery Housing

handle is hein.journals/healaw31 and id is 60 raw text is: ADDRESSING THE OPIQID CRISIS THROUGH QUALITY RECOVERY HOUSING Beth Ann Middlebrook, Esq. The Watershed Treatment Programs, Inc. Delray Beach, FL Pat Taylor P.T. Addiction Recovery Consultants Takoma Park, MD The President's Commission on Combating Drug Addiction and the Opioid Crisis (Commission) recently released its recommendations for addressing addiction in the nation. Fol- lowing up on the President's declaration of the opioid crisis as a public health emergency, the Commission made several recommendations related to housing opportunities for people in or seeking recovery from addiction. These include that (1) the U.S. Department of Health and Human Services (HHS) implement guidelines and reimburse- ment policies for recovery housing and (2) the Office of National Drug Con- trol Policy (ONDCP), federal agen- cies, the National Alliance for Recovery Residences (NARR), the National Association of State Alcohol and Drug Abuse Directors (NASADAD), and housing stakeholders work collabora- tively to develop quality standards and best practices for recovery residences, including the creation of model state and local policies; identification of bar- riers, such as zoning restrictions and discrimination; and development of strategies to address these issues. On October 3, 2018, the U.S. Con- gress passed H.R. 6 - the SUPPORT for Patients and Communities Act,2 which was signed into law on October 24, 2018. The Act includes a provision on recovery housing consistent with the recommendations of the Commis- sion. Subtitle D of the Act, Ensuring Access to Quality Sober Living, includes Section 7031 - National recovery hous- ing best practices. This Section requires HHS to issue best practices for entities operating recovery housing facilities to assist those recovering from an 24 opioid use disorder. This provision also requires HHS to identify or facil- itate the development of common indicators that could be used to iden- tify potentially fraudulent recovery housing operators.3 In addition, Sec- tion 1017 of the Act directs HHS to issue a report on innovative state ini- tiatives and covered housing-related services that state Medicaid programs may use to provide supports to Medic- aid enrollees with substance use disor- ders who are experiencing homelessness or are at risk of homelessness; Section 8071 authorizes a pilot program to pro- vide individuals in recovery from a sub- stance use disorder with stable, temporary housing.4 The pilot program for recovery housing is to be funded through amounts appropriated in the Fiscal Year 2020 Transportation, Hous- ing & Urban Development spending bill and allocated based on a funding formula established by the Secretary of Housing and Urban Development.5 The Commission's recommenda- tions and the federal legislation that has passed reflect a growing recogni- tion and understanding that if people with addiction are to get and stay well, continuing care and support are often needed, including a sober, safe and healthy living environment that promotes and supports a life in recov- ery from addiction. Access to a stable living environ- ment is fundamental to a person's health and well-being. Recovery resi- dences that are safe and effective are also integral to addressing the opioid epidemic, which claimed the lives of over 70,000 people from drug over- dose in 2017, a significant increase over 2016.6 Drug overdose is the num- ber one cause of accidental death in the United States and its impact is felt across every demographic and zip code. According to the Surgeon Gen- eral's Report on Alcohol, Drugs and Health,7 recovery residences are meant to provide both a substance-free envi- ronment and mutual support for resi- dents. It is of vital importance that the regulation of these residences has begun to evolve. What Are Recovery Residences? Recovery residences span from high to low levels of structure and recovery oriented non-clinical ser- vices and activities commensurate with the needs of residents at various stages of recovery. They range from independent, resident-run homes to staff-managed residences that house individuals who are still receiving outpatient clinical services. Relapse rates are high for individuals in early recovery who do not live in environ- ments that support recovery, and the progress they make while attending outpatient treatment can be lost or compromised in the absence of these supportive living environments. Recovery residences serve as a bridge between 24 hour-per-day highly supervised treatment and a full return to independent community living.8 The National Institute on Drug Abuse suggests that recovering people should spend 90 days in some form of recov- ery housing.9 Many individuals stay during and/or after outpatient treat- ment, with self-determined residency lasting for several months up to years. A study on recovery housing con- ducted in 2010 by the Alcohol Research Group of the Public Health Institute, entitled Sober Living Houses for Alcohol and Drug Dependence: 18-Month Outcomes, demonstrated that people who resided in recovery housing were more likely to maintain their sobriety, stay gainfully employed and avoid arrest.10 According to the National Coun- cil on Behavioral Health, recovery Volume 31, Number 2, December 2018 The Health Lawyer

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