sober housing halfway house treatment allies in recovery dominique simon-levine drug intervention alcohol intervention addiction addict recovery

Illustration © Eleanor Davis

 

A member of AiR’s member site recently expressed concern about how halfway houses / sober housing deal with overdose or relapse.

…. If an addict is in a halfway residence, and they use, they are forced to leave. I don’t understand — they are put out the door onto the street, so that would put them right back full-time from where they came. No help, no nothing … Isn’t that true? What do you think about this?

My son has been in – out – and back into a residential halfway in Springfield. Since he has been there, there have been 2 or 3 overdoses. The staff did not now how to use Narcan, however one of the residents was, but wasn’t allowed to administer (probably due to the legality). Now I understand they just call an ambulance… and the resident must leave the residence… out in the street again…

What can be done to help them – anything?…..

Dominique Simon-Levine responds to these questions below.

Being thrown out for using drugs or alcohol in a residential program is controversial. Sober housing programs argue that a house and milieu cannot be kept safe if someone is using, so that person is then required to leave.

In order to start anew with the process of sobriety, a resident who has relapsed should be sent to a more intensive level of treatment (for example: clinical stabilization services or CSS in Massachusetts), but too often nothing is available and the only option is detox, which may not be medically appropriate if the drug use/relapse was brief. With nowhere obvious to go, the person ends up back on the street in a full-blown relapse.

The other scenario is that the person who uses denies their use and/or is angered at being discharged from the house and refuses any further help, ending up on the street.

Here is a good link that describes sober living.

Residential programs expect residents to follow the rules. Their obligation to a resident ends when he/she relapses. One of the greatest difficulties with our system of care for substance abuse is how silo’d it is. Providers aren’t reimbursed for warm hand-offs or getting someone from program A to program B — there are just too many ways people can slip through the cracks.

Families are often the only ones stepping in. Our blog posts and learning modules repeatedly stress this and encourage you to help your loved one into Program A, then from Program A to Program B, etc.

To this, we add one more possible resource: you may be able to use the services of a private consultant or publicly funded case manager.

The New York Times published a piece on private consultants who research appropriate treatment options and shepherd a person through the process, for families who can afford such a service. Read the article here.

For the rest of us, there are case management programs throughout the country supported through state or federal aid. Case managers refer and follow someone through the system and through the cycle of recovery. One place to look for a case management program is by going to SAMHSA.gov, then click on grants.

Grants are archived by year of award. There are several initiatives that support case management services. Here are several from grant year 2015.

Follow this link and click on the initiative to see if any of the grantees are near you:

 TI-14-007
Initial
 Grants for the Benefit of Homeless Individuals-Services in Supportive Housing (GBHI-SSH)
 TI-15-006
Initial
 Targeted Capacity Expansion: Substance Use Disorder Treatment for Racial/Ethnic Minority Populations at High-Risk for  HIV/AIDS (TCE-HIV: High Risk Populations)
 TI-15-007
Modified
 Targeted Capacity Expansion: Medication Assisted Treatment – Prescription Drug and Opioid Addiction (MAT-PDOA)
 TI-15-012   Modified  Offender Reentry Program (ORP)

Don’t let the titles of these grant initiatives deter you from calling them. Individual grantees have different criteria for admission.

Prolonged and seamless treatment for substance problems is difficult to make happen. When someone gets discharged from a sober home for using, the family needs to step in and push for more treatment. Look for case management. If none is available, the family will have to be that case manager.

While this adds to an already exhausting effort on your part, putting energy into getting your loved one into or back into treatment is the best way to end substance abuse in your family.