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s the opioid epidemic spikes, more and more unregulated “sober houses” are popping up around the nation — and state lawmakers are moving to crack down.

States from New Jersey to Utah are seeking to impose minimal standards on sober homes, a term that can apply to anything from a run-down rooming house with dozens of tenants to an upscale recovery center offering counseling sessions, job training, and yoga classes. Recovering addicts stay for weeks or months at a time, often after arriving straight from inpatient rehab programs or psychiatric hospitals.

Some addicts consider such homes vital to their recovery. But neighbors often complain that they bring noise, traffic, drug paraphernalia, and a revolving door of strangers into otherwise quiet communities. The homes vary a great deal in how closely they supervise the recovering addicts and in how strictly they maintain a drug-free environment.

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And many proprietors bristle at state efforts to impose standards, such as background checks on the staff.

“A lot of people presume that there is a nightmare of terrible sober houses,” said Chris Edrington, a former heroin addict. He’s now the executive director of St. Paul Sober Living, which operates homes in Minnesota and Colorado and has successfully fought off local efforts to shut down some of his properties.

Chris Eddington
Chris Edrington, executive director of St. Paul Sober Living. Ackerman + Gruber for STAT

“There are some bad apples out there, but it’s way exaggerated,” he said. “You have to separate the image of the big, scary addict — the kind you see in commercials with the scary music and a needle and a spoon — from people who really want to change.”

Federal law prohibits communities from enacting local regulations, such as zoning, that limit housing options for recovering addicts.

But states are finding creative ways to crack down.

In Arizona, both the state House and Senate have passed a bill giving city and county governments the right to require sober homes to notify them when they open. The proposal also allows local governments to require that sober living homes have trained managers, maintenance plans, and supervision for residents. The bill went to Governor Doug Ducey last Friday.

Massachusetts and Florida, meanwhile, recently created voluntary certification programs for sober homes in conjunction with the National Association of Recovery Residences, which has about 2,000 sober homes in its national registry. To nudge proprietors to comply, the states refuse to hand out grants to any home that isn’t certified. They also bar state-funded addiction treatment programs from referring clients to any sober home that hasn’t gone through the program.

To be certified, sober homes must show that they have strict rules against drug use on the property, that they track their residents’ progress, and that they organize peer support programs, among other requirements. They also must undergo safety inspections by a state-approved certifying organization.

Legislators in California and Pennsylvania are considering similar laws, hoping to stem the proliferation of sober homes.

“It’s exploded in the last three to four years,” said Bryan Allen, chief of staff for state Representative Tina Davis of Pennsylvania, who introduced that state’s bill. “The problem is that anybody can start a recovery home, and pack 15 to 20 people into 1,000 square feet of house.”

Other states are taking a more incremental approach: New Jersey Governor Chris Christie recently signed legislation requiring recovery houses to alert the next of kin when a client is evicted for relapsing. It’s called “Nick’s Law” after Nick Rohdes, a 24-year-old heroin addict who died of an overdose after being kicked out of a sober house for using drugs.

And Minnesota and Ohio are looking at setting aside grant money for sober homes that meet state criteria.

The proprietors of sober homes are pushing back.

Jacqueline Lia-Rivera, who runs Keep it Simple Sobriety in Cleveland, is suspicious of certification or incentive programs.

“If they want to tell us how many staff to have, I’m not interested,” she said. “If they want to tell us to have a certain kind of therapy, I’m not into that either.”

St. Paul Sober Living
Seth Dolinsky, a program director, meets with women during their weekly meeting at one of St. Paul Sober Living’s sober houses in St. Paul, Minn. Ackerman + Gruber for STAT

For many former addicts pursuing recovery, Edrington said, sober homes offer essential support. They serve people of all incomes and from all walks of life; monthly rents can range from $400 for a bunk in a shared bedroom to $4,000 for a single room in an upscale center.

“Most people with at least five years sobriety will tell you that it’s having the community of people that makes the difference,” Edrington said.

One of the hottest clashes between sober homes and state legislators is taking place in Utah.

Last May, the state began requiring sober homes to be licensed. To qualify, the homes need to have a medical treatment plan and meet minimal staffing guidelines.

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But sober home operators are resisting. In January, the operator of seven sober homes in Utah, NXLevel Networks, sued the state. Proprietor Allen Andersen claimed that the licensing mandate puts an inappropriate burden on facilities that serve recovering addicts, who are protected under federal disability law.

“The state is vastly overreaching,” said Andersen’s attorney, Ted McBride. “And as far as their justification of safety, I’m not buying it.”

Some sober home advocates hope they’ll be able to come to a middle ground with state lawmakers.

Anita Bradley, director of the Northern Ohio Recovery Association, which operates sober homes in Cleveland, said she would fight against certain regulatory proposals, like requiring background checks for staff. That might discourage former addicts from managing sober homes, she said.

“The houses I’m accustomed to are run by people in recovery themselves,” said Bradley, a former cocaine addict. “They are kind of, ‘been there, done that.’”

On the other hand, Bradley said some state oversight could be useful to chase out proprietors who run dangerous or ineffective programs.

“I would rather have a sober home and be monitored,” she said, “than to see somebody running a flophouse full of people getting high.”

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