A disturbing article in last weekend's New York Times detailed deplorable conditions in a segment of New York City's housing market nominally serving individuals in early recovery from alcoholism and addiction. This item comes in the wake of a visible enforcement action against a Bronx-based organization. As disturbing as these pieces are, they describe conditions that have prevailed there for years, with the tacit support of government and private agencies that refer vulnerable people to this housing, and then mostly look the other way as abuses occur. It is perhaps the most vivid current example of what happens in a system without standards and accountability for many providers of recovery services.
For most residents struggling to overcome addiction, this system is a dead end. It cannot function effectively as a recovery resource, and has instead become a vehicle for exploitation of thousands of vulnerable people. Although touted as “recovery housing,” it appears that very little recovery support is provided to the residents. Instead the system is described as having nonexistent supervision, no maintenance of drug- and alcohol-free environments, and even tolerance of alcohol and drug use. Legitimate recovery residences in the area suggest that the “three quarter house” designation is a term of mere convenience, designed to bring these housing units under the protection of fair housing laws. We wouldn't be surprised to learn that a large portion of this housing failed to meet the city's own standards for habitability.
Equally disturbing is the culture of inducement that appears to be one of the key components of maintaining the system, where the landlords and treatment programs have financial relationships for referrals. This particular form of fraud diverts money to landlords that is intended to pay for outpatient treatment services. These payments are the basis for the revolving door where, in order to maintain his or her housing, a recovering individual who completes treatment must find a way to be admitted to another program willing to engage in this fraud, and the key to admission is often a relapse. Failure to be used as a pawn in this scheme means either eviction or being forced to pay unaffordable rent. These residents are among the city's most disadvantaged and vulnerable—men and women whose only alternatives are shelters or the street. This practice is inexcusable, and it's fueled by the absence of adequate housing subsidies or operating resources for quality recovery housing.
Sadly, the existence of a system like this is the entirely predictable result of the combination of failed policies and financing in both healthcare and housing for people with substance use disorders that currently exists in New York and other places. Legitimate providers and services are crowded out, displaced by a predatory system reliant on vulnerability, opportunism, and misguided good intentions manifested by a willingness to overlook serious problems.
As the national standards body for recovery residences, NARR (the National Alliance for Recovery Residences) knows that the problems described here are not unique to New York City. We wonder what kind of human tragedy will be sufficient to motivate change. We also know that it's possible to maintain healthy, safe and recovery-supportive systems of recovery housing. New York has taken none of the prerequisite steps to making such a system possible. We urge them to do so by adopting the NARR quality standards, supporting a state affiliate to support the development and operation of quality recovery residences, and deploying the science of recovery management for people in recovery, including those exiting treatment programs. Ohio, Massachusetts and Florida have begun to support real standards for recovery residences, with our help. These states will be limiting referrals from publicly funded agencies only to residences that meet our standards. We offer our assistance to OASAS (the New York Office of Alcoholism and Substance Abuse Services) and to the New York State Department of Health in addressing this tragedy.