Thwarting Recovery [Sober houses in Delray Beach, Florida]
When several inpatient treatment centers, drawn by low taxes and warm weather, opened their doors here to addicts more than 35 years ago, it seemed a godsend to substance abusers.
Soon, other centers, mostly legitimate, followed. Recovering addicts lived together after treatment in supervised apartments or single-family homes.
The residences were known as sober homes, where addicts could recover far from temptations and drug-abusing friends back home.
Addicts attended outpatient therapy, found jobs and buoyed each other as they waded back into everyday life. Many stayed in Delray Beach, drawing more addicts as word spread.
In time, Narcotics Anonymous and Alcoholics Anonymous meetings were almost as easy to find as a cup of coffee; today there are at least 150 meetings a week.
Experts called the treatment and sober house system the Florida Model, and it spread quickly across the country.
Hundreds of sober homes — some reputable, many of them fraud mills and flop houses for drug users — sprawl across Delray Beach and several surrounding cities.
No one knows exactly how many exist because they do not require certification, only city approval if they want to house more than three unrelated people.
Hoping for a fresh start, thousands of young addicts from outside Florida wind up here in places that benefit from relapse rather than the recovery they advertise.
“The state of Florida licenses haircutters, yet we don’t license any of the people involved in the supervision of young adults suffering from substance abuse disorder, far away from home, without means,” said Cary Glickstein, the mayor of Delray Beach. “These desperate patients and family members are getting exploited and abused.”
But the proliferation of fraudulent sober homes was in part also the result of two well-intentioned federal laws. First came a 2008 law that gave addicts more generous insurance benefits; then the Affordable Care Act, which permits adults under 26 to use their parents’ insurance, requires insurance companies to cover people with pre-existing conditions and allows for multiple drug relapses.
The result was a whole new category of young addicts with access to insurance benefits.
This gave rise to a new class of abusive operator, as painstakingly chronicled in The Palm Beach Post: the corrupt sober house owner.
Many drug treatment centers — which also treated inpatients — started paying sober-home owners “bonuses” from insurance money and fees for referring outpatients to their centers while they underwent therapy, according to law enforcement, a grand jury report and court records.
This is illegal.
Sober homes, which are not covered by insurance, can get thousands of dollars a month for each recovering addict, in large part from treatment providers, law enforcement and city officials said.
Much of it goes into the owners’ pockets.
But it is also used to pay rent so patients can live free and to provide perks that lure patients from other sober houses: manicures, mopeds, gym memberships and, worst of all, drugs.
Relapses are welcome because they restart the benefits clock.
To increase profits, many treatment centers and labs overbill insurance companies for unnecessary tests, including urine, blood and DNA. Some have billed insurance companies thousands of dollars for a urine test screen. Patients often unnecessarily undergo multiple urine tests a week
Sober houses are categorized as group homes for the disabled. This has complicated arrests, cases and lawsuits, although some treatment centers, lab and sober-house owners in the area have been prosecuted on state or federal charges for patient brokering and money laundering, the result of the Sober Homes Task Force.
In some of the worst cases, women were held captive, raped and drugged in sober homes
Addicts v. the ‘Bad Guys’
Sober homes here are everywhere. They are in wealthy beach-side enclaves, middle-class strongholds and gentrifying neighborhoods. Sometimes whole apartment buildings are converted into sober homes.
The houses can be gorgeous; they can also be grim.
Most of those are in low-income neighborhoods, where property is cheap, drug dealers plentiful and residents less inclined to make a fuss.
The last thing this area needed was hundreds of white “hard-core junkies” from out of state, he said.
But sober houses opened anyway, attracted by cheap housing and residents who are wary of authority.
This is what happens when people are allowed to run unregulated businesses. It would be nice if we could live without so many rules and regulations, but without them, shysters and con men run amok.
The rules aren’t just for us, they are for people who try to prey on us.
Dealers soon sized up their new customers and stocked up on the drug of choice: heroin.
Relapses and overdoses skyrocketed, particularly after potent synthetic opioids like fentanyl and Carfentanil hit the street. But addicts, who seldom have drugs on them, get a trip to the hospital. Dealers, if caught, get a trip to jail.
You put the heroin users here, with poor people, with a history of drugs and violence, with no regulation.
The “new homeless” — as the police call addicts who get booted from sober houses once insurance money runs out — are living on the streets.
Residents blame the city, in part, for the sober-house sprawl. Delray Beach officials are so afraid of lawsuits that they are paralyzed, Ms. Goldstein said.
Mayor Glickstein, who was just re-elected, said that federal anti-discrimination laws protecting people in recovery are so strict that cities that try to curtail sober houses routinely lose big money lawsuits. It happened in nearby Boca Raton.
A Pipeline to Relapse
For many addicts, living in sober homes was a pipeline to relapse. …the sober homes, meant to ease her recovery, did the opposite.
“Everyone was always high, and when people are in there getting high, you run around with them getting high,” said Ms. Ramalho, 26, who returned home in 2016 and is now sober after spinning out of control in Delray Beach. “It’s supposed to be the biggest recovery capital, but it’s really the biggest relapse capital.”
She overdosed three times. Twice she wound up in the hospital. Once, she nearly died after the sober house supervisor brought in heroin, she said, which is not uncommon in some sober homes.
Even the white vans, called “druggie buggies,” that take people to therapy are not off limits. Ms. Ramalho said she looked back during one ride and saw a man overdosing. They changed plans: “We had to carry him into the hospital.”