Editor’s note: This is the second of two stories on housing and addiction. You can read the first story here.
Ann Benrud has lived happily in her St. Paul home for 26 years. The house next door is a duplex that was often rented to students from the nearby university, so she’s seen her share of parties and noisy move-in days, but for the most part everyone on her block has coexisted happily. Then, in December 2023, the duplex was purchased and, Benrud said, life in her neighborhood began to change.
It started quietly enough, Benrud said, with a moving van pulling up on her driveway one evening and unloading furniture. The movers told Benrud that the duplex was being turned into a sober home for as many as 28 men.
“That’s how I found out,” she said. “No other communication by anybody.” Later, Benrud said she and her neighbors were informed of the change via a flyer from their local district council.
At first, Benrud said she tried to make the best of it, introducing herself to sober home residents and the house manager, but things quickly felt like they were getting out of hand. “There were ambulance calls, fights, people running across my lawn,” she said. “You could smell weed being smoked there all the time. From the house manager’s window even.”
Art Eguia, the operator of the sober home next door to Benrud, also operates four other sober residences in Minnesota. He said the home in question is operated under an abstinence-based model, where mood-altering substances are not allowed. Residents who wish to smoke marijuana are asked to do so outside, away from the home. Even if residents do follow his rules, he continued, that doesn’t matter because people tend to have preconceived ideas about sober homes. “Neighbors are always going to say they smell marijuana,” he said. “Everybody is OK with a sober home as long as it is not in their neighborhood.”
Later, the sober home’s male residents were moved out and a group of women were moved in. This change didn’t help much. “When the women came, there were boyfriends and girlfriends fighting,” Benrud said. “One time, there was a man and a woman fighting in my driveway. He took a bike and made like he was going to throw it at her.”
Benrud knows her story sounds like a classic case of NIMBY (Not In My Backyard), but she says that didn’t have to be the case. The neighbors on the duplex’s other side put their house on the market as soon as they heard that a sober home was moving in, but she decided to stay put.
“I believe in people’s second chances,” Benrud said. “I absolutely believe in sober homes — especially well-run sober homes. If a sober home is not run properly, things can get out of hand really quickly, and that’s not good for anybody.”
There are hundreds of sober homes in the Twin Cities alone, and most do not cause problems for their neighbors. But some advocates for abstinence-based sober living say the growth of harm-reduction options — where house managers focus on safety over sobriety, meeting participants where they are at in the recovery journey — combined with new state laws requiring all sober homes to allow residents to possess potentially mood-altering prescription medications like Adderall or Xanax used to treat co-occurring mental health disorders — has the potential to create problems for residents and neighbors.
Related: A ‘slippery slope’: Long-established sober homes face changing attitudes about addiction treatment
“Sober homes quietly co-existed in our society for over 50 years,” said John Curtiss, co-founder, chief executive and president of The Retreat, a national alcohol and drug recovery center based in Wayzata. “Harm-reduction homes are by nature messier than abstinence-based homes. They are more difficult to manage. You are taking people with no off switch, with moderate-to-severe substance-use disorder (SUD), and giving them access to mood-altering chemicals like cannabis, Adderall, benzos.”
In the past, when sober houses were all abstinence based and did not allow mood-altering chemicals, Curtiss said, running a sober home was “easy.”
“The rules were: You have to be sober to live there. You have to work full time and be an engaged member of society,” he said. But, with growing support for the harm-reduction model of care statewide, the way sober homes are run is changing, he said: “Now the old rules don’t apply to all sober-living homes.”
As a person who owes his personal and professional success to a strict adherence to an abstinence-based model of recovery, this reality — not to mention the new legislative requirements — has been a hard pill for Curtiss to swallow.
“It’s going to turn the whole sober-house movement into a much more risky situation for the community and the people living in the homes,” he said. “You are going to have a lot of mood-altering chemicals in these houses that are being abused by others — and this is going to affect everyone in the community.”
Curtiss said he’d like to see poorly managed sober homes “shut down. They create chaos. It’s depressing for me to watch what’s happened to the sober-house world — particularly having grown up in it and having lived in a sober-living environment.”
‘We are at a different time’
There is a much larger problem affecting the community than a few rowdy sober homes, said Eddy Krumpotich, a harm reduction advocate and founder of the Minnesota Harm Reduction Collaborative.
Krumpotich came to Minnesota in 2013, addicted to methamphetamines and desperate for help. “I grew up in central Maryland in an upper-middle-class white family in a very wealthy county,” he said. “I’m not someone who you would stereotype to be a substance-use disorder individual. My story reflects the diagnoses and traumas that I believe are the gateway drug to SUD and are reflected in a lot of treatment modalities that can be improved in sober housing.”
Krumpotich said that his own addiction has been fueled by his ADHD, and that Adderall, a stimulant often prescribed to treat the condition, has been helpful in mostly keeping him away from more addictive illegal substances.
“Science basically says that you are eight times more likely to get SUD if you are left untreated [for mental illness]. In my case, I was left untreated for ADHD. My brain and my body had a natural depletion of dopamine. My story is about amphetamine use to increase dopamine.” He said he has tried abstinence-based treatment dozens of times, but was never able to maintain sobriety with that approach.
Instead, Krumpotich said he’s focused on a biopsychosocial model of addiction treatment, one that looks at the root causes of SUD, and maintains that addiction has its origins in personal trauma and history, and can occur regardless of a person’s character, virtue or moral fiber. Krumpotich said that he supports a harm-reduction approach to recovery, one that understands that not everyone is able to live a substance-free life, but with support — including medication assisted treatment (MAT) — people with SUD are able to live healthy, productive lives.
Krumpotich said he worked with NAMI-Minnesota Executive Director Sue Abderholden and Gov. Tim Walz’ office to craft the 2024 sober-home legislation. Though some recovery advocates like Curtiss say that access to potentially mood-altering medications has the potential to upend the recovery of sober home residents, Krumpotich and other harm-reduction boosters say that the benefits of MAT are so great and the negative societal impact of the opioid-addiction crisis so significant that the disruption caused by a few poorly run sober homes is worth it.
“People might say, ‘I don’t want people using outside. I don’t want addicts living in my neighborhood,’” Krumpotich said. “Fine. Where do you want them to recover? Should they be living on the street? Should they be dying? Or should they be brought into care immediately and live in sober homes where they can get help? If you really believe that SUD is a mental-health issue, why are we denying the medications that treat that disorder?”
Kenneth Roberts, chief clinical officer of NUWAY Alliance, a Minneapolis-based nonprofit treatment and recovery organization operating 16 harm-reduction recovery homes around the state, said that too often the approach to recovery taken by his organization is misunderstood by people brought up in the 12 steps.
“One of my concerns any time harm reduction comes into the conversation is it has become a really hot-button issue in the industry,” Roberts said. “I feel like sometimes it gets weaponized in terms of driving an agenda.” The truth is, Roberts added, the term “harm reduction” is too often misrepresented and labeled as “dangerous” or “misguided.” He added: “At the end of the day, any sort of clinical intervention is, in effect, harm reduction.”
He views Curtiss’ — and others’ — objections to a shift toward harm reduction as resistance to change. But the time has come to change cultural views about SUD, he said.
“John is definitely a member of what I would lovingly call the ‘old guard,’” Roberts said. This group has played a key role in the history of addiction treatment. “The way that SUD first got legitimate recognition as something other than a moral failing is with the emergence of AA,” he said.
For a long time, Roberts continued, the Alcoholics Anonymous approach has been the “de-facto” view of how substance use and addiction should be treated. “As someone who has benefitted from 12-step recovery, I understand all of its values and it is something that is integrated and promoted as part of our programming,” he said, “but I think … we are at a different time with what is going on in the world with SUD.”
Roberts said that if we want to combat discrimination around SUD and mental illness, it is important to balance the concepts and principles of abstinence-based recovery with “what the science is telling us. We need to continue to drive the conversation by understanding SUD as a medical condition and treat it like we would treat chronic diseases like diabetes or cancer. The science now is about following doctor’s recommendations and taking your medications.”
NUWAY has been around for 55 years, Roberts said, and has deep roots in the Minnesota Model of addiction treatment. “At our programs and in our settings where we house people, we have an abstinence-based expectation in a safe, trauma-informed environment,” he said. Does that expectation mean that clients don’t use substances? “It happens all the time,” Roberts said. “The way we view that is as an occurrence of your (symptomatology).”
Danny Jordan, Hazelden Betty Ford manager of outpatient services, said most of the sober homes run or recommended by his nonprofit support the use of MAT. This stance is backed up by research, he explained, and that approach aligns with the organization’s values. “We are using evidence-based research and science to determine the best ways of recovery,” Jordan said. “We have determined that MAT is a very helpful tool in the treatment of opioid use disorder and alcohol use disorder. We believe that approach, in our opinion — and within what the science shows — is going to be the best outcome for long-term recovery.”
Through The Retreat, Curtiss operates six sober homes in St. Paul, where opioid antagonists like suboxone are only rarely allowed and other potentially addictive substances like Adderall or Xanax are generally forbidden. The same rule holds in all of The Retreat’s housing.
Curtiss is well aware that that approach makes him a bit of a dinosaur. But he adds that his model has been deeply researched with 18 years of positive outcome studies.
“The focus here has always been 12-step, abstinence-based,” he said. “I know we’re basically it; there aren’t many others like us left in Minnesota. Clinical programs might say, ‘We’re abstinence-based,’ but they’re more harm reduction these days. Sadly, it seems like that’s the way of the world.”
The wrong direction?
While many people in the recovery community tout the benefits of harm reduction, there are still sober home operators who object to the state’s new medication requirements. Chris Erdingtion, founder and CEO of St. Paul Sober Living, a provider of sober housing and recovery programming in Minnesota and Colorado, said he thinks people in recovery should have more options about the kind of sober home they want to live in. The new legislation will force all sober homes to be alike, he maintains.
“I want there to be choices,” Erdington said. “If you’re a meth-head, you probably shouldn’t live in a house with folks on Adderall. There are people for whom Xanax is it, and what if they move into a house where they know their roommate has it in a dresser drawer? That’s ridiculous.”
Erdington believes that the new legislation doesn’t give sober-home operators the opportunity to structure their homes in the way they feel works best for their residents. “You should be able to go in and ask, ‘What kinds of meds are allowed? And if you have something that doesn’t work for me I’m going to go to another place,’” he said.
Drew Horowitz, CEO of Elite Recovery, an intensive outpatient and inpatient addiction treatment service provider based in the Twin Cities, said the changes that will occur in all Minnesota sober homes because of the new legislation has the potential to irreconcilably alter the way sober homes operate.
“It used to be when I first got sober that there was just one model,” Horowitz said. Things were simpler then, he added: “The sober living community was a lot safer.” Under the new legislation, he said sober home operators will be forced to “redefine what recovery means. It is whatever you decide it should be. And that’s risky.”
Today, with monthly Medicaid payments now available for sober home residents, Horowitz said many sober-home operators with no history in the recovery movement are now in the business for the money, rather than the goal of providing support for their fellow travelers.
In recent years, Horowitz added, Minnesota has seen an influx of new sober home operators who’ve opened harm-reduction homes that are notoriously lenient about drug use among their residents. “The fallout from this has been kind of bad,” he said. “We’ve seen so many bad operators. We’ve seen horrible things happen to clients.”
Some of these new sober homes are, Horowitz said, “just horrible. They are just housing people to get paid. At Elite, we are really careful. I know other people are saying they’re careful, but we see people dying in sober living all the time. I think we need to have some regulation, otherwise it is going to turn into a circus.”
Another change brought about by the new legislation is the decision that the state ombudsman for mental health and developmental disabilities is now in charge of promoting the highest standards of treatment quality and justice for residents of sober homes. Residents can now file a complaint about unfair or unsafe treatment with the ombudsman’s office.
While her office is not a regulatory entity, Lisa Harrison-Hadler, Minnesota state ombudsman for mental health and developmental disabilities, explained that her staff does “receive and investigate complaints. When those complaints are substantiated we can recommend steps for our clients.”
Harrison-Hadler said she and her staff are aware of concerns raised by some sober-home operators about the negative impact the new legislation could have on the people that live in their homes.
“We’re very aware of the discussion and the concerns among some of the individuals who were involved in that,” she said, “but we really do feel that where we landed is the best decision for Minnesota.” While a foundation in abstinence is important to many recovery and treatment programs, Harrison-Hadler said, “having access to MAT is the gold standard for many in treatment in regards to their particular disorder and treatment needs.”
When a sober home resident feels they have been mistreated or harmed and decides to file a complaint with her office, Harrison-Hadler said her staff makes a point of letting them know that the decisions they hand down carry limited weight.
“When somebody contacts our office from a sober home we often know that they are in a very vulnerable situation,” she said. “We do inform people that we will look into their concerns — but we can’t guarantee that there will be no retaliation because there is no enforcement mechanism. We can’t guarantee that the provider will follow our recommendations.”
Aric Smedstad, operations director for St. Paul Spirit House, a for-profit organization with four east Twin Cities metro sober homes, said many of his homes’ residents choose their sober home based on which medications are allowed there. Under the new rules, all sober homes will be required to allow all medications, a radical change from how he runs his homes today.
“I have four people that chose this house because we allow some medications and don’t allow others,” Smedstad said. “Starting in January, it won’t work that way at all — and I don’t know how my guys are going to take that.”
Horowitz said he believes the new legislation could turn many of the state’s sober homes into a kind of Wild West, with little oversight and protections for residents. He knows that not everyone agrees with this opinion, and he hopes that his dire predictions are wrong.
Horowitz believes the state should find a way to regulate sober homes and their operators beyond the ombudsman’s office. “They have vulnerable people living in them with an illness that could kill them. Sober homes need to be accredited. They need to have some type of manual. So many of these houses don’t have any regulation. The operators of those homes are like, ‘Whatever. We don’t care what happens here. Just as long as we get our monthly check.’ It’s a real shame that we’ve gotten to this point in this state.”
Andy Steiner
Andy Steiner is a Twin Cities-based writer and editor. Before becoming a full-time freelancer, she worked as senior editor at Utne Reader and editor of the Minnesota Women’s Press. Email her at asteiner@minnpost.com.
