Editor’s note: This is the first of two stories on housing and addiction.
John Curtiss looks back fondly on his sober home days.
Like many people seeking help for addiction, Curtiss arrived in Minnesota on a one-way ticket, heading straight to the Hazelden campus in Center City. He desperately needed to kick his addiction to alcohol and Valium, and even though he was still young, this felt like his last chance.
“It was January 1976,” Curtiss recalled. “I was 23 years old. I was coming from my hometown of Cincinnati. I was a scared kid.” At Hazelden (now known as Hazelden Betty Ford), Curtiss went through a painful, 21-day benzodiazepine withdrawal and later moved into a Hazelden-run residential halfway house called Fellowship Club in the old Schmidt Brewmaster’s mansion off West Seventh Street in St. Paul. “It saved my life,” Curtiss now says of the recovery program, which took him eight-and-a-half months to complete.
After he completed his program at Hazelden, Curtiss knew he still needed support to keep his recovery on track. So he and a group of friends who’d also just completed the program decided to create a sober house of their own, a place where they could live safely together, substance-free. This was back in the days when sober homes were still a new concept, Curtiss explained, and groups like his came together in a casual, ad-hoc fashion.
“It was three men and two women and a couple of kids and dogs,” Curtiss recalled. “We all rented a house in West St. Paul. We went to meetings every day. I volunteered. This was the era of disco; sometimes we went out and learned line dancing. We had fast cars that we liked to take care of. It was like a little sober commune. The neighbors loved us.”
This experience convinced Curtiss, who eventually worked at Hazelden Betty Ford for nearly 20 years — first as an addiction counselor and then eventually as vice president of the national continuum before co-founding The Retreat, an alcohol and drug recovery center based in Wayzata — that time living closely with peers focused on sobriety is a foundational step in building a healthy, happy, substance-free life like the one he’s been living for the last 48 years.
A changing landscape
Until relatively recently, many members of the state’s recovery community seemed to agree with Curtiss: Starting in the early 1980s, addiction treatment providers around Minnesota began opening their own abstinence-based sober homes, substance-free residential programs for people in early recovery, often located in large houses in established communities. (St. Paul turned out to be an especially popular location, with several old Summit Avenue mansions and stately homes on nearby streets purchased for that purpose.) Independent sober home owners joined in, and before long several months to a year spent in abstinence-based sober living became an almost expected step in the recovery journey.
In 2007, a group of leaders in the state’s recovery community came together to form the nonprofit Minnesota Association of Sober Homes (MASH) as a way to provide a unified voice and ethical and operational standards for owners of these programs. Membership in the group has always been voluntary and MASH does not regulate sober home operation. The association has some 53 members that collectively operate 153 sober homes. There is no official tally of the number of non-MASH sober home operators in Minnesota, but a source close to the nonprofit estimated that there are approximately 127 non-MASH members that own and operate as many as 300 sober homes around the state.
Spending time in a sober home can help to ensure that the recovery skills learned in a treatment program are solid enough to survive in the real world, Curtiss said. “Everyone leaves treatment on the pink cloud,” he said. “You have all these great plans, and then, about three to eight weeks in, is the danger zone. The ego reemerges, the old relationship shows up again. You’re back in the old neighborhood and it’s a lot harder than you thought it would be.”
But a new focus on a “harm-reduction” approach to addiction treatment — emphasizing a spectrum of approaches to drug use including medication assisted treatment (MAT) allowing the use of FDA-approved medications like methadone, suboxone and naltrexone to curb cravings, as well as other drugs like Xanax or Adderall to treat co-occurring mental health disorders, or even maintaining homes that meet residents “where they’re at,” addressing the conditions of use along with the use itself — means there are fewer and fewer truly “sober” sober homes in the state.
Danny Jordan, manager of outpatient services for Hazelden Betty Ford, said that staff at his organization nearly always recommend that graduates of their residential treatment programs spend some time in sober living.
“A lot of the time people’s understanding is, ‘I go to residential treatment for 28 days, then, OK now I’m fixed.’” Jordan said. “But when people get back to their home environment, life is still life and just because they removed themselves to go to treatment doesn’t mean that all of the problems that were there before are going to go away.” Though some program graduates can’t realistically accommodate a stay in sober housing into their lives, Jordan said that it is still highly encouraged: “I would say we recommend it for most of the people we work with.”
The concept of abstinence-based recovery, a central aspect of the Minnesota Model, has its origins at Hazelden Betty Ford. But today, the organization has moved to embrace MAT for people with opioid- and alcohol-use disorders. The game has changed in response to the state of the world, harm-reduction advocates say: Addiction to substances like heroin or oxycodone are so acute and potentially deadly that any drug that can quell cravings or support healthy living can and should be an important part of the recovery process. Those who support harm reduction say these drugs should not be banned from sober homes — even if some of the medications could prove to be addictive to other residents.
“They all help aid in the recovery process,” Jordan said of MAT options like suboxone or naltrexone for opioid use disorder. “We’ve had great outcomes with them.”
The rule in Curtiss’ first sober home — and in many of the others that immediately followed — was that no potentially addictive substances were allowed, and that residents who were caught using substances were asked to leave. But in recent years, faced with a growing addiction crisis, many sober-home operators have seen first-hand how the use of certain FDA-approved medications can help a person escape the grip of severe addiction. The majority of Minnesota’s sober homes now allow their residents to use a range of prescription medications while participating in their programs, and support for this approach is growing. Some even allow the use of medical cannabis.
Research has backed up harm reduction. A report released by the PEW Charitable Trust cites studies finding that MAT significantly increases a patient’s adherence to treatment and reduces illicit opioid use, compared with non-drug approaches. Other research cited in the report found that MAT also helps to reduce risky behaviors, including the injection of drugs that increase transmission of infectious diseases like HIV or hepatitis C.
But Curtiss and some of his recovery colleagues remain harder to convince. The Retreat operates six self-governing sober homes. In rare examples, some of Curtiss’ homes have allowed opioid antagonists, but other potentially addictive substances, even those prescribed for co-occurring disorders like anxiety and ADHD, are generally not allowed. In a shifting environment, this approach increasingly sets the homes apart.
Randy Anderson, a recovery advocate and founder of Bold North Recovery, an organization that trains peer recovery coaches, said abstinence was key in his own difficult journey to recovery.
“I think the road that we’ve now gone down is really dangerous,” Anderson said. In today’s environment, he added, it feels like “my abstinence-based pathway of recovery is no longer a valid one.” While Anderson agrees that non-addictive but essential meds, like those he takes for high blood pressure or acid-reflux disease, should be allowed in sober homes, the presence of drugs that have the potential to be addictive, like the stimulant Adderall used in the treatment of ADHD or mood-altering benzodiazepines like Xanax, could cause problems among residents.
“I know for me that when I was in a sober home, I needed to go to a place with high accountability, that was very restrictive,” Anderson said. “If my roommates had lockboxes with their medications in them, I guarantee I would be one of the first ones to break into their lockbox to get their medication. I had a criminal mindset. I didn’t want to stop using drugs.”
While harm-reduction advocates emphasize the growing need for this approach to recovery and sober living, Curtiss wants his homes to stay as substance-free as possible. The best way to operate a sober home is the least complicated one, he believes: “Just get them sober, teach them how to live a responsible life. Running an abstinence-based, 12-step sober home is easy. There’s not a lot of drama. There’s always somebody that’s challenged, but when you start letting folks smoke weed and take benzos and Adderall and everything else, you’ve got a mess on your hands.“
Legislating harm reduction
For several years, Sue Abderholden, executive director of NAMI-Minnesota, has spent time at the state Capitol working to convince legislators to bring greater attention to sober homes that house thousands of people with substance use disorder (SUD). She believes, in her role as an advocate for people with mental illness, that for too long sober homes have operated with no regulation, a dangerous situation for members of a vulnerable population.
While many sober homes are clean and well-run, some programs are poorly maintained and even unsafe, Abderholden said. She and her NAMI colleagues have advocated for greater oversight and regulation of sober home operations and operators — as well as new requirements that all sober homes must allow residents access to FDA-approved prescription medications to treat co-occurring mental health disorders.
Their work resulted in legislation that helped to narrow attention on sober homes and their operators.
“They defined sober homes,” Abderholden said of the legislation. “They have to have written policies on access to prescribed meds. They have to have an opiate antagonist in the home. There is a bill of rights now. People can make complaints to the state ombudsman for mental health.”
While most sober home operators did not openly object to the bill of rights or the ombudsman, many, Curtiss especially, pushed back against Abderholden’s group’s latest victory: that sober homes will be required to allow all legally prescribed medications, effective June 1, 2026. (Sober homes will be required to allow drugs prescribed to treat OUD by January 1, 2025.) They argued that the presence of certain potentially addictive, but legally prescribed, medications in a home could create chaos and upend the recovery of some residents.
Abderholden disagrees. “You can keep things under lock and key,” she said of potentially addictive drugs. “We did a lot of research on it, on what other states are doing. There are national recommendations. I think as a state we are an outlier with our approach.”
The change happened in steps. In the 2023 session, the Minnesota Department of Human Services, in collaboration with MASH, was tasked with conducting a survey to identify sober home settings across the state and to collect information about the services they provide, their funding sources, whether they specialize in serving specific populations and other information. The report is scheduled to be completed in mid-2025
‘It’s a huge deal’
Curtiss isn’t the only sober-home operator who finds this new legislative requirement concerning, but he is among the most vocal.
“Sue Abderholden is a dog on a bone,” he said. “I know she and NAMI do good work, but their moves here are ruining sober living and it will make it much worse over the next many years. They want to turn all sober homes into little harm-reduction treatment programs with low-pay, low-level staff. It’s going to be an absolute mess.”
While Curtiss said he feels confident that his sober homes are safe “in our own little bubble,” and will keep operating safely despite the new legislative requirements, he said when he has testified before the Legislature his goal has been to “fight for everyone in the recovery community. I’m fighting against Sue and whatever she wants to do. I’m trying to speak on behalf of this next generation of people. I want to make sure this [abstinence-based] model exists for them.” He said he thinks it is “unfortunate” that the legislation passed. “It’s a slippery slope,” he said. “I don’t know what’s going to happen next.”
Lexi Reed-Holtum, a recovery advocate, MASH board member and a woman in long-term recovery, said that she is concerned the new legislation could have a negative effect on sober home residents.
“I believe it is an overstep for the state of Minnesota to mandate that all sober homes must take all medications,” Reed-Holtum said. “It’s like we’re making rules in a reactionary way with not enough information.”
She added that the requirement will reduce options for people in recovery who would rather live in a home where no substances are allowed. While she has empathy for people who need MAT to recover, Reed-Holtum said that requiring all sober homes to allow all prescription medications is going too far. “I think the state is overstepping here to make that mandate,” she said. “We should have the right to choose the care and type of living environment we want to live in.”
Eddy Krumpotich, a harm reduction advocate and founder of the Minnesota Harm Reduction Collaborative, worked with Abderholden on pressing for the legislation. He said his struggle with severe ADHD eventually led him to addiction. He tried and failed traditional abstinence-based addiction treatment many times before finally finding MAT and lasting recovery.
“I went to 50 abstinence-based treatment programs,” Krumpotich said. “What worked was when I was put on a treatment for my mental health.”
Potentially addictive medications like Adderall have proved essential to his recovery, Krumpotich said, and that’s why he threw his support behind the new legislation.
“These medications allow people to live as they are and how they choose,” Krumpotich said.
As operations director for St. Paul Spirit House, a for-profit organization with four east-metro sober homes, Aric Smedstad has plenty of opinions about how homes for people in early recovery should be run. He knows better than anyone how important sober living is to long-term recovery — but he didn’t always feel that way.
“I was the guy that wanted nothing to do with sober housing,” Smedstad said of his first few weeks in a St. Paul Spirit House facility. He argued with the house manager and the program’s founders. He resisted rules. “I didn’t want any part of it,” he said. “But then I gave it six weeks — and my life actually got better.”
These days, Smedstad is an unapologetic advocate for the power of sober housing. Outside of his operations-director duties, he’s also a live-in house manager at Hazelwood House, an expansive and clean two-story house with a tidy lawn on a quiet cul-de-sac in St. Paul’s east side.
As he shows a visitor around Hazelwood House, pointing out neatly-made beds and a spotless kitchen with multiple refrigerators, Smedstad’s pride in his work is clear: It’s been a long, difficult road to get to where he is now, and he credits an abstinence-based approach to his success. Hazelwood House is for men only, and Smedstad said he fears that the new legislation would put many of its current residents, young men fresh out of residential treatment programs, at risk of relapse.
“What I am trying to advocate for in Minnesota is choice of residence,” Smedstad said. From his perspective, the change “just happened: Wham. It will go into effect in January. It’s a huge deal. I have four young men in this house who abused Xanax and Adderall. What will I do now?”
All St. Paul Spirit House residences allow suboxone for treatment of opioid use disorder (OUD). Smedstad explained that staff also approve the use of other medications on a case-by-case basis. But he believes that the new legislative requirements could easily turn the recovery world upside down.
“No matter what you do to keep meds private, it gets out. You are dealing with eight or 10 guys in a house,” he said. “I can be as HIPAA compliant as I want, but people talk. A person could have an addiction to benzos or something else and they start to obsess. And when they obsess they are going to do whatever they can to get their hands on that prescription.”
With the added risk that some medications could be counterfeit and cut with Fentanyl, Smedstad said, that obsession could become deadly. He wants the decision about what medications are allowed in his houses to be left up to individual house managers and operators. “I’m really an advocate that sober houses should have a choice in what they allow in their homes,” he said. “If we don’t, it could turn into a real mess.”
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.
