A growing number of unregulated homes for recovering addicts have emerged on Long Island in the past decade that local officials and treatment experts say create a system often with unsafe living conditions that contributes more to relapse than sobriety.
An estimated 200 so-called "sober homes" here now form a cottage industry fueled by public assistance subsidies for recovering addicts seeking inexpensive housing. Many of these homes have few or no ties to certified treatment programs, experts say, and some are plagued by overcrowding, crime and unsafe conditions.
"Sober homes are exploiting vulnerable people who are reluctant to report the abuses, the inadequacies and the risks that some of these housing facilities pose because they have nowhere to go," said Suffolk County's Social Services Commissioner Gregory Blass, who, like other officials, said he has seen the number increase in recent years.
Ideally, sober homes are intended as a bridge between treatment and full re-entry into society for addicts, a place where they can live for a few months or more after receiving expensive hospital or detox clinic treatment. During their first year of recovery, residents are usually expected -- but not required by law -- to continue in a 12-step or similar rehab program.
And in some successful places -- usually overseen by well-regarded treatment programs -- that approach actually works as intended, drug experts say.
At the privately run, not-for-profit Seafield sober home in Flanders, which officials have praised, the residents go to therapy with counselors and attend anti-drug meetings.
"Somebody has got to be directing the ship and making sure the food is there and the place is clean and everybody is sober and no one is abusing the house rules," said John Haley, the top executive at Seafield.
But at many of these privately owned sober homes on Long Island, experts and officials say, a host of problems have developed due to the lack of a legal mandate to provide residents with counseling and support, combined with little oversight.
At its worst, officials and experts said, some residents in drug-plagued homes have relapsed after thousands of dollars' worth of treatment.
Falling back into drug use
Mike Josell took almost 20 years to kick his heroin addiction. But his recovery quickly came to an end, he said, when he entered a Medford sober home.
"It turned out to be a horrible move -- the place was just like a [heroin] shooting gallery," recalled Josell, 47, who now lives in Brentwood.
In interviews with dozens of treatment counselors, health officials, recovering addicts, neighbors and landlords, a Newsday / News 12 Long Island investigation found a lack of oversight made it easy to run a sober home.
The government does not require any special licensing or employee training. And there is no clear-cut definition of what a "sober home" is, a Suffolk County panel that studied the problem found, with even fewer regulations about how they should operate.
His body had lain on a bathroom floor for six hours until someone called for help, authorities said.
Twomey's mother, Margaret, said what makes his death harder to bear is that he was in a place where he was supposed to be recovering from his addiction.
"I don't think I'll ever accept that," she said, "because this is where he was supposed to be safe. And he wasn't safe here."
Attempts to reach the home's owners were unsuccessful.
Medical and treatment experts say the drug-taking often present at many sober homes undermines earlier treatment received by recovering addicts at hospitals or rehab centers, which can cost $10,000 or more, usually paid by Medicaid or employer benefits.
"It's a real problem because you're spending a lot of money to treat people aggressively and then you're throwing them right back into the environment that, in many cases, served as the impetus to get kids into drugs in the first place," said Dr. Stephen L. Dewey, a neuroscientist at North Shore-Long Island Jewish Health System in Manhasset.
Most sober homes are in poor and minority communities, according to experts and available records, and often landlords house many people in one residence, which enables some owners to bring in more than twice what they paid for the property.
For example, in Shirley, a group of buyers paid $216,000 in 2005 for a single-family house along William Floyd Parkway that soon opened up as a sober home. They collected at least $453,000 in government rent subsidies from 360 residents who lived for a few months in the building from 2008 through last year, according to records.
Adrian Thomas, a co-owner and manager of that house and others in the surrounding area, readily acknowledges collecting more than $450,000 in public money for room and board during this span. He declined to detail his expenses.
"Some folks are pointing at the bottom line and they're saying, 'Wow, that's a large number of folks' and looking at the dollars," he said. "As an entrepreneur, what that means is that there are 360 lives that we've helped."
Suffolk Legis. Kate M. Browning (WF-Shirley) says there are more than a dozen sober homes like Thomas' in her Brookhaven district. "He's just recruiting these people, bringing them in, and he's making a fortune," said Browning, standing outside another nearby sober home run by Thomas in her district.
Browning says she objects to a system by which public money subsidizes poorly run sober homes, adding to the social problems to which government must respond.
At the Shirley house run by Thomas, the local ambulance squad reported 17 calls for assistance in the first four months of 2010 for problems ranging from respiratory disease to the admitted use of alcohol or drugs, at an estimated cost to taxpayers of $11,050 in ambulance calls, according to available records and interviews.
Though he once called his house a "sober home," Thomas says he now avoids that term because of its controversy in the neighborhood. He says he runs his homes as a business with residents left to find rehab on their own. Volunteer residents try to maintain a drug-free environment while he stays in touch by cellphone, he says.
Efforts for reform
Local, state and federal agencies struggle for proper ways to oversee these homes.
Last year, a federal judge threw out Suffolk's 2003 sober home law that would have required inspections, an on-premise manager and a limit of six residents.
The court said the law, which had never been enforced because of the legal battle, was over-restrictive and a violation of federal fair housing and disability statutes. Other similar lawsuits around the nation have upheld the rights of sober homes to exist without discrimination.
Consequently, overcrowded and unsafe homes may go unaddressed, said the Suffolk panel that studied the problem.
"Currently, 'sober homes' are subject to no government or professional regulation," it said in its May 2010 report. "Instead, greedy absentee landlords run many sober homes at the expense of their fragile residents, local communities and Suffolk taxpayers. Hidden from public view, many sober homes are operated by unscrupulous landlords who have no interest in fulfilling the mission of a responsible sober home."
Since then, a newly enacted Suffolk law has created an oversight board designed to encourage more well-run sober homes with ties to a licensed treatment program, rather than crack down on mismanaged ones.
Struggle in Nassau
Nassau officials face a similar dilemma, saying sober homes often are run without supervision and are concentrated in low-income neighborhoods.
"A lot of times, there's no supervision in these homes," said Mayor Wayne Hall of Hempstead, where two drug-related deaths took place in 2008 at a sober home with 37 residents. Hall said the deaths are indicative of the criminal activity that occurs in some Hempstead Village sober homes.
Village documents indicate the owner, who could not reached for comment, collected more than $190,000 a year in government subsidized rents. "The landlord is collecting the money, they call it a sober home, and other people there are abusing drugs and alcohol."
Nationally, 20,000 "unsuitable" sober homes exist, plagued by overcrowding, continued drug abuse and little oversight by owners, estimates Paul Molloy, chief of Oxford House, a network of recovery homes, including one in Farmingdale.
He said between 10 percent and 20 percent of those leaving recovery programs wind up in a sober home. Most of these people are poor and are on government assistance, he said.
The state does not mandate that a person leaving a treatment program needs to enter a sober home. People usually wind up there on their own, often by word of mouth, experts said.
Overall, New York State spends more than $350 million annually for hospital-based detoxification services, much of it paid by Medicaid, according to a 2008 state study. But despite this large amount of money invested in recovery efforts for New York's 1.8 million substance abusers, state and federal agencies say they don't have a firm idea of how many wind up in sober homes.
Who to monitor homes?
Most well-managed residences on Long Island are connected to treatment programs, usually run by nonprofits or church-affiliated charities, says Richard Buchman, president of the Long Island Recovery Association, a nonprofit group that advocates for the needs of recovering addicts. They can be vital for recovering addicts needing an affordable place to stay as they look for a job or get their lives in order, Buchman said.
But increasingly, experts say, these kinds of facilities have diminished -- usually because of community opposition or financial problems -- while privately run homes without any ties to treatment have grown.
In the debate about government oversight, Long Island officials have asked the state to regulate all sober homes and require ties to treatment. But the state Office of Alcoholism and Substance Abuse Services believes the job of monitoring sober homes is best done by locals, said spokeswoman Dianne Henk.
Suffolk's new law is designed eventually to provide higher room and board subsidies for well-run sober homes, lawmakers said, rather than risk legal problems created by Suffolk's old law overturned by a federal judge that tried to regulate the poor ones.
But without effective oversight, says Richard Koubek, chairman of Suffolk's panel that studied the problem, the current system will continue to allow the worst sober homes to avoid scrutiny.
"What the unscrupulous people are doing is packing in lots and lots of residents, providing no services," Koubek said. "My guess is that they're making a lot of money because so many of them continue to stay in the field."