Developing recovery housing must be a state-wide effort, forum found

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recovery roundtable
Attendees at the Recovery Housing Roundtable Forum discuss barriers and solutions to at a St. Anselm Center for Ethics in Society forum in April. The findings were released Thursday. Photo/Saint Anslem Center for Ethics in Society

MANCHESTER, NH –A safe environment for people emerging from addiction is an essential step to their recovery, but there are many barriers in New Hampshire to developing residences for those who need the service.

Findings from the Recovery Housing Roundtable Forum that discussed the issue determined that barriers in New Hampshire to such residences range from a lack of understanding in communities, zoning red tape and lack of communication, transportation for residents to jobs and services and more.

A concerted effort that includes municipal governments, state officials and local stakeholders is needed to provide more recovery housing, which will help tackle the state’s addiction crisis, the forum determined.

The Center for Ethics in Society released the findings Thursday. The forum was held April 12 at St. Anslem as part of the center’s Housing We Need initiative in partnership with the New Hampshire Community Development Finance Authority.

Recovery housing is a sober, safe, and healthy living environment that promotes recovery from alcohol, drug use and associated problems, organizers of the event said. A recovery residence provides a family-like living environment to sustain recovery, which is defined as abstinence from alcohol and other non-prescribed drug use and improvement in physical, mental, spiritual, and social well-being. In a recovery residence, an individual builds resources that will support their recovery once they live independently.

Such housing is key to recovery from addiction, Darrell Mitchell, chair of the National Alliance of Recovery Residences, told the forum audience. “If treatment was all that was needed, then we wouldn’t have an epidemic,” he said.

“Treatment is so necessary for people to get stabilized, in hopes they can get into recovery and change their lives.” Long-term success depends on recovery housing, because its specific social model creates connections, Mitchell said.

Kim Bock, executive director of the NH Coalition of Recovery Residences, said, “You would never do surgery knee replacement surgery without physical therapy afterwards. You know it wouldn’t work. And that’s what treatment is like. If you don’t have the right environment, it’s not going to work.”

According to the NHCORR website, , there are 90 certified recovery residences in New Hampshire, with capacity for 1,160 people. Of those, 31 are female-only, with capacity for 353 residents; 58 are male-only, with capacity for 801 residents; one, with capacity for six residents, is LGBTQ+-only.

The website shows that 10 of the residences have availability for new residents.

The lack of recovery housing isn’t just a capacity problem, but also a location problem, Bock said at the forum.

“We all know that New Hampshire doesn’t have enough housing for anybody,” she said. “There’s certainly not enough for people in recovery.”

The majority of the state’s recovery housing is on the Interstate 93 corridor, with much of it in southern New Hampshire. There are a few on the Seacoast, a couple in western New Hampshire and one in Claremont, in the northern end of the state. “Beyond that, most of the state is empty,” Bock said.

There is no recovery housing for women west of I-93. “Women aren’t going to go to Manchester and Nashua if they live in Lebanon, because they can’t leave their children,” she said.

Bock said that lack of access to recovery housing means that people “struggle for more years with addiction.”

Recovery teaches people how to be part of a family and a community again, how to reach out and connect with others, Bock said. They relearn that when they interact on a social level, it makes them feel good and builds self-esteem. “We call that building recovery capital,” she said.

Recovery houses must be certified by the NHCORR as well as approved by the town or city they’re located in.

NHCORR map
A New Hampshire Coalition on Recovery Residences map shows were the state’s 90 residences are located. Lack of access to such care for those in treatment is a challenge, experts said at a St. Anselm Center for Ethics in Society forum. NHCORR map

overdose deaths by town map 2 scaled
A New Hampshire Drug Monitoring Initiative map shows where the state’s overdose death’s in 2022 were. NHDMI graphic

EMT calls for overdose map 2 scaled
A New Hampshire Drug Monitoring Initiative map shows EMT response to opioid overdose or use calls in 2022 were. NHDMI graphic

hospital drug admissions graphic 2 scaled
Graphics from the New Hampshire Drug Monitoring Initiative show hospitalization and treatment for substance use disorder trends. NHDMI graphic

Certification of recovery houses involves not only meeting state and national standards, but making sure the building itself has proper bedrooms, bathrooms, smoke detectors and more. The NHCORR also interviews the residents of a house that’s being certified to make sure the written policies are being carried out.

She also said that residents of recovery houses are required to work, and it’s something municipalities should know when making decisions about houses. Not only does it help those in recovery gain self-esteem, but it’s “a great source of employees for a town.”

Bock said there is funding available on the federal and state levels to develop more recovering houses, but support from the towns is crucial. “It’s finding the place in your community to begin to take care of everybody in the community, and make the entire community grow in a more healthy way,” she said.

According to the New Hampshire Drug Monitoring Initiative, in 2022 there were 434 confirmed drug overdose deaths and 39 cases pending toxicology from last year as of February in the state. Coos County, the state’s northernmost, had the highest suspected drug use resulting in overdose deaths per capita, at 6.97 deaths per 10,000 population. Hillsborough County was second highest, with 4.16 overdose deaths per 10,000 population, and was highest in treatment sought, at 7.08 per 10,000.

Overdose deaths and hospitalizations decreased in 2022, but are still high in the state. According to the NH Drug Monitoring Initiative, admissions to state-funded treatment facilities are down largely because the Affordable Care Act has been fully implemented in the state, resulting in increased access to affordable health insurance and coverage for substance use disorder treatment. The fact that state expanded its Medicaid program also helped people with for substance use disorder get more access to treatment.

But barriers to recovery housing after treatment still remain, those at the forum said.

Recovery House Barriers, Solutions

Some of the findings on barriers stemming from discussions at the forum:

  • Lack of understanding about recovery homes, how they operate, and how they are beneficial for communities and a misunderstanding about who is living in the homes.
  • Approval processes are lengthy and confusing, and those creating such housing often don’t know where to start or what code requirements or local land use regulations exist (minimum parking spots, sprinklers, etc.)
  • Land and infrastructure can be expensive, there is little funding for recovery homes, and some building and fire code require expensive modifications. 
  • Lack of communication among stakeholders, and with the public, about requirements and processes necessary for approval of recovery homes. 
  • Especially in rural areas, lack of transportation makes it hard for those in the homes to find employment and to get to jobs and access local services.
  • There are even fewer options for women in recovery, with few available to them, and those that are not suited for families and childcare.

Some of the solutions that the forum discussed are:

  • More education for stakeholders (communities, planners, municipal officials, building/fire officials, etc.) about recovery housing.
  • A “shared language” about the topic defined and accepted across sectors.
  • Certification of recovery homes by nationally recognized organizations can reassure communities that recovery homes are safe and well-run.
  • Data showing the impact of recovery housing on communities, or the cost of incarceration versus the cost of a recovery home, should be collected and made accessible.
  • Municipal officials must think creatively about how recovery housing can meet building and fire code standards. 
  • More funding opportunities (including for for-profit recovery homes). 
  • More communication and collaboration between local, state, and national leaders.
  • Recovery housing stakeholders need to find ways to offer transportation for residents of recovery homes to reach jobs and services. 
  • Recovery homes will be more accessible to people if they are allowed or encouraged to follow different models, including offering more options for women and families.

Besides Mitchell and Bock, speakers who shared their experience with recovery housing were State Fire Marshal Sean Toomey; attorney Craig Donais of Wadleigh, Starr & Peters; and Shawn Cannizzaro, Hope 2 Freedom Recovery Homes. (A video of the event’s speakers is below.)

A panel discussion on how to create more recovery homes in New Hampshire communities included ideas from planners, employers, building code officials and recovery home operators. The panel included Donna Benton, director of planning and community development in Dover and president of the NH Planners Association; Mark Bonta, Littleton plant director of Genfoot America and advisory council member of the Recovery Friendly Workplace Initiative; Daisy Pierce, executive director of Navigating Recovery of the Lakes Region and an advisory council member of RFWI; and Bill McKinney, manager and building official in Nashua and president of NH Building Officials Association.

Municipal officials and planners from around the state, as well as recovery home operators and residents, building and fire code officials, and other stakeholders, also held roundtable conversations about barriers to recovery housing, solutions, and ways to promote recovery housing in our communities.


 

About this Author

Maureen Milliken

Maureen Milliken is a contract reporter and content producer for consumer financial agencies. She has worked for northern New England publications, including the New Hampshire Union Leader, for 25 years, and most recently at Mainebiz in Portland, Maine. She can be found on LinkedIn and Twitter.