Residential rehab

NICK EICHER, HOST: We’ve covered many angles of the opioid crisis, so you may be familiar with the scale of the problem: 64,000 overdose deaths in 2016, with rates still rising.

We’ve told you about faith-based rehab, about sheriffs trying new approaches, and about the growing foster-care crisis spurred by the epidemic. We’ve also noted how Medicaid fraud and abuse contributes to the problem.

MARY REICHARD, HOST: Today we’re bringing you another slice of this story: residential homes converted into detox centers. Lawmakers from coast to coast are grappling with this. Many states have found ways to limit the number of residential rehabs in a single community.

Other states have found this difficult to control.

EICHER: California is one of those states. WORLD Radio’s Jill Nelson has the story of Orange County’s struggle with the explosion of residential rehabs.

AUDIO: We don’t make too many structural changes to the house. 

JILL NELSON, REPORTER: From the outside, this three-bedroom home in Laguna Hills, California, looks like all the rest of the homes on the street. But on the inside…

PETRUCCI: There are nurses on staff 24-7 and there is a licensed medical doctor on who is call 24-7 as well. So this is just like a hospital, just in a residential setting.

This home was recently transformed into a residential detox facility. A chef and a fitness trainer will be soon be joining the staff.

This facility’s COO is Vince Petrucci. He’s a former addict. He says our nation’s drug problem is so big that hospitals are out of space and not affordable. And because of that, the drug problem has spilled over into neighborhoods and city meetings.  

PAUL: I’m involved in the criminal justice system, and it’s very apparent with these centers, it attracts unsavory elements. There’s no way around that.

Paul is one of around 100 people who turned out for a jam-packed neighborhood meeting in Mission Viejo earlier this year.

At one town hall in Laguna Hills, close to 600 people showed up. Most were angry citizens asking why the city has not addressed all the sober living homes. Orange County has at least 1,100 licensed rehab facilities.

AUDIO: We’re talking about constant second hand smoke…

People complain about increased theft and too many vehicles parked on the street. Many centers hire professional chefs and yoga instructors. Medical personnel are required.

Most people are shocked that businesses like these are allowed to operate in residential communities. But the cities’ hands are tied. California state law defines residential rehabs as single-family homes, not businesses, even though as many as six patients, plus staff, might be living in one.

Frank Urey is a former mayor and city council member in Orange County. He says this issue has been one of the most debated topics at city council meetings for the past decade.

UREY: What happens is you have all these detox halfway houses being set up in California because the weather is great and people come out here, five or six months later their insurance runs out and these centers are actually just putting people on the streets, which if you take a look at California’s homeless problem, you’ll find that a large part of the new homeless in California aren’t even residents here. They’re from out of state. 

Federal law says recovering addicts are a protected group. So when Newport Beach tried to regulate sober living homes, several rehabs sued. Six cities in Orange County helped pay Newport’s legal fees, but the city was forced into a $5 million settlement.

State Assemblyman Bill Brough, addressing the crowd at a 2016 meeting, said this issue is not only about disrupting quiet neighborhoods.

AUDIO: We can’t even get in there to find out if these things are working. Now I agree that people need help, they need to go to facilities, but these homes are not the right facilities to go to. Look, I’m not a doctor… (applause)

Critics say the state of California does a poor job assessing the effectiveness of residential rehabs. Some are under investigation for negligence.

Vince Petrucci admits even good programs face serious challenges. He says Obamacare mandated that insurance companies cover rehab treatment, so some people jump from one rehab to the next for three or four years at a time. They take advantage of the free housing.

Petrucci says one of their goals is to help people out of this cycle… and the struggle is worth it.

PETRUCCI: We have 60-year-olds that literally have not emotionally grown since they were 15-years-old. And to see them grab onto responsibility and take charge of their life and then see… that there’s other ways to process life. It’s a pretty cool experience and it makes it worthwhile. 

For WORLD Radio, I’m Jill Nelson reporting from Orange County, California.

(Photo/Jill Nelson)

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