Medication Assisted Treatment for Opioid Addiction, Harm Reduction and Zero-Tolerance Sober Living Houses

As a recovering addict and alcoholic who has spent over 20 years in and out of treatment centers and programs, the rooms of AA/NA, jails and hospitals, on medication and off of it, spent over half of my adult life living in sober living houses, and who is now the Founder and Director of River Sober Living in Boise, ID – I have one prominent thought on recovery, a basic idea that pertains to the whole spectrum of what a person with substance use disorder experiences and what will work best for their recovery: It’s relative to the individual. There isn’t a single prescribed formula or program that works in the same way for everyone.

The roadmap that brings peace and respect into someone’s life and what gets them to the place where they aspire to be mentally, spiritually and physically in their recovery – is different compared to how every other person will accomplish what they set out to do in recovery. They may have similar or even the same goals, but the compass they use to accomplish them will most surely guide them down a unique path. Some basics may be in place, like working a 12-step program and finding a social support group, but the method of working the steps or finding like-minded people in recovery will be different because people are different, every sponsor, guide, mentor or coach is different, and the details that encapsulate a person’s life and makes it their own journey, history and thoughts - that may help sustain their sobriety, or destroy it - will be different than the person speaking and sitting next to them. The thoughts and emotions that must be addressed by a person wanting to fulfill their aspirations of long-term sobriety will be slightly, if not completely different than mine. The way I ultimately come to terms with my shattered sense-of-self and start to repair it – will not work for, maybe has not worked for, and may not even make sense to others in recovery.

Going deeper, what sobriety is to one man or woman, is not sobriety to the next.  This relates heavily to MAT (medication assisted treatment) for opioid addiction (predominantly: suboxone, methadone.) This is a complex subject and a catalyst to heated-discussions if you try to put recovery and sobriety into a static definition.

Is it sobriety? If taking a prescribed narcotic as instructed, in place of another narcotic, helps get a person off the streets, back into life, into their family’s lives, back into school, back to work, back to being a law-abiding citizen, back to truly living and not just merely surviving by thieving and manipulating – who’s to say that it’s not sobriety for that person? If it’s not your sobriety, then don’t take suboxone or methadone. Simple. No need for debate. I have my own personal sobriety, what it means to me and how I maintain it, but I choose to not tell others what theirs should be.

MAT opens the door to a discussion regarding “harm reduction”. 

“Harm reduction” is frequently discussed in my conversations with treatment centers, counselors and associates with other sober living houses. How does one best approach substance use disorder relapse, medication assisted treatment (suboxone, methadone) and understand the best practices, policies and procedures for a wide-array of recovery services?

An excerpt from The Harm Reduction Coalition’s definition of harm reduction is “a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.”  This definition, as I understand it, could be applied to every treatment plan, living situation, family structure, legal process and penalty, etc.  Do I believe in harm reduction?  Most definitely, but not across the board. Where do you draw the line? Do you “harm reduce” someone in a situation that ultimately and adversely effects their family and/or everyone else in recovery around them? One must approach it on a case-by-case basis. Is a “harm reduction” environment the best policy for sober living houses? I believe it depends on what environment you are promising to your residents. 

River Sober Living has a zero-tolerance policy, and on a case-by-case basis, we will provide housing to individuals prescribed MAT, but they must sign an agreement stating that they will travel to their clinic or treatment center every day to take their prescription and sign a release of information for River’s Management. They cannot take possession of it outside of their prescribing facility and continue to be a resident of River Sober Living. This policy is put into place because MAT prescriptions are narcotics, they have illicit effects, they have street-value and they have a likelihood to be “diverted” (for uses and persons not prescribed it) far more than other psychotherapeutic drugs. Just a resident knowing that there is something in their house that will give them instant relief from emotional or physical turmoil – could set them off on a relapse. For an individual in recovery living at our house who is not prescribed MAT, MAT is not their program of sobriety and could be a liability to their sobriety. River Sober Living has the responsibility to provide a zero-tolerance sober living house – to the entire house.

In my experience (as a resident and an operator of sober living houses), I have had hundreds if not over a thousand conversations regarding a zero-tolerance sober living house policy with counselors, therapists, clinicians, clinical directors, law enforcement, prospective and current residents, housemates, house managers, family members of residents, and owners of other sober living houses. I am convinced that the zero-tolerance policy should not be compromised. If a person uses or drinks while they are living at one of our houses, even a little bit, inside or outside of our house, they must move out for a minimum of 30 days and then re-apply to become a resident again. Most everyone who I have spoken with supports the zero-tolerance sober living policy and understands why it holds its place outside of “harm reduction”.  This is where my aforementioned statement of the adverse effects to others in recovery who are living with them comes into play.

Every single potential or current resident of River Sober Living, and every resident I’ve ever lived with at zero-tolerance houses, has expressed to me that one of their main deciding factors of living at that house was the zero-tolerance policy. They want the accountability and safety, and they don’t want to live with housemates who continually relapse, or purposefully take advantage of 1st , 2nd, 3rd strike or case-by-case policies. They want a sober living house, not a sober living house where people don’t use or drink that much – but continue to live there. 

If you have 10 guys living together under a case-by-case relapse policy of any kind, in any given month you could conceivably have every one of the 10 residents relapsing, or even repeatedly relapsing in that time frame but still continue to live there. Would you still have an accountable sober living house, or a house where the policies themselves, and the housemates are a liability to each other’s sobriety? Most would say the latter. Our house doesn’t have clinical staff. We are not our resident’s case manager or counselor. Our Management is not qualified to decide anything other than if our residents are sober - or are they not. We have the responsibility to decide that is best for the house as a whole.

River is constantly searching for ways to improve upon existing policies and explore avenues that will best serve our residents. As being such, I am open to feedback on this topic and any others you’d like to address.

Thank you for your time and attention,

Brandt Gibson
Founder, Director
River Sober Living, Boise
brandt@riversoberliving.com

Idaho Statesman Business Weekly Article, it's been a ride.

He struggled to stay sober. Now he’s opened a sober-living house in Boise

BY RAINO ZOLLER

Trailhead Boise member Brandt Gibson has always had entrepreneurial aspirations but has struggled to remain sober long enough to follow through on any of his ideas. However, his recovery this time around has led him to a more established sense of self.

He joined Trailhead in search of entrepreneurial advice and on May 1 opened River Sober Living, a sober-living house near Franklin and Maple Grove roads in Boise.

For 10 years, Gibson struggled to maintain sobriety. He bounced around the workforce — working a job for a couple of weeks, hitting bottom, then picking himself up a few days later. Then he’d find another job and continue the cycle.

This cycle forced frequent relocations — he’s spent time in California, Idaho, Arizona and Hawaii. He’s worked almost every job imaginable, including as a freelance designer, executive recruiter and a beekeeper.

After gaining clarity on his life direction, Gibson chose to follow his dream of developing something entrepreneurial. He decided to go with what he knew best: recovery and sober-living houses.

Gibson’s vision for River Sober Living is to provide a different type of living, one that promotes sobriety through self-motivation, peer support, and personal and spiritual growth.

“I’ve always known, and never had any problem admitting, that I am ‘powerless over alcohol and that my life had become unmanageable’ – but I thought I could work with that,” River Sober Living founder Brandt Gibson writes in a blog on his website. “Admitting defeat is the first brick in my recovery process, and it has saved my life.”

Gibson has lived in a variety of places. “In my experience, whenever I lived in a house where everybody was self-motivated, there was an amazing peer support environment” he says. “People were there to pick each other up. Lifelong friendships have been made because of that environment. When individuals that weren’t self-motivated were mixed with people that were, that brotherhood and peer support didn’t exist, and failure rates were higher.”

After hearing about Trailhead from a family member, Gibson joined. “I felt like because I hadn’t started a business didn’t mean that I wouldn’t be welcomed here or that I couldn’t find support,” he says. “It was awesome right up front.”

Gibson uses Trailhead to hold meetings, network with other entrepreneurs and learn how to grow his business. “Every time I’ve needed help on any element of my business, Trailhead has been able to help, or connect me with somebody that could.”

The first River Sober Living house is already full and has a waiting list, and plans for the second are being made. Gibson’s dream is to open houses throughout Idaho.

Raino Zoller, info@trailheadboise.org, is the former executive director of Trailhead.

 

I always knew my life was shit and that I am powerless over alcohol.....but I thought I could work with that.

I never wanted to live the life that drinking and using afforded me – I always wanted to live my vision of a successful life by being emotionally, financially and physically available to myself and my family and to live up to my potential, but I could never get there AND drink at the same time. I lived a life of inner-conflict because I was morally and emotionally in a continual tug-of-war with myself. I was not whom I chose to show to the world, to myself or to my family. I was better than that, I knew it, I just couldn’t get there by running away, drinking and using.

I’ve always known, and never had any problem admitting that I am “powerless over alcohol and that my life had become unmanageable” – but I thought I could work with that. I knew there was a way that I could drink and live my vision of a successful life – all I needed was a better car, more money in the bank, more exercise, a better job, cooler friends, nicer clothes, a new romantic relationship, a new place to live – just “that something” that would make me feel better about myself so I didn’t have to destroy myself with alcohol was out there, I knew it, and all I had to do was find it, hit the restart button and then everything would be perfect.

It wasn’t until one day I was lying in bed with empty liquor and wine bottles lining the wall filled with urine (due to heavy isolation) that it occurred to me I had been in that place more than a few times in my life and that I was beaten – not powerless, I already knew that – I WAS BEAT. I had a premise, an absolute belief that I could find a way to drink and have everything I’d ever want that I had finally proven false.

Admitting defeat is the first brick in my recovery process and it has saved my life; There is something out there that no matter how much heart, soul, mind, body, sheer will or determination I put into it– I will always lose.

When I was in my first inpatient rehabilitation facility, a friend of mine in recovery wrote in my journal as we parted ways, what he wrote has stuck with me to this day and I reflect upon it often –

“Stay sober, that way people will know the truth about Brandt.”

I’ve realized that I can’t just take the alcohol or substance out of myself, my roadblocks then get thrown away and I magically become the person I’ve always wanted to be, but I strive to put practical tools to use that I have learned in my recovery and I have started taking steps towards building a person and a life I can be proud of.

It is time to stop avoiding what is really going on inside my soul and body by way of drinking and using, and put real work into repairing myself.

Autumn River Trees crop.jpg

The founding of River Sober Living is very personal to me. I have had a long recovery process as many an alcoholic and/or drug addict tends to have. I lived in over 10 different sober living houses during my chaotic existence, and it is that experience that I am reflecting upon as a model of what has helped me and others I know, gain and sustain sobriety.

 

River Sober Living in Boise, ID. is setting the bar high for Idaho state approved "Staffed, Safe and Sober Houses". River will empower sober-residents to take control of their lives by providing them with a prideful, safe, and healthy sober-living environment. We strive to supply avenues that foster personal growth by providing opportunities for volunteerism, recreation, hobbyists activities and professional and life-skill development.

 

We project opening the door to our first house on May 1st, 2017. Please explore our site to find out more about River Sober Living.