Planned ‘sober house’ fails to meet key criteria

My name is Dr. Jeffrey Deitz, a resident of Quintard Avenue, Norwalk. I am an Addiction Medicine specialist, having spent decades treating substance use disorders (SUD), a chronic, oftentimes fatal disease. SUD treatment settings run the gamut from detoxification, to 28-day inpatient, to intensive residential treatment, to partial hospitalization and intensive outpatient therapy, and after considerable progress in treatment, to sober houses and living at home. Every SUD patient must be evaluated individually before he or she is assigned to the proper level of care, with criteria set by the American Society of Addiction Medicine. Putting patients in the wrong setting risks relapse and death.

By far, the highest risk population for relapse and death from overdose, are recently-incarcerated individuals with Opiate Use Disorder who are released into the community. Because of forced sobriety while in prison their tolerance to opiate drugs are markedly reduced so when they relapse on drugs they are up to eight times as likely to die from over opiate overdose compared to the national rate.

In his review, Dr. Douglas Polcin, senior scientist at the Alcohol Research Group, defines sober living house (SLH) concisely: “SLH’s are alcohol and drug free living environments for individuals attempting to maintain abstinence from alcohol and drugs. They offer no formal treatment but either mandate or strongly encourage attendance at 12-step groups.”

Note Polcin’s phrasing “no formal treatment . . encourage 12-step groups.” This is exactly what Pivot Ministry did for forty years at 17 Quintard Avenue in Norwalk. Surely Pivot Norwalk residents gathered informally to discuss recovery, but Pivot Norwalk never offered structured, on-site programs. Not one.

Enter Firetree, Ltd., a sprawling Pennsylvania entity that offers programs for individuals returning from prison to the community, many of whom suffer from SUD. In 2014, Pivot sold 17 Quintard to Firetree under circumstances that remain shrouded, although the real value in the transaction was the zoning variance granted to Pivot decades earlier designating 17 Quintard a “drug rehab,” a vague and obsolete term that it is meaningless in today’s world of specialized SUD treatment. However, Firetree needed Pivot’s grandfathered zoning variance to slide by City Hall and obviate public hearings about its true intended use.

Before the sale, Firetree contacted Norwalk Mayor Harry Rilling with plans to open an 18-bed prison reentry facility claiming “same use” as Pivot. Thereafter an entity named “Firetree/Pivot” obtained permits from Norwalk to renovate 17 Quintard extensively in time to fulfill a multimillion dollar contract with the Bureau of Prisons for a facility with 24-hour monitoring and extensive on-site residential treatment. Given Firetree’s extensive experience in the field it must know of the propensity for overdose death in that population, so extensive on-site residential treatment makes sense clinically and is good care. It follows that Firetree knows full well that Sober house living for that population—that is one with no formal treatment program—would be woefully inadequate, indeed dangerous.

After an alert neighbor realized what was happening, all hell broke loose. Yes we made a stink. So would anyone if the next door neighbor opened a prison without telling you! How could Norwalk violate our trust so flagrantly when the mayor knew all along? Under intense pressure Norwalk’s zoning board of appeals (ZBA) denied Firetree’s request to operate the prison facility because the proposed use was more intense than Pivot’s. Imagine! Firetree nearly snuck in under cover, evidently with the mayor’s knowledge.

Not only that, but Norwalk’s building codes were not enforced, nor were its zoning regulations. Why 18 residents, when Norwalk zoning limits occupancy to one resident per 250 square feet, 10 residents in a building that size? Simply because Firetree needed 18 beds to turn a profit.

And now Firetree’s at it again, yet again with the City of Norwalk’s blessing, rebranding 17 Quintard as a “sober house.” Same intensity programming; same patient population; only a different name. Why “sober house?” Because after the ZBA denial Firetree sued Norwalk claiming it was discriminating against patients with SUD. Note the shift away from prisoners towards SUD, allowing Firetree to litigate under the Americans for Disability Act (ADA) since SUD is considered a disability, while incarceration is not.

Same program; different name. No one can understand why Norwalk City Hall is so unexplainably complicit in Firetree’s plan to open what clearly falls under ASAM levels 3.1 to 3.3, residential treatment, a far, far cry from “sober house.”

The problem cannot be ADA, because no 18-bed nursing home or school for troubled children would be permitted in a residential neighborhood because of overcrowding and traffic congestion.

How can Norwalk’s Department of Health let Firetree cram 18 individuals plus staff in a single family residence? How can Norwalk’s Department of Health let Firetree open a “sober house” with an eightfold increased risk of drug overdose death unless, in fact, it is not a sober house? Why doesn’t Mayor Rilling make Firetree apply for a zoning variance to operate an 18-bed residential treatment facility? Why is Norwalk plowing ahead, allowing a “sober house” that isn’t a sober house? The situation reeks of cronyism and duplicity, and calls for investigation by an outside authority.

Every Norwalk resident should be concerned, for if City Hall fails to enforce zoning and bows to outside pressure in one neighborhood it can do it anywhere.

Personally, I welcome a sober house as long as it obeys zoning laws and heeds Polcin’s definition. So if Firetree Norwalk is truly a sober house it will offer “no formal treatment.” Neither will Firetree nor its myriad subsidiaries bill insurance or Medicaid for residential treatment services. Let Firetree allow an outside evaluator to certify that each resident is appropriate for “sober house” living and relegate all counseling and treatment to non-financially affiliated community agencies and I will gladly welcome ten people dedicated to recovery into my neighborhood.

I’ll even bring the cookies.

Jeffrey Deitz MD

Norwalk, Connecticut