Mind and Body

Changing the lexicon, practice of recovery housing in RI

Under the guidance of Jonathan Goyer, Oxford House recovery housing model finds a new home in Rhode Island

Photo by Richard Asinof [file photo]

Jonathan Goyer, in front of a portrait of Jim Gillen.

By Richard Asinof
Posted 11/11/19
A model of recovery housing, Oxford House, has found a home in West Warwick, thanks to the guidance of Jonathan Goyer, seeking to address the unmet need for those seeking recovery housing, with a current waiting list of more than 800 in Rhode Island.
What are the entrepreneurial opportunities for innovations in the recovery community that move beyond the current status quo? Is there a need to address gender differences in thinking about recovery and treatment strategies, particularly for mothers with young children? What will it take to change the practice of asking about pain as a vital sign of health by medical providers? Will it take the threat of a lawsuit for the R.I. General Assembly to adhere to parity laws when it comes to behavioral and mental health care and increase the low Medicaid rates paid?
As successful as many of the interventions pioneered by Rhode Island in the last few years to address the substance use epidemic have been, there remain large gaps in the delivery of services, in many cases related to the narrow focus on opioids and prescription painkillers, to the exclusion of alcohol and other substances, as well as the lack of a strategic approach to harm reduction.
In addition, the larger issue, identified by sociologist Shannon Monnat as the deaths of despair, linking deaths from alcohol, suicide and drugs and tying it to economic disparities, remains a taboo topic for many government interventions.
Many of the innovative interventions pioneered around substance use have been the result of peer recovery models. But the value of those doing the work in peer recovery still remains an unappreciated resource, particularly as the interventions have become formalized and consolidated into institutionalized programs. Who is paying attention to providing the supports that recovery community advocates need to succeed?
The “exodus” of many Rhode Island recovery community innovators in recent months – including Deb Dettor, Tom Coderre, Jonathan Goyer and Holly Cekala – can be seen as a natural progression, or it can be seen as a worrying trend in the face of growing corporate control. Who is paying attention?

PROVIDENCE – Last week ConvergenceRI attended a lecture by Robert Ashford, MSW, who spoke on Tuesday evening, Nov. 5, at Brown University, about stigma, bias and discrimination, with a particular focus on the use of language, at an event sponsored by RICARES, the Donovan Project, and the COBRE on Opioids and Overdose.

Ashford had a lot to unpack in his 90-minute lecture, presenting findings from new academic research about how negative choices in language – everything from drug addict to dirty, from medication-assisted treatment to relapse, from enabler to co-dependent – kept many in recovery constrained within a linguistic stigma box.

“Recovery,” Ashford began, “is an individualized, intentional dynamic and relationship process involving substantial efforts to improve wellness.” Recovery, he continued, “is not a linear process; it is not time-limited.” Further, according to the research, many in recovery do not self-identify as being in recovery, Ashford said.

The audience of about 30 attending the lecture included many of the more knowledgeable members of the recovery community in Rhode Island, including Monica Smith, executive director of RICARES, Brandon Marshall, a researcher at the Brown School of Public Health, Deb Dettor, the former director of Recovery Support Services at the Anchor Recovery Community Center, and Jonathan Goyer, recovery community advocate.

However, Ashford talked and talked and talked, waiting until the end to allow for any interactive questions from the audience.

Perhaps it was because ConvergenceRI was still in “recovery” from complex spine surgery done in September, making it painful to have to sit in an uncomfortable chair and have to listen to someone lecture for more than 90 minutes.

Perhaps it was because the talk brought out the worst in ConvergenceRI’s allergic reaction to the “I talk, you listen” power dynamic of academic presentations.

Walking out, after Ashford’s talk had finally concluded, what first came to mind was a poem by Walt Whitman from his epic volume, Leaves of Grass, “When I heard the learn’d astronomer”:

When I heard the learn’d astronomer,
When the proofs, the figures, were ranged in columns before me,
When I was shown the charts and diagrams, to add, divide, and measure them
When I sitting heard the astronomer where he lectured with much applause in the lecture room,
How soon unaccountable I became tired and sick,
Till rising and gliding out I wander’d off by myself,
In the mystical moist night-air, and from time to time,
Look’d up in the perfect silence at the stars.


A great conversation

What ConvergenceRI wander’d into next was a great conversation with Jonathan Goyer, someone who has taken the words about recovery as voiced by Ashford – an individualized, intentional dynamic and relationship process to improve wellness – and put them into action.

For much of the past three years, Goyer had served as the director of the Anchor MORE [Mobile Outreach Recovery Efforts] program, which deployed peer recovery coaches to shelters, soup kitchens, bus stations and other geographic areas of the state that lack recovery supports, coordinating efforts of six peer recovery coaches.

Goyer has also been serving an expert advisor for the Governor’s Task Force on Overdose Prevention and Intervention, having been a co-author of the Task Force’s original strategic plan. For those who regularly attend the Task Force meetings, Goyer often serves in the role of asking critical, probing questions.

Following the Ashford lecture, Goyer agreed to sit down and share his recent efforts to launch a new kind of recovery housing in Rhode Island, under the Oxford House model, with the first location having opened its doors on Nov. 1 in West Warwick.

“We can push as many different treatments as we want to push, and we can believe in many different concepts,” Goyer said. “But for me, what tells the story of what is successful in this epidemic is this: meeting people where they are at, and providing the resources that they are willing to engage with, at any point in time.”

And, Goyer continued, explaining his endeavor to bring the Oxford House recovery housing model to Rhode Island, “A waiting list of 800 people [for recovery housing] tells me that people are willing to engage in this type of resource.”

Here is the most recent ConvergenceRI interview with Jonathan Goyer.

ConvergenceRI: Tell me about Oxford House and what you are doing?
GOYER:
Oxford House is an organization based out of Washington, D.C. It is a type of model of recovery house that has been in existence for 44 years. There are 2,500 Oxford houses throughout the country, in 48 different states.

Rhode Island and Wyoming were the two remaining states that did not have an Oxford House.

ConvergenceRI: Until now.
GOYER:
Yes, until now, as far as Rhode Island goes. Wyoming is going to be singled out.

Oxford Houses are designed to be democratically run, peer-led recovery houses that operate on an equal-shared expense cost model.

Backing up, I’m not saying that an Oxford House is for everybody. But, as we’ve migrated in this field in understanding a spectrum of treatments in recovery resource options, one of our fundamental beliefs has become [that there are] many pathways to recovery.

So, 12-step recovery isn’t for everybody; yoga isn’t for everybody; residential treatment isn’t for everybody; not even everybody needs detox, for example.

There are many, many pathways to recovery.

Now, within that, we need to have a subset of options, within those options.

So, the Oxford House model of recovery housing is going to be providing Rhode Island an additional type of recovery house.

ConvergenceRI: Are you going to be the CEO of this group in Rhode Island?
GOYER:
No, I am not.

I have been studying the Oxford model for over two years. I have flown across the country, visited different houses. I’ve become friends with a lot of individuals who live in the houses, who work for the organization. And, I have decided that it was really something that Rhode Island needed.

It took me a while to get one opened here. I was able to do so with my own nonprofit.

Not many people know that I have a nonprofit in Rhode Island, but I have had it for two years, it is called Access To Recovery, we are a 501 [c] 3, nonprofit organization.

I was able to [do this] with entirely donated money, as we do not contend or strive to obtain state funds. We are entirely community-based, donation-based revenue organization.

We are essentially the funding backers for Oxford House [in Rhode Island].

If you research the organization online, they will say it costs about $6,000 to get an Oxford House going.

That is the national average. Of course, geographically, that differs, whether you are in New York City or Tulsa, Oklahoma.

But the average cost is $6,000 per house. My organization is simply providing those funds so that Oxford can become established in Rhode Island.

ConvergenceRI: It seems like this is a natural progression in your work as part of the recovery community, an understanding of the need to innovate and change paths. Is that accurate?
GOYER:
Absolutely

ConvergenceRI: The idea is to figure out how you don’t get stuck in the status quo.
GOYER:
Exactly, This is certainly not my first innovative effort in Rhode Island as it pertains to the addiction epidemic that we’re experiencing.

ConvergenceRI: Substance use epidemic?
GOYER:
[laughing] Very true, and then some.

I’ve been [working in] recovery advocacy in Rhode Island for almost seven years now. Having been able to serve as an expert advisor to the Governor’s Task Force, and having been a co-author to the original strategic plan, and to the extended strategic plan put out by the state of Rhode Island, it really has allowed me to have boots on the ground, ears and eyes everywhere, and be really aware of the work that is going on in Rhode Island.

And, Rhode Island has done an incredible amount of work, even in the last two years alone, as far as funding new efforts and reaching new populations and [exploring] different approaches to the epidemic.

But we are always going to have those gaps. Recovery housing in Rhode Island is a huge gap. Granted, we now have state funding to pay for individuals to live in a recovery residence for up to nine months.

The waiting lists for that, unfortunately, are [more than] 800 people.

Now what’s happening, parallel to this, it’s a common known fact, is that [costs in] the real estate market are increasing. The average cost for a resident right now, if they are self-paying, to live in a recovery house, is $145 per week. I’ve seen it as high as $185 per week.

But the average cost is $145 per week. And that is across the board, whether you are sharing a bedroom with someone, or have your own bedroom, it’s $145 a week.

That is, in my opinion, inaccessible and unsustainable, particularly for someone new in recovery. As you can imagine, somebody’s that is new in recovery, and by new in recovery, I mean somebody in their first three, four, five years in recovery, are struggling to pay off previous debts, perhaps pay off court fines and court costs, restitution, child support, reinstating their license, whatever financial damages they have accrued during their active addiction.

So, the costs of this Oxford House, this first Oxford House, which opened Nov. 1, are $95 per week.

When you do the math on that, if you have an Oxford House that has eight residents in it, that are all saving $50 a week, in total that amounts to more than $20,000 per year.

Essentially, my nonprofit is looking at this as an opportunity to subsidize recovery housing for individuals in a much more global way.

It allows residents, obviously, to save more money, [by making recovery housing] more accessible, more sustainable.

Furthermore, the dynamic of an Oxford House is that it is a democratically run environment, you get a say in how the house is run.

ConvergenceRI: What does democratically run mean?
GOYER:
When you live in a traditional recovery house in Rhode Island, you pay your $145 a week, and that’s it.

You are not paying the bills for the house, you’re not aware of the debts accrued as a result of the lease, or the mortgage payment, or utility bills.

Now, in this Oxford House, everyone is responsible to cover those things. So, you actually have people learning, oh, this is how I pay an electric bill every month. Oh, this is what happens when we leave the heat on all day.

Practical, real-life scenarios that these individuals are going to be getting an opportunity to experience and balance and learn and perfect and polish, so that they can apply that to their lives.

ConvergenceRI: Will you replicate the model in more places in Rhode Island?
GOYER:
It is my vision to open as many Oxford Houses as we need.

With the first house, one of the struggles that we have had, was finding home owners that are willing to rent to Oxford for that intended purpose. I was able to meet a really nice gentleman in West Warwick

ConvergenceRI: So, the first home opened is in West Warwick?
GOYER:
Yes, in West Warwick. This gentleman was at first, of course, a little skeptical, as everybody has the right to be.

But we sat down and had a discussion, and he really became open-minded to it.

And, when he found out how long the [Oxford House] organization has been in existence, how many years the model has been in practice, and how it has become evidence-based, he was willing to give it a shot.

So, we got our first homeowner/stakeholder on board here, we signed the lease.

ConvergenceRI: How long is the lease for?
GOYER:
The lease is going to be for 15 months, with a one-year renewal. And, after that, assuming all goes well, he is all for signing a five-year lease, which is what we’d really like to see.

My personal experience is that I spent my whole first year in recovery in a recovery house. And, to this day, although I don’t live in a traditional recovery house, I continue to live with people in recovery. Because, when I live my life surrounded by caring, loving, like-minded individuals, it makes my decision-making a lot easier, in terms of doing the right thing.

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