Who wants to read about substance abuse?
Won't it be the same old story - taxpayer money spent on social services to turn drug addicts and alcoholics around - only the problem seems to get worse?
But wait, says clinical and community psychologist Leonard Jason. After two years of checking it out, the DePaul University researcher says he's found something that really works, "an amazing grassroots phenomenon," he says, that's been accomplished almost entirely with volunteers at almost no cost to taxpayers.
It's called Oxford House, and it has grown from one self-run, self-supporting recovery house in the Washington, D.C., area in 1975, to more than 500 in 35 states in 1994. In Washington state, the first house opened in August 1990; today, there are 28.
Oxford House's concept is deceptively simple. Self-run means no professionals, such as counselors or house managers, and a pure democracy. Every resident has one vote, all participate in running the house, with officers rotating every six months. That eliminates "us against them" sentiments and the addict's traditional resentment of authority, fosters responsibility and, as residents' leadership and self-management skills grow, self-confidence.
Every resident must pay his own way; established houses help new houses get started. Unlike traditional half-way houses, with often-short time limits, residents can stay as long as they like, as long as they pay their rent and follow the number one rule: sobriety.
Relapse means automatic expulsion. (They can reapply, but only after 30 days of sobriety.)
"An incredible system of health care delivery," Jason calls it.
"A mission and a movement" is the description by founder J. Paul Molloy - a former drunk, former wife-beater, and former Republican counsel to the Senate Commerce Committee. (It was by dint of his Capitol Hill political connections that, in 1988, a bill was passed corralling states into setting up $100,000 revolving loan funds to start up new houses along the Oxford House model. After that, expansion took off.)
The big puzzle, says Jason, is why he is the only one researching the "why and how" of Oxford House's apparent success - given a field where traditional treatment is expensive yet recidivism is high.
Not only that, he says, it's a potential model for solving other social problems, from homelessness to gangs. "No one thinks in these types of innovative ways because sometimes our preciousness as `professionals' has been threatened. We need to look at grassroots efforts of people to solve their own problems," Jason says.
"We professionals are very good at changing behavior, but not very good at what community psychologists say we should be doing: create `ecological systems' within the community that are supportive, protective, instill values."
Oxford House, he concludes, is just such an ecological system.
4 p.m. on a Sunday. All seven members of Oxford House, Oak Tree, are present for the weekly "business meeting," seated around their dining table at the spotlessly clean, comfortable four-bedroom North End home.
Their ages range from 24 to 42. They are a maintenance supervisor, a mechanic, a warehouseman, a concrete carpenter, a dry wall helper, a dump truck driver, and an industrial salesman. Four are white, two are black, one is Latino.
All are former alcoholics and/or drug users whose number one goal is to stay clean and sober. Living at Oxford House is key to their plan.
As usual, much of the meeting is routine, conducted in dry parliamentary fashion. The men vote to buy two new fry pans, two laundry baskets, light bulbs and a can opener. The treasurer reports on their bank account ($1,087), bills, and fines levied ($50 to one resident for being late in rent, $20 for missing a business meeting; $5 for not doing an assigned chore).
But today emotions run higher than usual. Two members have just been kicked out. Dave was way late in his rent; he has shown up to explain. Mark was booted for relapsing to heroin use.
Dave, 29, a computer programmer analyst, seated in a corner, pleads his case. He disappeared without letting them know where he was, or when they could expect rent, because he was in the Snohomish County jail. Stopped for jaywalking, the police officer discovered his outstanding warrants for car theft and forgery - things he did before he went into treatment last June
Every time he called Oxford House collect from jail, he got the answering machine. He finally got through, he said - to Mark, and he didn't know Mark had relapsed.
The guys consider the situation. They give Dave points for still staying clean and sober, still attending NA. "I don't want to see anybody on the street who is serious about not relapsing," says Guy Walker, 31, the mechanic, who has been here since June, when he left treatment.
Because Mark was paid up through the month, they have a little cushion. But Dave must come up with the $250 month's rent.
Walker tells him about a temporary-work agency around the corner, says he can make $35-$40 a day, mostly construction jobs. Walker knows, because in his own bad old days he'd do a temp job, then blow the money that night on booze. Dave promises he'll jump on the idea.
Oid Mattox, 38, the dump truck driver and mechanic, suggests another condition: Dave must get his legal problems settled, and report to everyone at the next meeting. Dave promises to do that. "My normal state is to run, go to another state. But I can't afford to do that. I'm making major changes, to clean up this wreckage I've made of my life."
"Welcome back," a couple of the guys say, and everyone murmurs assent.
"Stay clean," adds president Mike Winsberry, the maintenance supervisor, at 42 their "elder statesman."
There is discussion of the condition of the house (the garage is a mess; three of the guys just rebuilt Winsberry's engine inside); getting new dead-bolts because Mark has the house key. Mattox talks about the presentations he has made at treatment centers, to recruit new members to Oxford Houses. He is supposed to be leaving to start a new Oxford House in Tacoma - experienced members are tapped to "seed" and lead new houses - but now that's in doubt; the Tacoma landlord is asking too much money.
Plans are made for an upcoming workshop in Vancouver, where they can learn better ways to run the houses and fulfill the different officer roles, and for a potluck at the Mercer Island house with founder Molloy, who will be in town.
They close with "reflections." Each man shares how his week has gone:
A tiff with a boss, news that a younger brother is into drugs . . . excitement over joining a gym . . . anticipation of the Vancouver workshop. Several say they have been so busy with Oxford House-related work, they haven't had time to think about "using."
Dave talks about his great sense of relief of being accepted "home" again. Out on the streets, "I was noticing homeless people more than I ever have. The misery. The drug abuse. I'm a guy with a college education, upper middle class family, it scared me. I'm grateful to you guys."
There is disappointment all around about Mark's relapse. Winsberry sums it up. "At least we salvaged one," he says, referring to Dave. "We can't save the world. You have to save yourself. It's bad out there."
He feels bad about Mark, he says, but Oak Tree is a strong house and will stay strong.
(In the almost-year long history of the house, Mark makes the third failure. One guy was kicked out after being picked up for a DWI, another for trying to start a fight - ironically, with Mark).
But the highlight is Walker's week. His dad was in town, for the first time in a year. When he'd last seen his dad, Walker had been homeless, and bummed $10 off him; he heard that his dad commented to others that "I was sucking off welfare and I'd never amount to anything."
But this time, he took his Dad out to dinner, drove him in his newly financed car, took him to the garage where he's now assistant manager and showed him his new tool box (he'd pawned his tools in his drunk days) and showed him Oxford House - a place nicer than his family had ever lived in. His dad saw him give his little brother a dirt bike he'd just bought, and watched the boy's eyes light up. "Giving truly is the funniest thing on earth," Walker says.
Postscript: In the weeks following that business meeting, the industrial salesman is kicked out after it's discovered that he cashed some of the Oxford House checks at a tavern. And Winsberry decides that, after almost a year of residency, he's going to get a place of his own. He says he's learned as much as he can, and he's feeling ready to move on.
How it started
The guys are looking forward to meeting Molloy almost the way adherents of a religion look to a spiritual leader.
Molloy, 55, says he has steadfastly resisted any guru-type trappings: "I fight this personal cult thing. The worst thing was Synanon (the California-based drug-rehabilitation center that became embroiled in allegations of violence and harassment in the 1970s). Oxford House has gone out of its way to make sure that doesn't happen."
He says he doesn't collect his salary - his wife supports him. In town for a visit, he stays at the Bellevue Oxford House. Insurance against power hunger also prompts the democratic structure.
Still, it is clear that there would be no Oxford House without the vision and political savvy of Molloy. And, although he intended to step down as CEO in 1992, he quickly changed his mind, saying there was too much infighting and no one ready to take over.
It was hardly a career he envisioned back in 1975, when he and several others complained at their AA meeting that the county was closing the Maryland halfway house where they were living.
Molloy had just gone through treatment, his world having finally collapsed as his alcoholism worsened; he had been drinking two fifths of Canadian Club a day. His wife committed him briefly to a mental institution, and filed for divorce. His high-powered career as a congressional staff lawyer crashed.
One AA member told the complaining men to stop pitying themselves and rent their own house. Another AA member loaned them $750 to do it; six took up the plan.
They flourished. Their new house soon had a surplus of $1,200, and members voted to rent another house - to take care of all the applicants asking to move in.
After 2 1/2 years, Molloy moved out, but remained involved as a volunteer. .
The network of Oxford Houses continued to grow, but really took off when Congress established the revolving loan fund. In his Republican soul, Molloy didn't like the government involvement, but says he realized there was no way to achieve major expansion without it. He still prefers to get funding from foundations.
He takes comfort that the only cost to taxpayers is the occasional house that fails without paying back its loan, and even then, fellow houses in the chapter have been known to take it upon themselves to repay the money.
Plus, there are the salaries of organizers that some counties or states hire to set up a new house.
All houses are located in "good neighborhoods," according to Molloy. The idea is to bolster self-esteem and a sense of starting over, reduce temptation of easy access to drugs, and ensure that residents don't take up old habits and acquaintances in former haunts.
Each house is independent, with residents admitted by vote of the others. Clusters of houses are organized into chapters, which provide quality control and mutual support. Money collected from chapter dues can bail out houses in temporary trouble.
Since 1975, 6,000 men and women have lived in Oxford Houses, on average staying 15 months, although some stay for years. Today, there are 4,536 men and women living in an Oxford House.
Staying clean - the numbers
The tricky part is the statistics on recidivism. Professor Jason wants to do long-term tracking.
The organization cites about an 80 percent success rate, meaning that 20 percent relapse while in an Oxford House (21 percent in Washington state). But there is no tracking after they leave. The most comprehensive study done to date has found a 90 percent relapse rate within 18 months following treatment programs in general, although 2-3 percent get clean and sober every year after that, says Molloy. The main problem is that there is no support for the treated substance abuser after treatment, and they usually go back into the environment where their addiction took hold - a recipe for falling back into old habits and friends.
Not in my neighborhood
While it doesn't cost taxpayers a lot of money, Oxford House sometimes does exact a more difficult price: community acceptance.
While many neighbors have grown to accept the Oxford House presence in their midst, others have not. It's not that the houses stand out as being residences of "undesirables." Actually, residents go out of their way to be good neighbors, knowing the scrutiny they're under: rent is paid on time, houses are kept up, even rehabbed in some cases. But neighbors often fear that their own property values will slip.
Oxford House has fought lawsuits all over the country, including a city of Edmonds case that recently was decided by the 9th Circuit Court of Appeals, over where they can locate. At issue is the interpretation of the federal law governing the rights of the disabled to live where they choose.
Edmonds contends its zoning law - which prohibits more than five unrelated persons from living together in a single-family neighborhood - is exempt from the fair housing law. The American Civil Liberties Union on behalf of Oxford House, along with the U.S. Justice Department, took the opposite view, and the Ninth Circuit agreed. It then sent back the question of whether Edmonds' zoning law violates rights of the disabled to the lower court.
That is one of two circuit decisions now standing in the country - the other is in Georgia, and reaches the opposite conclusion. Some believe the matter will have to be decided by the U.S. Supreme Court.
For now, though, the 9th Circuit prevails here, and the decision already has prompted other communities in the state, including Bellevue, to rethink restrictions on Oxford Houses.
Washington - a strong state
The Washington victory was fitting so far as Oxford House is concerned, given that this state has been a strong supporter. Three of the nine board members are Washingtonians, and many of the state's houses and volunteers are considered particularly effective.
Molloy attributes this to at least some state support for services for recovering addicts and alcoholics ("here maybe they're not on the front burner, but they're an item on the stove"). In some states, he says, the support is lacking because of the perception that substance abuse is "a black problem."
Here, state officials have lauded Oxford House. Some of the state managers say there are some who Oxford House isn't right for: those too young and immature, or a mentally ill addict who needs more intervention, may not be ready.
But, says Steve Freng, systems chief for the Division of Alcoholism and Substance Abuse Services in King County: "Oxford House. . . is the most thoughtful, decentralized yet structured approach that I have seen in my career."
It hasn't all been a wild success story here, however.
Since 1990, three houses have failed: two in Everett and one in Bothell. State outreach coordinator Myrna Brown, the grandmotherly "den mother of Oxford House," says several problems were at work: the Bothell house was too far from transportation; in one of the Everett houses, the landlord kept upping the rent (they've since learned to insist on leases); and she suspects Everett may have been too far from the rest of the houses in the chapter for proper support.
These days Brown - a recovering alcoholic, former executive director of the Republican Party in Multnomah County, former program director for the Oregon state Republican Party - has trained her focus on Thurston and Mason counties and may extend that to Grays Harbor. Her goal: to fill in the I-5 corridor.
Eventually, the organization sees the need for 100 houses in the state. Freng says King County probably could use 20-30 (there are 10 now, and a total of 14 in King, Snohomish and Island counties).
Oxford House still is operating on a shoestring, though no longer all-volunteer. Nowadays there are 26 paid employees, 10 of those outreach workers who help open new houses.
Molloy says his goal is 10,000 houses open in the country by the year 2,000.
That would seem to require a miracle, but with the enthusiasm of its believer residents, who knows?
Hear Oid Mattox, a decorated Vietnam veteran brought to the brink of suicide by his cocaine habit before he joined Oxford House:
"Because of Oxford House I've seen people who have gotten good jobs, gotten back relationships with a child, given their parents hope. I've seen people jump up and hug you after you tell them their application has been accepted to an Oxford House. I've seen a lot of success stories. A lot of miracles."
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------------------------------------------------------------------ A SURVEY OF WASHINGTON STATE MEN AND WOMEN IN OXFORD HOUSES SHOWS: ------------------------------------------------------------------
-- The majority have been in treatment before: 18 percent enter having just completed their first treatment, 19 percent have been in treatment more than 10 times. The average resident has been through detoxication without further treatment an average of 2.5 times, and in addition have been through treatment an average of twice.
-- Some 62 percent have been homeless during their addiction, an average of three-plus times; 13 percent were homeless at the time they entered Oxford House.
-- 75 percent have served jail time, the average length a little over nine months, the average number of prior arrests almost 6. No different in relapse rate was found between those who served jail time and those who didn't.
-- Educational level ranges from less than 8th grade to graduate college degrees, but the median is a little above high-school graduation.
-- They are 85 percent white, 9 percent black, 1 percent Hispanic, and 5 percent other.
-- Their median age is 36.
-- They attend an average of almost four meetings of AA or NA weekly.
-- They are divided roughly half and half between former drug addicts (49 percent) and recovering alcoholics (51 percent).