A three-quarter home in Pittsburgh was a key stop in my recovery from opioid addiction

‘Some homes are better than others, but I believe the conversation around recovery homes is often oversimplified.’

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Joanna Bernstein's addiction to opioids began with a potentially life-threatening bacterial infection. (Photo by Ryan Loew/PublicSource)

Joanna Bernstein's addiction to opioids began with a potentially life-threatening bacterial infection. (Photo by Ryan Loew/PublicSource)

Compelling personal stories
told by the people living them.

I woke up in the middle of the night pouring with sweat as if I had just finished running a marathon. I’ve never been in so much pain. It was all in my stomach. I needed to get to the bathroom. At the time, I was living alone. I crawled to the bathroom on my hands and knees. In fear that I was about to die, I called an ambulance and was rushed to the emergency room. 

I had contracted a potentially life-threatening bacterial infection. Antibiotics cleared the infection, but I was still in pain. I was discharged from the hospital three days later with a referral to a gastrointestinal doctor and a big bottle of Percocet  — with refills. 

It was then, in March 2014, that my descent into opioid addiction had begun.

For the next two years, my symptoms worsened, and doctors continued to prescribe me Percocet (acetaminophen with oxycodone) and oxycodone for abdominal pain. I did legitimately need them. But it didn’t take long for me to start abusing them.

At first, I would just take an extra half pill here and there. Then it progressed to an extra pill or two, then two or three and so forth. At the height of my pill addiction, I was taking roughly 80 to 100 mg of oxycodone a day when my prescription listed 50 mg as the daily maximum.

I was also spending a lot of money buying pills on the street to supplement my prescription. I was lying to my loved ones and felt like I was living a double life. 

It was then, in December 2016, that my recovery story began. My journey included inpatient and outpatient rehabilitation. I stayed clean for more than a year, then had my first relapse in early 2018, got clean again, then had a much uglier relapse in October 2018, when I resorted to using heroin. 

A few months before my second relapse, I underwent surgery to remove my endometriosis and was prescribed oxycodone to help me deal with post-surgery pain. I had also recently moved in with my mom after breaking up with my boyfriend. I moved out of the apartment we’d been sharing. Then I ran out of pills.

It was the perfect storm.

I attended inpatient rehab again, and when my mother wouldn't let me live at home, my only option came to be a three-quarter house. It worked for me and, while I acknowledge the opinions of those who criticize three-quarter houses, this is my story.

Misery in rehab

I was sitting on the lone chair in the hallway of inpatient rehab, pressing the pay phone to my ear as hard as I could to prevent it from falling apart. Another patient had been in an argument with a family member back home a few weeks before and slammed the phone, breaking the plastic.

“You’re going to let me come home after this, right? You said you would.”

My mom was on the other end. Three days earlier, she had driven me to the inpatient rehab. That’s where I was calling from. 

We barely spoke during the car ride. She was devastated and angry. I was sad, sick and still high from the night before. Before I agreed to go to rehab, I asked her if I could come back and live with her once I completed the program. She said I could. A few days later, she changed her mind.

“You can’t come back here,” she told me over the phone. 

I screamed and hung up on her. I knew why she didn’t want me to return to her home. I had been using heroin under her roof and lying about it for the past several weeks. 

My transition from pills to heroin follows the standard narrative: pills become harder to get and much more expensive. Heroin is cheap and more readily available. 

I didn’t just wake up one day and say, ‘This is going to be the day I try heroin.’ But one day I woke up, desperately wanting to get high. I couldn’t find any pills. 

That was the day that I felt like I officially became a statistic. I was the next pill addict to bite the dust. 

I quickly discovered that where I was living in East Liberty was about five minutes from an open air drug market. 

I used heroin for about two months before checking myself into rehab. I didn’t want to use, but my disease did. I was using sporadically enough to not develop a physical dependence. When I would stop for a few days, I would not go into withdrawal. The fact that I wasn’t ever going into withdrawal made it that much easier for me to return to using. But my consumption was increasing. 

The morning I went to rehab, I threw up from having taken too much the night before. I later learned from internet research that vomiting after consuming large quantities of heroin can be a sign that one is close to overdosing. After throwing up, I felt much better and got into my mom’s car high as a kite and completely miserable at the same time.

After my mom told me that I couldn’t come back home, I knew that I was going to have to go to a three-quarter house. A halfway house is a six-month commitment, which I wasn't willing to make. Most of my friends are married or have kids and don't have extra space. Plus, I didn't want to be intrusive. I had nowhere else to go.

 A three-quarter house is a transitional housing space that provides a lower level of care and supervision than a halfway house. While halfway houses are still considered treatment programs and are officially regulated, three-quarter homes are not technically treatment programs and, for the most part, are not regulated

There are mixed opinions on three-quarter houses in the recovery community, and with good reason. Some homes are better than others, but I believe the conversation around recovery homes is often oversimplified. 

The fact that there is no formal regulation of these homes draws a great amount of criticism, particularly from government officials in areas with higher concentrations of three-quarter houses. 

In a Pittsburgh Post-Gazette story from January 2017 on three-quarter houses, then-Councilwoman Natalia Rudiak said three-quarter houses are “simply warehousing those who are struggling with addiction and trying to remain sober.” 

But at the time I had to go to a three-quarter house, I didn’t know all of this. All I knew was that I'd never been to one and I was nervous and scared. 

"I no longer live in a three-quarter house, I have a strong relationship with my higher power, and I have lost the obsession and compulsion to use drugs," writes Joanna Bernstein. (Photo by Ryan Loew/PublicSource)

"I no longer live in a three-quarter house, I have a strong relationship with my higher power, and I have lost the obsession and compulsion to use drugs," writes Joanna Bernstein. (Photo by Ryan Loew/PublicSource)

One of the employees at the inpatient rehab I attended provided me with a list of three-quarter houses in the area that were viewed as reputable. I started making phone calls and kept being told that there weren’t any beds available. 

Eventually, an owner of one of the three-quarter houses gave me a referral for a house not on the list. She said it was a good, safe house.

The referral was for a place in Carrick. I called and the woman who answered said they had a bed for me. 

When I arrived at the house I received a warm welcome from the house manager. She was very personable and instantly quieted most of the anxiety that I had about entering the house. The house manager is responsible for conducting drug tests, making sure that all house rules are followed and that chores are completed. The house manager is also responsible for kicking out anyone who fails a drug screen at any point in time.

The house manager went over the rules with me, gave me a contract to sign, drug tested me and then showed me to a room I’d be sharing with another woman. It was a decent size and while my bed wasn’t exactly comfortable, it was still 10 times better than the thick vinyl pad of a bed that I had been sleeping on in rehab. I made my bed, laid down and thought about how I got there.

Three-quarter house experience

My roommate at the house, McKenzie Mallia, had been to a couple of different three-quarter houses in Carrick and Beechview. She understands why there are criticisms of three-quarter houses from the outside (that they don’t provide treatment, prioritize profit, etc.), but believes that perspective is limited.

“I think that it depends on which house you’re living in because some houses, yeah, absolutely, it’s just about the money,” McKenzie sad. “Should I live under a rock because I’m a drug addict? Like, no. People can change.”

McKenzie came to Pittsburgh in 2017 in an attempt to get clean. Unlike me, Mckenzie didn’t start with pills. She went straight to heroin.

“I was 19 and my ex-boyfriend was a heroin addict and I had never touched opiates at that point. My ex-boyfriend shot me up,” she said.

For a few years, she didn’t touch it again. Then she met someone new and started using heroin again. By the time she arrived in Pittsburgh, she had already been to rehab six times. 

The house had five bedrooms and could hold nine people total. I never felt like I was in an overcrowded environment. I sometimes had to wait a little longer than I would have preferred to use the bathroom. But there was always space for my food in the refrigerator, a place at the table for me to eat and a big, comfortable seat for me to recline in while watching TV or just relaxing in the living room.

If anything, I felt that being constantly surrounded by other women committed to their recovery and enduring the same struggle as me helped me stay clean.

One of the most important parts of my recovery is my participation in an anonymous 12-step fellowship. Everyone in the house was required to attend 12-step meetings. Some of us went more than others but it did seem like everyone went at least once a week. I have always vigorously attended meetings and can say with extreme confidence that I don’t think that I ever would have been able to accumulate any clean time without actively participating in a 12-step fellowship and attending meetings, getting a sponsor and working through the steps. 

During my stay at the house in Carrick, I saw several women get kicked out for relapsing on drugs and alcohol. Houses have different rules and consequences surrounding using. The rule at this three-quarter house was that if you were caught using and failed a drug test, you had to leave for three days and could only be readmitted into the house if you could pass a drug test upon return. After a second relapse, someone could only return if they completed an inpatient rehab program. 

When I first met McKenzie, she was returning after having been kicked out. 

I thought that the house’s policy on kicking people out and then readmitting them under certain circumstances made sense. For many addicts, relapse is part of their recovery story. It has been a part of mine. 

Between 40 to 60 percent of people who've been treated for addiction or alcoholism relapse within a year, according to a 2014 study in the Journal of the American Medical Association. 

Other three-quarter homes are stricter and do not grant addicts second or third chances. McKenzie was kicked out of a house in Brookline for good during one relapse.

The decision to kick someone out may sound easy. It’s not. After someone is kicked out for using, nobody has any idea where they are going to go or what they are going to do. Just a few months before I moved into the Carrick house, two young women were kicked out for using. In less than a week after, both died from overdoses. 

After seeming like the one who always got the boot, McKenzie later became the one who decided who got to stay and who had to go. She was promoted to house manager. After some time in that role, she recently left the house to move in with her boyfriend.

The Carrick three-quarter house I stayed in for three months has provided an opportunity for me, McKenzie and many other women like us to grow and to create stable foundations for our recovery.

While living there, I got a full-time job at a restaurant Downtown. It was the first steady job I’d had in more than three years. I worked double shifts and my feet would throb for hours once I returned home. For the first time in my life, the pain felt good and I didn’t want to make it go away. That pain, ironically, was a sign of healing for me. My endometriosis was gone, I was clean and sober, and my body was finally healthy enough for me to work.

I no longer live in a three-quarter house, I have a strong relationship with my higher power, and I have lost the obsession and compulsion to use drugs.

I work. I write. I thank God that I haven’t died from this disease like countless others have. I still miss my ex sometimes and plenty of days are far from easy. Most importantly, I know that no matter what, as long as I don’t pick up the first drug or drink, I will be just fine.

Joanna Bernstein is a writer in Pittsburgh. She can be reached at joannaruth.bernstein@gmail.com.

This story was fact-checked by Harinee Suthakar.

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