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Opioid addiction is a prevalent issue across the United States. The numbers of opioid-related deaths are climbing, according to the California Department of Health. In 2021, for example, there were 71,000 opioid-related overdoses, and 7,000 were in California. From 2017 to 2021, the death rate due to opioid overdose jumped from 251 to 743 in Orange County. This figure came from a community forum held on June 20, 2023, in Rancho Santa Margarita.

All cities in Orange County are experiencing the impacts of the growing opioid crisis, and concerned citizens want to see preventive campaigns and treatment options. However, when it comes to establishing new or expanded drug treatment centers, many residents have concerns when a new center is proposed for their community. Primarily, they are concerned about the treatment center increasing crime rates and lowering property values. While these are legitimate concerns, several studies have been conducted around the country proving neither is accurate, and the benefits of adding treatment centers outweigh any potential negative impacts. Nonetheless, the stigma surrounding substance abuse remains strong.

To counter this stigma, more communication between stakeholders and residents is necessary to implement new facilities in Orange County as the opioid problem grows. One example discussed throughout this article is for a proposed treatment center in Tustin. However, the issue also impacts any existing and proposed Laguna rehab centers, as well as centers in Irvine, Newport Beach, Costa Mesa, and all towns within Orange County. Using Tustin as a recent example, we can explore residents’ legitimate concerns, separate them from unfair bias, and recommend ways to improve communication on both sides of the issue. Perhaps with a greater understanding of the research and attentiveness to the residents’ wishes, more treatment centers can open and be successful for all.

Tustin

As an example of community opposition to treatment centers, the Orange County city of Tustin recently spoke out with concerns against efforts to open a drug treatment center.  In January of 2023, Acadia Healthcare submitted a conditional use permit from Tustin’s Planning Commission to allow the company to operate an outpatient treatment and counseling center. The center would administer medication on-site as part of its services. The planning commission denied the permit, and the property owner appealed. The Tustin City Council denied the appeal for the proposed opioid treatment center, citing that Acadia had filed an incomplete application. The details of that application and the missing elements remain unclear. However, the point speaks to a communication breakdown between the parties that has led to this opposition.

Why the Opposition

Communities are reacting to the opioid epidemic in other ways. Beginning in 2013, legislators in California and other states have brought pharmaceutical companies to court and received billions of dollars in financial compensation for community losses. In Orange County, several cities have allocated settlement money to fund rehabilitation resources and prevention campaigns. Tustin was one of those cities that approved their participation in the settlement in 2021.

Yet, when it comes to establishing clinics and sober-living homes, Tustin, like other cities, is resistant. Most of the time, opposition to establishing new drug treatment centers and sober living homes stems from concerns about safety, increased crime rate, and decreased property values. Residents are concerned about facilities close to schools and residential neighborhoods. Small business owners worry that a center in a commercial district will draw more criminals to the area. Considering many businesses are still recovering from the COVID-19 pandemic, they are particularly sensitive to anything that may interrupt foot traffic to their brick-and-mortar storefronts.

Tustin expressed such concerns about the safety of the center if the clinic was approved. While Acadia countered those concerns, the council members cited what they felt were incomplete sections of Acadia’s permit application.

Fear of Increased Crime Rate

While people recognize that more treatment centers are needed to combat the opioid epidemic, California residents are hesitant about integrating treatment centers into their communities where they live and work. When these facilities open near other community centers, schools, or populated commerce areas, people worry that it will attract drug sellers and active drug users. They assume this will increase the crime rate in the area. Such were the concerns of Tustin’s residents. They were concerned that the recovery center would prompt increased loitering in the area, leading to violence and other crimes. The proposed site was close to another medical facility that provided dialysis.

This collective phenomenon has been dubbed NIMBY, which stands for “not in my backyard.” Residents of urban communities often oppose additions such as bars and dance clubs, subsidized housing communities, halfway houses, group homes, and, of course, drug treatment centers. Residents fear that a drug treatment facility that services addicts will also attract crime.

Urban residents have the right to be concerned about safety, noise and traffic, and unpleasant behavior on the street because all these can reduce the quality of their lives and livelihoods. Further, facilities that serve special populations, like those with mental health issues or drug problems, often are stigmatized. That leads to concerns about crime, in particular, increases in violent crimes.

While such concerns seem logical, there have been several studies proving that the placement of drug treatment centers does not increase crime rates. In fact, it often lowers it. One such study, led by Debra Furr-Holden, PhD, was published in the Journal of Studies on Alcohol and Drugs. It analyzed Baltimore crime statistics near various establishments, including drug treatment centers. The results revealed that fewer crimes were committed near drug treatment centers than convenience stores and liquor stores.

Furr-Holden and her team obtained data on violent crimes from the Baltimore City Police Department’s Uniform Crime Report. With that, they plotted more than 9,000 of those crimes on a map. Then, they tabulated violent crimes committed within 1,400 feet of the local drug treatment centers. They did the same for liquor, corner, and convenience stores.

The data revealed that 38% more violent crimes were committed near liquor stores and 31% more near corner stores than the treatment centers. Drug treatment centers do not impact crime rates any more than commercial businesses.

Because drug treatment facilities are needed more than ever, communities should communicate with researchers as well as policymakers and treatment center leadership and maintain an open, honest dialogue about placing centers within the community. Addiction is a medical condition that requires medical treatment. It’s also a medical condition with a stigma attached that leads people to believe that people with an addiction are criminals who bring trouble upon themselves. While addiction is a devastating condition, it’s also a treatable one. Thus, treatment centers are needed wherever people are suffering from the condition.

Fear of Reduced Property Values

Another concern citizens have when a new substance abuse treatment center is proposed is the perceived threat of the center lowering property values of the surrounding properties.

As is the case in Tustin, the idea of a drug treatment center can trigger protests, heated city hall meetings, and citizen attempts to block development. Homeowners and property owners often believe that opening a substance abuse treatment center in a neighborhood will bring the previously discussed crime, which, in turn, decreases property values.

Contrary to this common belief, studies have shown these fears are unfounded. For example, a study published by the National Bureau for Economic Research found that substance abuse centers do not negatively affect property values.

Researchers at the University of New Mexico and Temple University concluded that there is no impact on the property values after including factors such as property value before the center’s introduction and benefits for surrounding businesses. This study compared property values from 2003 and 2016 for areas in and around Seattle, Washington. Other studies have yielded similar results for their respective states and counties.

Mitigating Community Concerns

Drug rehab centers can be safely opened in communities as long as there are enough support programs and safety protocols in place. It’s important to note that there is a difference between people with an addiction who commit crimes and criminals who are involved in drugs. People with an addiction seeking supportive programs and treatment are not criminals. They are patients seeking help for a medical condition.

Even so, any treatment center should implement protocols that limit patients from loitering or congregating within the community, as that can trigger insecurity. In addition, the location of the treatment center itself should be placed with careful consideration, for example, not near a school or (conversely) a nightclub.

The proposed location for the treatment center in Tustin is within 1,000 feet of a middle school, a park,  residential units, and within 500 feet of retail stores and restaurants. It’s also sharing a building with a dialysis center and is across the street from a senior living home. Residents fear that the treatment center would negatively affect city commerce and the dialysis patients in the building. They feel as though it’s not an appropriate location and that the center will lead to increased loitering, homelessness, and crime in the area. While Tustin residents agree that the opioid crisis needs to be addressed, the NIMBY mentality applies in that they do not want treatment centers near their homes or businesses.

Acadia Healthcare feels that prejudice is behind the resistance from council representatives. That, along with a lack of response from the city, are factors in the project not being approved. Opening a drug treatment center is an opportunity to help people; however, community opposition has led to broken communication with the city. Many fears can be dispelled if a community is willing to open a dialog. This also speaks to the reason the permit was denied a second time. Council members felt the application was incomplete. If so, more communication earlier in the process could effectively resolve this issue.

Solutions for All

The opioid crisis costs the United States more than $500 billion per year. To combat the epidemic, inpatient facilities offer an effective means of treating substance abuse disorders. The challenge is finding an appropriate location. Due to the concerns discussed in this article, facility management has difficulty opening centers in needed areas. As a result, only about 1 in 10 patients seeking treatment can receive it.

The NIMBY concern prevents centers from finding homes in convenient settings, convenient to the patients, that is. What is the solution? Center owners should perform due diligence in finding the right location that services the patients in the area and also provides a good fit for the community. Drug rehab facilities are for adults and, logically, should not be placed near schools, daycares, parks, or other places where children gather.

That said, facility directors should be diligent about facility rules against loitering and congregating in groups outside the facility. If nothing else, this will prevent crowds from blocking foot traffic and improve the optics for concerned neighbors.

Regarding the very preliminary stages, the proposal should invite homeowners and business owners to weigh in on location. Communication can be established well ahead of time to educate residents on the research supporting drug treatment centers and dispelling the stereotypes that lead people to believe the presence of the facility will increase crime and lower property values.

In Tustin’s case, more communication could have occurred before the permit came before the City Council. In addition, the council’s request for more information on the permit application may have assayed some citizen concerns. Further, the location was problematic in its proximity to schools and parks and the shared space with seriously ill dialysis patients. A dedicated building would be a more appropriate space.

An owner needs to acquire and address a myriad of regulations and licenses to open a drug rehabilitation center or sober living home. Even if every item is addressed, all certificates are applied for, fees are paid, and zoning regulations are followed, the facility may never open its doors unless the community accepts it.

The NIMBY mentality is strong and not entirely unfounded. The company proposing the new treatment facility must get the community’s buy-in to open and operate the treatment center. The stigma attached to substance abuse patients is strong, and literature must be provided so residents can recognize it as a medical condition that impacts everyone. Studies show that a drug treatment center does not negatively impact residential or business communities. Facilities aren’t a definitive cure, though they are proven, effective treatment options for people with an addiction. For patients wanting to reach recovery, they are a lifeline. It’s up to facility owners and residents to work together to ensure the community thrives and patients receive the treatment they deserve.