A “wet house” is a specialized model of supportive housing designed for individuals with chronic and severe alcohol use disorder (AUD). This residential facility provides stable shelter and supportive services without demanding abstinence from alcohol as a condition of residency. This unique approach is rooted in the recognition that a segment of the population with AUD and homelessness has not been successfully served by conventional methods. By providing permanent housing first, the wet house aims to stabilize the individual’s life before addressing the underlying substance use disorder.
Defining the Harm Reduction Model
The philosophy governing a wet house is known as the harm reduction model, a public health strategy that prioritizes minimizing the negative health and social consequences associated with substance use. This model operates on the pragmatic understanding that while substance use is occurring, the immediate goal should be to reduce death, disease, and injury. The focus shifts from immediate sobriety to the objective of reducing the risks imposed by homelessness, such as exposure, violence, and reliance on emergency services.
Harm reduction contrasts fundamentally with abstinence-only treatment models, which often require individuals to be sober to qualify for housing or services. Traditional approaches, like detox centers or 12-step programs, can unintentionally exclude the most vulnerable individuals who face high rates of relapse. Requiring sobriety for housing maintains the cycle of homelessness, public intoxication, and incarceration for this specific population. The wet house model acknowledges the chronic, relapsing nature of severe AUD and offers a stable environment where consumption can be managed and monitored.
This stabilization leads to measurable improvements in health and behavior, even without demanding abstinence. Studies on wet house residents have shown a significant reduction in delirium tremens (DTs), a severe form of alcohol withdrawal, simply by providing consistent shelter and nutrition. Research demonstrated that over two years, residents in one Seattle facility reduced their average daily alcohol intake by 40 percent. The stability of housing allows for a more consistent pattern of drinking, reducing the acute risks associated with binge drinking on the streets.
Who Wet Houses Serve
The wet house model is specifically tailored for a highly vulnerable and medically fragile subset of the population with chronic alcohol use disorder. These individuals are typically defined by a long history of severe AUD and are considered chronically homeless, meaning they have been continuously homeless for a year or more or have experienced four or more episodes of homelessness in the past three years. Many residents have previously cycled through multiple traditional treatment programs, often failing due to the immediate requirement for sobriety.
The target resident profile includes those who are the heaviest users of public services, frequently utilizing emergency rooms, police services, and jail systems for alcohol-related issues. A pioneering wet house in Seattle selected residents from a list of the most frequent users of the city’s public hospital, jail, and sobering center. These individuals often suffer from multiple co-occurring conditions, including severe mental illness and advanced chronic diseases, which were neglected while they were living on the street.
This population, whose primary health risk is a lack of stable shelter, is often deemed “untreatable” by traditional models. Wet houses provide a last-resort option for individuals whose lives are at risk due to exposure and the health effects of continuous, unregulated alcohol consumption. By providing housing first, the model addresses the most immediate threat to their lives: homelessness.
Operational Structure and Daily Life
The daily operation of a wet house provides a supportive, low-barrier environment combined with professional oversight. Residents receive private rooms, which helps establish dignity and security, along with access to communal areas for meals and social interaction. The environment is designed to be permanent, reflecting the “housing first” approach.
Staffing is a crucial component of the operational structure, often including a multidisciplinary team to address complex resident needs. This team can consist of social workers, case managers, and medical professionals, such as on-site nurses or nurse practitioners. Medical staff allows for the immediate treatment of minor injuries and the management of chronic conditions exacerbated by life on the streets.
The rules regarding alcohol consumption are a defining feature of the model and are designed to mitigate risk. While residents are allowed to drink, consumption is usually restricted to their private quarters, preventing public inebriation and creating a safer communal environment. Staff members actively monitor residents, not to enforce sobriety, but to prevent acute medical emergencies like alcohol poisoning or severe withdrawal. This supervised environment transforms a high-risk activity on the street into a relatively contained one indoors.
The daily structure aims to stabilize residents’ lives and reintroduce them to basic supportive services. Once housed, residents are more receptive to voluntary services, including nutritional support, medical care, and mental health counseling. This stability allows staff to address underlying health issues, such as hypertension, liver disease, and malnutrition, which were often ignored during periods of chronic homelessness. The consistent reduction in public health crises, like frequent emergency room visits and hospital admissions, serves as a primary measure of the model’s success.
Funding and Community Integration
Wet houses are financed through a complex mixture of public and private funding streams. Initial capital costs are often covered by non-profit organizations or government grants focused on housing and social services. Ongoing operational costs, including staffing and maintenance, are supported by a combination of federal housing subsidies, state grants, and philanthropic donations.
The financial argument for wet houses centers on cost-effectiveness and taxpayer savings. Studies show that the cost of housing a resident in a wet house ($13,000 to $18,000) is significantly lower than the costs incurred when the same individual is cycling through emergency services and the criminal justice system. Before being housed, some chronically homeless individuals can cost taxpayers over $80,000 annually in public services.
Community integration presents a significant challenge for wet houses, often encountering strong opposition labeled as the “Not In My Backyard” (NIMBY) phenomenon. Concerns revolve around fears of increased crime, panhandling, and the perception that the facility is enabling addiction. Successful integration requires rigorous planning, transparent communication with local residents, and a clear demonstration of the public safety and financial benefits that result from housing this vulnerable population.