Recovery housing provides safe, healthy living environments that leverage social and mutual aid to maintain recovery.
A cost savings of $29,000 per person, using recovery housing.
Recovery Housing provides a living environment free from alcohol and illicit drug use and centered on peer support and connection to services that promote sustained recovery. By providing alcohol and drug-free environments people who are pursuing recovery from addiction can live with peers in recovery and connect to other recovery services and supports. While recovery housing can vary greatly in design, from independent, resident-run homes to staff managed residences where clinical services are provided, all recovery housing provides safe, healthy living environments that leverage social and mutual aid to maintain recovery. The National Alliance for Recovery Residences has delineated four levels of support offered by different types of recovery residences and outlined ethical principles as well as quality standards for recovery housing across levels (see https://narronline.org/resources/).
Substance use disorders can have dire social consequences including: limited education, minimal work history, low or no income, increased criminal backgrounds, poor rental history, and poor credit. As a result, many people seeking recovery have difficulty accessing private or public rental housing, or obtaining mortgages. Because federal policy does not consider the sole diagnosis of addiction to be a disabling condition, recovering persons cannot access Medicaid coverage for the Aged, Blind, and Disabled, disability income, vocational rehabilitation services, or Section 8 rental assistance on this diagnosis alone.
Without the availability of flexible, supportive, recovery-focused housing options, people are less likely to recover from addiction and more likely to face continued difficulties that impact their well-being, families, and communities. These difficulties include costly health care as a result of acute and chronic medical complications and trauma; high use of emergency departments and public health care systems; being high risk for judicial involvement; and an inability to obtain and maintain employment. These challenges are compounded by a lack of affordable housing and the difficulties in maintaining housing while someone is struggling with addiction.
“ Recovery housing promotes sustained recovery.
WHO IS RECOVERY HOUSING FOR?
- People that are in recovery from drug and alcohol addiction.
- People that desire a safe and structured living environment with others in recovery.
- People that want to engage in support, services, or treatment opportunities to further their recovery.
- People who are at-risk of homelessness because they are exiting treatment, incarceration, military duty or are living in a home or neighborhood that puts them at risk of returning to substance use.
Recovery housing creates an environment free from immediate and repeated triggers for relapse and provides a vital bridge from homelessness, unsafe housing, or institutions to eventual independent living. Recovery housing values:
- A length of stay that is driven by the resident.
- Access to a non-linear spectrum of housing to support changing and varying needs of individuals throughout the recovery process.
- A right-sized level of support where residents choose what type of housing and support they need.
RECOVERY HOUSING: ASSESING THE EVIDENCE
Existing research has established recovery housing as a model that supports long-term recovery.[i],[ii] Depending on the level of support, length of stay, and model type, recovery housing has been associated with a number of positive outcomes including:
- Decreased substance use[iii],4,5
- Reduced probability of relapse/reoccurrence3
- Lower rates of incarceration[iv],5
- Higher income4
- Increased employment rates[v]
- Improved family functioning[vi]
Specifically, there are a few well-researched models and communities contributing to the overall evidence-base for such models. Both the Oxford House model and variety of therapeutic community models are listed on SAMHSA National Registry of Evidence-based Programs and Practices (see http://www.samhsa.gov/nrepp).
- Oxford Houses, characterized as democratically run, self-supporting, and drug-free homes, are more effective in reducing substance abuse than referral to usual aftercare options following treatment.3,4 Further, costs of running these homes is low[vii] and are offset by the benefits associated with them such as reduced illegal activity, incarceration, and substance use.[viii] There are more than 1,800 Oxford Houses in the United States.[ix]
- Sober Living Houses, democratically-run drug free homes that mandate participation in 12-step meetings, have been most studied in California, where more than 300 individual houses are members of the Sober Living Network in Southern California alone.2,,[x][xi] Research conducted in sober living houses in Northern California have found improvements in substance use, psychiatric symptoms, employment, and arrests.10,,[xii][xiii]
- Recovery homes in Philadelphia are sober living arrangements often used in conjunction with outpatient treatment, self-help, and other community-based services. Qualitative research has shown operators of these homes see their roles as more than just helping residents remain abstinent, a desire likely stemming from being in recovery themselves or from being a recipient of the benefits of living in a recovery home.2,[xiv]
- Recovery housing in Ohio can vary across the spectrum of recovery residence levels of support. Recent qualitative research has shown that although recovery housing has not been integrated into many housing and treatment continuums in the state, there is growing consensus about its importance and need for various subpopulations.[xv]
A common predictor of positive outcomes across recovery housing types is the support individuals receive in recovery-oriented communities.4 This is consistent with broader research that suggests that one factor affecting the success of treatment is the availability of recovery capital, which includes the economic and social resources necessary to access help, initiate abstinence, and maintain a recovery lifestyle.[xvi] Social support, such as that provided through 12-step program participation and social network support for sobriety, a key component of recovery housing, has been shown to directly affect recovery outcomes, including reducing the probability of relapse.3,,,[xvii][xviii][xix]
[i] Laudet A. B., Humphreys K. (2013). Promoting recovery in an evolving policy context: What do we know and what do we need to know about recovery support services? Journal of Substance Abuse Treatment, 45, 126-133.
[ii] Mericle A. A., Miles J., Way F. (2015). Recovery residences and providing safe and supportive housing for individuals overcoming addiction. Journal of Drug Issues, 45, 368-384.
[iii] Jason, L. A., Davis, M. I., & Ferrari, J. R. (2007). The need for substance abuse after-care: Longitudinal analysis of Oxford House. Addictive Behaviors, 32(4), 803–818.
[iv] Jason, L. A., Olson, B. D., Ferrari, J. R., & Lo Sasso, A. T. (2006). Communal housing settings enhance substance abuse recovery. American Journal of Public Health, 96(10), 1727–1729.
[v] Polcin, D. L., Korcha, R. A., Bond, J., & Galloway, G. (2010). Sober living houses for alcohol and drug dependence: 18-month outcomes. Journal of Substance Abuse Treatment, 38 (4), 356–365.
[vi] JASON, L. A., AASE, D. M., MUELLER, D. G., & FERRARI, J. R. (2009). Current and Previous Residents of Self-Governed Recovery Homes: Characteristics of Long-Term Recovery. Alcoholism Treatment Quarterly, 27(4), 442–452. http://doi.org/10.1080/07347320903209715
[vii] Olson B. D., Viola J. J., Jason L. A., Davis M. I., Ferrari J. R., Rabin- Belyaev O. (2006). Economic costs of Oxford House inpatient treatment and incarceration: A preliminary report. Journal of Prevention & Intervention in the Community, 31, 63-74.
[viii] Lo Sasso A. T., Byro E., Jason L. A., Ferrari J. R., Olson B. (2012). Benefits and costs associated with mutual-help community-based recovery homes: The Oxford House model. Evaluation and Program Planning, 35, 47-53.
[ix] Oxford House. (2015). A year of progress for Oxford House. Oxford Grape, 40(1), 6. Retrieved from http://www.oxfordhouse.org/userfiles/file/doc/Jan%202015%20Grape%20Final.pdf
[x] Polcin D. L., Henderson D. M. (2008). A clean and sober place to live: Philosophy, structure, and purported therapeutic factors in sober living houses. Journal of Psychoactive Drugs, 40, 153-159.
[xi] Polcin D. L., Korcha R. A., Bond J., Galloway G. (2010b). Sober living houses for alcohol and drug dependence: 18-month outcomes. Journal of Substance Abuse Treatment, 38, 356-365.
[xii] Polcin D. L. (2009). A model of sober housing during outpatient treatment. Journal of Psychoactive Drugs, 41, 153-161.
[xiii] Polcin D. L., Korcha R. A., Bond J., Galloway G. (2010a). Eighteen month outcomes for clients receiving combined outpatient treatment and sober living houses. Journal of Substance Use, 15, 352-366.
[xiv] Mericle A. A., Miles J., Cacciola J. (2015). A critical component of the continuum of care for substance use disorders: Recovery homes in Philadelphia. Journal of Psychoactive Drugs, 47, 80-90.
[xv] Pannella Winn, L., & Paquette, K. (2016). Bringing recovery housing to scale in Ohio: Lessons learned. Journal of dual diagnosis, 12(2), 163-174.
[xvi] Cloud W., Granfield R. (2008). Conceptualizing recovery capital: Expansion of a theoretical construct. Substance Use & Misuse, 43, 1971-1986.
[xvii] Polcin, D., Mericle, A., Howell, J., Sheridan, D., & Christensen, J. (2014). Maximizing social model principles in residential recovery settings. Journal of Psychoactive Drugs, 46(5), 436– 443.
[xviii] Bond, J., Kaskutas, L., & Weisner, C. (2003). The persistent influence of social networks and Alcoholics Anonymous onabstinence. Journal of Studies on Alcohol, 64(4), 579–588.
[xix] Reif, S., George, P., Braude, L., Dougherty, R. H., Daniels, A. S., Ghose, S. S., & Delphin-Rittmon, M. E. (2014). Recovery housing: Assessing the evidence. Psychiatric Services, 65(3), 295–300.