The Value of Recovery Residences

​While many individuals are just learning of recovery housing, often referred to as sober living homes, recovery residences, or Oxford Houses, this concept has been present in the United States since the creation by the Washington Temperance Society in the 1840s (NARR, 2012). In the 1960s, the understanding of a need for an illicit substance-free living environment emerged to give individuals with substance use disorders a better chance of maintaining a recovery process. Three main residential settings arose, including the Minnesota Model (similar to today’s 28-day clinical programming), therapeutic communities (often found in the criminal justice system), and those based on a social model (Wittman & Polcin, 2014). The concept of recovery residences attaches to the social model construct and prioritizes a community atmosphere, peer-to-peer support, structure, accountability, and an illicit drug and alcohol-free environment. Jason et al. (2013) suggest dramatic effectiveness for consumers who participate in sober living environments, including a lower return to use rate, improved functioning, improved employment, and cost savings to communities.

Misconceptions of Recovery Residences

Many individuals believe that recovery residences are treatment providers. This statement is partly false. Recovery residences have several intensity levels, and while some may offer or require treatment, others do not. The National Association of Recovery Residences identifies four distinct intensity levels within recovery housing: Level 1 homes are the least restrictive and are often democratically operated with minimal external oversight; Level 2 homes have administrative support (often live-in house management)with optional ancillary services such as clinical treatment; Level 3 homes require residents to participate in some form of agency curriculum, offer a greater degree of structure and support, maintain credentialed staff, and may offer optional clinical services; and Level 4 homes are the most structured and feature licensed staff and clinical services.  Individuals with substance use disorder and co-occurring mental health conditions may benefit from Level 3 or 4 housing due to additional staffing and supportive services. It is important to note that not all homes receive third-party certification, meaning that not all homes meet the criteria for best practices in recovery housing or fit neatly into one of these intensity levels. Members of our community will benefit from understanding the value of certification to both the community and vulnerable populations residing in certified homes.

Families and community members sometimes believe recovery residence stays are covered by insurance, but this is not usually the case. Since most recovery residences do not offer clinical services, they cannot bill a resident’s insurance for services provided. Recovery residences typically require program fees from residents, and some receive donations or grants to remain sustainable. Another common misconception is that recovery residences are highly profitable. This statement is far from the truth for most operators. Recovery residences often incur costs related to mortgages or rent, utilities, staffing,  local municipality fees and inspections, toxicology screenings, and third-party certification fees.

The final misconception is that illegal activity and drug use are rampant in communities where recovery residences are present. Research has demonstrated lower rates of substance misuse among participants of recovery housing and lower rates of social interactions with individuals who misuse substances among individuals residing in a recovery residence (Polcin et al., 2010). Furthermore, these researchers found a reduction in psychiatric symptoms and increased participation in mutual aid support groups. This data suggests that recovery residences mitigate risks to community members and improve the likelihood of individuals with substance use disorders becoming productive, tax-paying, contributing, and essential members of our community.

Vital Piece of SUD Infrastructure

Though recovery residences often face resistance, recovery residences provide an essential service to communities. They serve the most vulnerable and disenfranchised, offering a safe, stable, illicit drug and alcohol-free living environment to initiate and sustain recovery. Residents of these programs develop the skills and abilities and the social, emotional, and spiritual connections essential to maintaining their recovery process. The emergence of third-party certifying agencies ensures that safe, high-quality recovery housing is available and accessible to all potential residents and that credible recovery housing operators can be celebrated and acknowledged for the work they do. 

References

A primer on recovery residences: Frequently asked questions. (2012). National Association of Recovery Residences (NARR). Accessible at www.narronline.com.

Jason, L.A., Mericle, A.A., Polcin, D.L., & White, W.L. (in press, 2013). The Role of Recovery Residences in Promoting Long-term Addiction Recovery. American Journal of Community Psychology. Posted at www.williamwhitepapers.com

Polcin, D. L., Korcha, R., Bond, J., & Galloway, G. (2010). What did we learn from our study on sober living houses and where do we go from here?. Journal of psychoactive drugs, 42(4), 425–433. https://doi.org/10.1080/02791072.2010.10400705 

Wittman, F. D., & Polcin, D. (2014). The Evolution of Peer Run Sober Housing as a Recovery Resource for California Communities. International journal of self help & self care, 8(2), 157–187. https://doi.org/10.2190/SH.8.2.c