Improve Recovery Housing

Introductory Paragraph

Recovery housing is a highly individualized choice based on a variety of needs. For those seeking recovery housing, finding safe, affordable, and supportive housing options can be difficult. There are many types of housing in different settings and different levels of care. Supportive housing for people in recovery can range from peer-run homes to licensed treatment programs. It is important for individuals and communities to ensure recovery housing options are reputable and have the best interests of their residents in mind.

Key Information

SAMHSA defines recovery housing as "safe, healthy, family-like substance-free living environments that support individuals in recovery from addiction. While recovery residences vary widely in structure, all are centered on peer support and a connection to services that promote long-term recovery. Substance-free does not prohibit prescribed medications taken as directed by a licensed prescriber.”

There are a variety of types of recovery home certifications and credentials:

• The National Alliance for Recovery Residences (NARR) is a 501(c)3 nonprofit organization dedicated to expanding the availability of well-operated, ethical, and supportive recovery housing. NARR offers recovery homes with a suite of options for certification.
• The Commission on Accreditation of Rehabilitation Facilities (CARF) is an independent, non-profit accreditor providing accreditation services worldwide at the request of health and human service providers. CARF accreditation demonstrates a provider's commitment to enhance its performance, manage its risk, and distinguish its service delivery.
• Oxford Houses are self-run and publicly supported. A 501(c)3 corporation serves as an umbrella organization connecting networked Oxford Houses. It also allocates resources to duplicate their model.
• Independently-Owned and Operated Homes Recovery homes may also be independently owned and operated as a small business outside of an existing credentialing network - offering flexibility and ease of admission. These homes are often peer-led, allowing the residents to provide mutual support to one another and become financially self-sufficient. Although independently-owned recovery houses do not provide on-site licensed professional services, they often have resources and relationships with local recovery support professionals. Even though independently owned recovery homes do not hold a license or formal certification, they conform to local zoning and building safety codes for residential occupancy.

Note: States may have independent certification or credentialing requirements. Please check the recovery residence certification guidelines within your own state for more information.

Relevant Research

The National Council for Behavioral Health documents research findings which detail the benefits recovery housing has provided to individuals in obtaining and maintaining long-term recovery. These include:

• Reduced risk of relapse/recurrence
• Lower rates of incarceration and recidivism
• Higher income
• Increased employment
• Improved family relationships
• Overall higher recovery capital

“Understanding Challenges for Recovery Homes during COVID-19.” This article addresses the different ways that recovery homes altered their model and structure as a result of COVID-19. Recovery homes use a social model approach to recovery that contrasts with mitigation procedures such as social distancing and stay-at-home orders. Individuals residing in recovery housing are at a higher risk of contracting COVID-19 due to the group living environment. NARR has adopted the CDC guidelines and has applied them to recovery home settings. Recovery houses other than those with NARR certification that are licensed through the state also follow strict health and safety guidelines. Recovery homes that are independently licensed have less oversight.

Impactful Federal, State, and Local Policies

The 2018 SUPPORT Act (Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment). In an effort to improve and expand recovery housing, Congress directed SAMSHA to collaborate with stakeholders and to facilitate the development of best practices for operating recovery housing. These best practices may include model laws that seek to prevent relapse and overdose (including greater access to MAT), as well as the development of indicators that could be used to identify fraudulent recovery housing operators.

The National Council for Behavioral Health developed a set of policy recommendations for nationwide adoption and implementation of recovery housing. These can be found in the toolkit titled “Building Recovery State Policy Guide for Supporting Recovery Housing.” In this guide, Alan Johnson, Florida Chief Assistant to the State Attorney, stated “We recommend that states be given the ability to require certification under NARR (National Alliance for Recovery Residences) or similar standards, or other recognized programs such as Oxford House™ to protect the vulnerable residents living in sober homes.”

SAFE Project maintains a list of current legislation on recovery housing by state. For more information please contact us at Community@safeproject.us.

Available Tools and Resource

• SAMHSA provides a guide titled "Best Practices for Recovery Housing."

• SAFE Project has a web page dedicated to recovery housing. It includes two downloadable resources. "A Community Case for Recovery Housing" addresses why communities should invest in recovery housing and covers seven concrete ways to support recovery housing. The "Choosing High-Quality Recovery Housing Workbook" provides information for individuals to make informed decisions on what recovery residence is best for them.

• NARR hosts an annual summit on recovery housing, and its website offers a variety of resources and services.

• NASTAD provides recommendations and considerations for planning and starting a supportive housing program.

Promising Practices

• Oregon. Central City Concern (CCC) is a nonprofit that has worked in Portland since 1979. It is a national model for integrating services which relieve homelessness, deliver substance use treatment and recovery options, provide jobs, and promote health. At its inception, CCC was charged with funding local recovery and treatment providers and preserving Old Town’s housing stock. They bought and renovated the Butte Hotel and other historic buildings and currently manage over 30 affordable housing units in Portland. One of these is the Richard L. Harris Building (also known as the “8×8”) a 12-story alcohol- and drug-free community building located above CCC’s Old Town Clinic. A news clip titled "What First Responders in Portland, Oregon, Are Doing" highlights the way the Portland community at-large is working with CCC in its efforts to offer peer support, employment training and assistance, and an extended safe place for people to build their foundation of recovery.