Improve Recovery Housing

Return to Opioid Top-Level Strategy Map or ZOOM MAP - Improve Treatment & Enable Recovery of People with SUDs or ZOOM MAP - Strengthen Peer Recovery Support Services & Programs


People who are in and recenttly coming out of treatment often struggle to find safe, affodable, and supportive housing options.  Without this basic need being met, the chances that someone in recovery - especially early recovery - will experience relapse increase greatly. Homelessness, returning to stay with friends who still use, or staying in another situation that does not support recovery often results in relapse.  When relapse takes place typiclly many more community resources are required to help the individual to recieve emergency health care, social services, treatment, and other costs related to addressing Substance Use Disorder.  Dr. Rachel Solatra says that people in shared recovery housing are three times as likely to complete treatment.

There can be many types of supportive housing or recovery housing, and the quality and attributes of the recovery housing can have a major impact on the success of the person in recovery. There are instances of "bad actors" in recovery housing that are part of schemes like the "Florida Shuffle" (get link to info) and where the best interest of the person in recovery is not important.  It is therefore important for individuals and communities to ensure recovery housing options are reputable and have the best interests of their residents in mind.

Supportive Housing for people in recovery can range from peer-run homes to licensed treatment programs.

Background Information on Recovery Housing

Each year, over two million people in the United States participate in alcohol or other drug treatment programs. Research has shown that the longer a person remains in a treatment or recovery environment, the greater are her or his chances of sustaining long-term recovery. Many treatment programs are 30 to 60 days long, which means that people in the early stages ofrecovery are often discharged from programs only to return to environments where alcohol or other drug use triggers abound. Recovery residences can provide a vital bridge from in-patient or institutional treatment to recovery communities and independent living. Long after discharge from treatment, recovery residences can assist people by providing a safe, healthy place to live that focuses or re-focuses them on their recovery and reduces the triggers for substance misuse.

 

Example of Innovations in Recovery Housing

Oxford House, Inc.

Oxford House is a concept and system of operations that supports behavior change and provides a stable, comfortable, long-term living environment that requires abstinence and builds self-sufficiency that supports successful long-term recovery. Oxford Houses are self-run and self-supported, so they are a scalable way to expand recovery housing. The Oxford House Manual(c) is a basic blueprint that provides the organization and structure that allow a group of recovering individuals to successfully live together in a supported environment in a rented home in a residential neighborhood where they share expenses. The residents self-manage the home, keeping the costs low and helping build skills needed for life. The original 13 Oxford Houses open in 1975 has grown to 2,287 houses with over 18,000 Oxford Recovery Beds (Dec. 31, 2017). Over 400,000 people have lived in Oxford Houses, and most have stayed clean and sober. Many research studies have show the effectiveness of the Oxford House model, and it has been frequently recognized as both and evidence-based practice and a best practice. In the past, Oxford Houses did not allow residents to be on MAT, but according to the 2017 annual report, "Oxford House residents will generally accept individuals using MAT and some residents may encourage the MAT recipient to taper off the use of these drugs. All Oxford House residents will monitor MAT users to make certain they stay on their prescription."
More on the Oxford House Inc. model

Oxford House also provides a database showing where there houses are located, vacancies, and other useful information for anyone looking to join and Oxford House:

https://www.oxfordvacancies.com

 

National Alliance for Recovery Residences (NARR)

The National Alliance for Recovery Residences, or NARR ([1]) is a 501-c3 nonprofit and recovery community organization (RCO) that currently serves 25 regional affiliate organizations. These affiliate organizations collectively support over 25,000 persons in addiction recovery who are living in over 2,500 certified recovery residences throughout the United States.

 

Portland Model using First Responders

In Portland, first responders can direct people to recovery housing.
 

 

Important Ways to Expand and Assure Quality of Recovery Housing

SAMSHA Resource - Recovery Housing: Best Practice and Suggested Guidelines

In an effort to improve and expand recovery housing, Congress directed SAMSHA to collaborate with stakeholders and facilitate thee development of best practices for operating recovery housing.  Authorized under the 2018 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) Act, 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 full resource can be found at:

https://www.samhsa.gov/sites/default/files/housing-best-practices-100819.pdf

 

Add points from the NARR Toolkit
 

 

Innovations to Enhance Supportive Housing (Recovery Homes)

Housing is such an important part of supporting recovery that it is worth exploring ways to continue to make it better or the resident and the others in the neighborhood. Many of the practices of "best practice" approaches like the Oxford House were developed in the 1970s and 1980s with modest improvements in recent years. But, there are so many new tools and strategies that could be used to make recovery homes even better. Here are some options worth exploring.
 

 

Community Care Coordination software

Use of Community Care Coordination software to help developed a whole parson care strategy for each individual living in a recovery home.
 

 

Apps to Support Mental Health & Well-Being

Use of on-line platforms (apps) that help people address underlying mental health issues of anxiety, depression or trauma, such as MyStrength
 

 

Peer Support Apps

Use of peer recovery support tools like rTribe or DelightMe
 

 

Recovery Support Apps

Use of supportive technologies like Rezility or rTribe to enhance the recovery success of people living in the recovery homes.
 

 

Faith Community Social Support

Support by faith communities and non-profit organizations in social and health-related activities, including:
  Community Gardening
  Chess Clubs
  Men's Sheds
  Music
  Mentoring
  Job skill development and job-finding help
 

 

Home Rehabilitation, Repair and Remodeling

 

Tools & Resources

TR - Improve Supportive & Affordable Housing Options for People in Recovery

Scorecard Building

Potential Objective Details
Potential Measures and Data Sources
Potential Actions and Partners

Resources to Investigate

More RTI on Improve Supportive & Affordable Housing Options for People in Recovery
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 PAGE MANAGER: [insert name here]
SUBJECT MATTER EXPERT: [fill out table below]

 

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Sources

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3. Oxford House, Inc. Annual Report, Fiscal Year 2017
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