By Brian Lucas
Often called “three-quarter houses,” recovery homes (or sober living houses) can be – and often are – a critical component in the long-term success of those in recovery. Alcohol and drug-free, they can provide a safe, peer-supported transitional living environment for clients who are not ready to return to pre-treatment living situations that were toxic, unsupportive and/or enabling.
Unless they are affiliated with licensed rehab facilities, recovery homes typically are for-profit businesses, often owned and operated by those who themselves are in recovery. They are financially sustained through weekly or monthly program fees charged to the residents, though they are not landlord/ tenant arrangements. There is typically no formal treatment component — like individual or group counseling — though some will host AA or NA meetings.
While some recovery homes belong to organizations or coalitions which monitor member homes for standards regarding health, safety, quality and adherence to organizational guidelines, the vast majority are stand-alone entities with no government oversight. There is no federal oversight of recovery homes, and very few states require licensing or certification by owners.
Consequently, there exists a wide gap between good recovery homes and bad ones. It can be very difficult to know whether one is getting a quality home or not, making the choice a crucial one. A wrong choice and the client could be entering a situation where there is little monitoring of activities of daily living, no accountability, and where the prospects of a successful outcome are poor. Indeed, some recovery home owners have far less interest in the successful long-term outcomes of clients than they have in filling beds and collecting program fees.
Conversely, choosing a good recovery home can greatly increase the chances of the client achieving sustained recovery and can help to set in place the foundation necessary for long-term success. Structured and rigid, they can help clients establish the daily disciplines in their lifestyles that are critical for, and applicable to, their recovery.
Those disciplines typically include requirements that clients: attend 12-step (or recovery-oriented) meetings on a daily or semi-daily basis; sign out when leaving the home and sign in when returning; keep common and personal living areas clean at all times; honor curfews; refrain from using or possessing drugs or alcohol; submit to regular and/or random breathalyzer or urine drug screens; respect other clients in the house; and obey all criminal laws. Relapse or failure to follow program rules typically has eviction from the house as a consequence.
Although there is a vast trove of research on the treatment of the disease of addiction, far less literature exists on the efficacy of recovery homes. But evidenced-based studies have shown that residents of recovery homes make significant improvements in a range of areas, including drug and alcohol use, employment, involvement with the criminal justice system and psychiatric health. They are also important to society at large, as those without access to good recovery homes can become burdens to health care systems, social welfare systems and the criminal justice system.
But as important as good recovery homes are in the recovery continuum, they still face a number of challenges. Namely:
- Most are located in densely populated residential neighborhoods, making access for rural clients difficult
- Incidents or negative experiences (a drug overdose, for example) can create or perpetuate a stigma among civic leaders or neighbors, that makes establishing or running a recovery home difficult
- The criminal justice system (particularly judges and probation officers) tend to ignore recovery homes as a sentencing option
- Lack of government oversight has allowed the proliferation of poorly-run recovery homes
- Poorly-run recovery homes, or unscrupulous owners, have given the industry a bad reputation in some circles, which can complicate the decision to choose a recovery home
For those considering a recovery home there are a few steps that can go a long way toward determining whether it’s a good recovery home or not:
- Do a site visit, if possible. Or have a friend or relative visit. Is it clean and orderly? Are the residents there relatively comfortable, alert and stress-free? Are rules, expectations and consequences clearly spelled out?
- Is the director or house manager available to be interviewed? Are they forthcoming, and do they answer questions thoroughly?
- Is the intake process thorough? Are there in-depth interviews with prospective clients?
- Most importantly, do patients in reputable rehab facilities regularly get referred to the home? Does the home have a good reputation in the recovery community?
Brian Lucas is an MSW candidate at the Wayne State University School of Social Work, an intern at Home of New Vision and the founder and executive director of Grace Recovery Homes in Hazel park.
First published in Home of New Vision and WRAP’s The Recovery Advocate, Volume 5, Winter 2020.