Communal-Living Settings for Adults Recovering from Substance Abuse

Abstract

Research on treatment outcome for addictive disorders indicates that a variety of interventions are effective. However, the progress clients make in treatment frequently is undermined by the lack of an alcohol and drug free living environment supporting sustained recovery. This introduction to a special edition on Oxford Houses suggests that treatment providers have not paid sufficient attention to the social environments where clients live after residential treatment or while attending outpatient programs. The paper begins with a description of the need for alcohol and drug free living environments. The history of communal living for recovering addicts and alcoholics is then reviewed and the Oxford House model emphasized as a recent and widespread communal living option for recovering persons. The structure and philosophy of Oxford Houses are presented along with recent outcome studies providing support for their effectiveness. Three different perspectives are presented as ways of conceptualizing how residents in Oxford Houses benefit: social context theory, self governance/self care, and peer affiliation/identification.

Recovery Housing: Assessing the Evidence

“…However, replication of study findings with greater specificity and in more settings is needed. (Psychiatric Services 65:295-300, 2014; doi: 10.1176/appi.ps.201300243) A ccess to stable and supportive housing is recognized in the addictions field as an important component of establishing and maintaining recovery from substance use disorders (1). Research suggests that maintaining recovery gains may be difficult for individuals who are not living in stable housing situations (2), and environmental cues may play a role in triggering relapse (3).…”

The effects of continuing care on emerging adult outcomes following residential addiction treatment

“…Specifically regarding evidence for sober living environments, these housing supports provide patients with a heterogeneous array of recovery resources, both across and within settings (Polcin, 2009). Oversight and monitoring can vary substantially, including toxicology screens, mandated 12-step MHO attendance, and requirements that residents either have employment or otherwise seek employment, a strong predictor of sustaining recovery (White, 2008).…”

“…In light of the consistency between these continuing care findings and others examined across the life course, however, clinicians might explicitly focus facilitation efforts on engaging patients with structured, recovery-supportive environments that link individuals with freely available 12-step MHOs after the initial episode of care. Regarding future investigations, the impact and reach of continuing care for young adults might be augmented through testing the broad array of settings and services within the sober living framework (Polcin, 2009), through adapting and testing 12-step facilitation approaches specifically for this age group to help reduce the financial burden of professional continuing care (Labbe et al, 2014), and through investigation of innovative mobile health applications (e.g., Gustafson et al, 2014) that may help overcome barriers to traditional approaches.…”

The “Translators”: Engaging Former Drug Users as Key Research Staff to Design and Implement a Risk Reduction Program for Rural Cocaine Users

“…Social network characteristics, particularly social support related to drug or alcohol abstinence, consistently predict better long-term treatment outcomes (Broome, Simpson, & Joe, 2002; Moos & Moos, 2006; Polcin, 2009). These effects have been attributed to social control, modeling of recovery behaviors, and creation of peer support networks for stress management and coping skills (c.f., Moos, 2006).…”