Commentary: Research on Recovery Residences is Critical
For many in recovery, hard-fought gains are often jeopardized by precarious living arrangements or untenable housing. Recovery residences, like recovery homes, sober living houses, and Oxford HousesTM represent an important component in the continuum of care for substance use disorders. Unfortunately, recovery residences, particularly recovery homes, are understudied in scientific literature and are often regarded with skepticism by community members. Without published research, licensed professionals, policymakers and potential funders will continue to question the legitimacy of recovery residences and peer-based recovery.
With funding from the Pennsylvania Department of Health, scientists at the Treatment Research Institute seek to fill this critical gap in the literature by studying recovery homes in Philadelphia. The city is ideal to study recovery homes because it has a high concentration: more than 250 privately funded recovery homes, 18 homes that receive funding from Philadelphia’s Office of Addiction Services (OAS), and several others that receive funding through SAMHSA’s Access to Recovery program.
Although data collection has been underway for only a few months, several important themes have emerged:
1. Recovery home operators are willing to participate in research. Despite the unpredictable nature of their busy schedules, site contacts have been extremely accommodating and have graciously welcomed research staff into their homes. They understand the necessity of research data in promoting the legitimacy of recovery homes and peer-based recovery.
2. Although site contacts have been welcoming and supportive of this research, we have encountered barriers because there is no central registry of recovery homes, and the recovery home landscape in Philadelphia changes frequently with homes closing and opening, or changing names, ownership or target population.
3. Despite not being considered formal “treatment providers,” recovery homes operate in a highly structured and therapeutically oriented manner. These homes have a number of rules and expectations for residents, and provide basic as well as a variety of recovery-oriented services, all at a modest cost to residents. All of the homes interviewed performed drug testing, and over half mandated involvement in AA/NA and/or substance abuse treatment. Residents had curfews, were expected to do chores and typically lived in shared sleeping quarters.
4. Although site contacts were stoic in discussing the challenges they face, many cited stigma from the community as a hindrance to home operation. To counter this stigma, many of the homes participated in community engagement activities, (e.g., litter abatement), which they felt fostered good neighbor practices and positively affected the attitudes of surrounding neighbors. Financial hardship was also cited as an impediment, but most operators found ways to overcome these obstacles, and remained hopeful in continuing to run their homes.
5. Finally, recovery home operators do what they do to help others in recovery, which often comes from a very personal place. Although they had varying levels of education and came from diverse professional backgrounds, nearly all were in recovery themselves. Often having come through the home they now operate, site contacts mentioned a sense of dedication to the program, stating “[t]his place saved my life.”
The findings from this study are preliminary, but we hope this work will raise awareness about the potentially critical role of recovery homes in meeting the needs of those in recovery and lead to future research. It is important to learn how these residences promote recovery and where they fit in the continuum of care for substance use disorders, and to identify factors that contribute to their sustainability. Data on the effectiveness and cost-effectiveness may allow us to say more about the essential services and value these homes provide to supporting those in recovery.
Amy A. Mericle, PhD, Jennifer Miles, BA, & John Cacciola, PhD
The writers are researchers in the Center on the Continuum of Care at the Philadelphia-based Treatment Research Institute (TRI), an independent, non-profit research and development organization dedicated to developing evidence-based solutions to the problems of substance use affecting families, schools, businesses, courts and healthcare.