The National Alliance of Recovery Residences (NARR) is a nonprofit organization that was found in 2011 and set national standards for halfway houses, three-quarter houses, sober living homes, etc. In addition, NARR now refers to all of these different facilities under the term recovery residences. Recovery residences, such as sober living homes, are not themselves treatment centers or locations that deliver any form of rehabilitation or formal treatment for individuals with substance use disorders. They are group homes designed to accommodate individuals with significant issues that are associated with recovery from substance abuse.
These facilities are designed to be transitional living homes that allow residents to adjust to the changes in their lives as they attempt to negotiate the early and middle stages of recovery from substance use disorders. They are designed to provide a stable living situation, educational opportunities, support, and, in some cases, access to treatment. Many people who stay in these recovery residences have very recently completed a withdrawal management program and need to get a strong foothold in their new lifestyle without the use of drugs or alcohol.
Why the Need for Sober Living Homes?
A number of individuals who have moderate to severe substance use disorders also have toxic environments or stressful living conditions that endanger their recovery. The relapse rate for individuals in recovery from substance use disorders is relatively high, even with formal supports in place. Individuals who simply complete a withdrawal management program and return to old environments are at an increased risk for relapse.
Sober living homes offer individuals a chance to establish a sober lifestyle, put into practice the principles of their substance use disorder treatment, and develop a plan for sober living before returning to the stressors of the real world. Recovery residences can help to reduce the initial relapse rate of individuals in early recovery by helping them to establish their long-term aftercare program and enhance their chances for a successful recovery.
What Are the Stipulations of Recovery Residences?
Specific recovery residences will have specific sets of rules. There are some general rules that most facilities adhere to, and individuals who break these rules are subject to certain sanctions and even discharge. An individual who has numerous rule violations can expect to have a short stay in a recovery residence as their behavior threatens the sobriety of the other residents in the facility. The general rules for sober living homes are outlined below.
- Sobriety is the primary rule in these residences. Individuals staying in these residences are often subject to random drug and alcohol testing.
- Most of these programs require residents to be involved in treatment for their substance use disorders. A number of these programs have direct ties to treatment centers or support groups in the community, including 12-Step programs, specific community mental health programs, and even private therapists.
- Certain consumer products are not allowed in many of these residences, such as mouthwash with alcohol, cold remedies that have potentially addicting drugs in them (e.g., Robitussin), private use of prescription medications (In many cases prescription medications are dispensed by the supervisors in these residences.), and other over-the-counter products that can be potential substances of abuse.
- Many of these homes have curfews for residents, and these are typically strictly enforced except in certain instances.
- A number of these residences require that individuals staying in them maintain some form of employment, although they can also attend school or engage in volunteer work.
- People staying in these homes are required to be relatively independent and self-sufficient. They are expected to pay rent, maintain their rooms, purchase their own food, prepare their food, clean up after themselves, etc. In addition, many of these facilities require that residents perform specific chores, such as lawn maintenance, house clean up, etc. Residents are also required to pay rent, although the rent is typically far less than they would have to pay it any other type of facility.
- Violence or any type of aggression toward staff, caretakers, or other members is strictly forbidden.
- Residents are expected to adhere to any other rules of the facility. Rules are typically reviewed with the person and any questions are answered before the person takes up residence in the recovery facility.
Depending on the violation, penalties for breaking rules can involve eviction or fines. Repeated violations of rules generally results in eviction.
What Is the Expected Length of Stay?
Sober living homes provide a safe haven for individuals in the early stages of recovery from moderate to severe substance use disorders and also offer them a structured living environment that is conducive to recovery. The length of stay in these recovery facilities is quite variable and depends on the person. According to sources like the book Addiction Recovery Management and the National Institute on Drug Abuse, the typical length of stay for individuals in these facilities is around 90 days; although, again, there is quite a bit of variability. However, a 2010 study reported in the Journal of Psychoactive Drugs reported average length of stays ranging between 100 and 254 days in various types of recovery residences.
Some of the factors that determine a specific person’s length of stay are outlined below:
- The ability to follow the program has a great deal of influence on how long an individual stays in a recovery residence. A person who cannot follow the rules and engages in numerous rule violations that are considered to be detrimental to the recovery of other residents in the facility typically will not remain in the home for very long.
- The person’s motivation and commitment to recovering from their substance use disorder can influence their length of stay. Individuals who are strongly motivated and committed to recovery often will be able to move faster through transitional living periods.
- The level of social support the person has will also contribute to their length of stay. People with close family and friends may find themselves wishing to leave transitional living environments sooner than individuals who have little or no social support.
- Physical and mental health are important factors in determining how long an individual stays in a sober living home. People who have a number of co-occurring psychological disorders, such as major depressive disorder, psychotic disorders, or personality disorders, or those who have significant physical issues may take longer to adjust. These individuals may need the support and structure that recovery residences provide for lengthy periods of time.
- Finances always play a major role in the length of stay in sober living homes. Some individuals may not be able to afford living outside the transitional environment, and this may result in a lengthier stay.
A person should stay in the recovery residence until:
- They have developed a program of recovery through attendance at therapy sessions, group sessions, or social support groups, such as 12-Step meetings.
- The person has a supportive social support network that is committed to their recovery. The individual can rely on this social support network to assist them once they leave the sober living home.
- The individual has been able to separate from significant risk factors for relapse, such as breaking off abusive relationships and not habitually associating with friends or family members who are using drugs or alcohol. The person has developed a solid relapse prevention program to deal with potential threats to their recovery.
- The person has ongoing treatment for any other co-occurring conditions.
Effectiveness of Sober Living Homes
Number of different research studies have investigated the effectiveness of these transitional living environments. There are several factors that contribute to the effectiveness of the recovery residence.
- Recovery residences that have very well-defined regulations and offer their residents structured approaches to recovery are more successful than programs that are more lenient in their structure and rules. Individuals in recovery often require specific guidelines and structure in the initial phases of recovery.
- People in these facilities who have continued to interact with individuals they typically interacted with while they were using their drug of choice had significantly poorer success rates. Programs that help recovering individuals develop new positive social support groups were more effective in assisting their residents in maintaining their recovery programs.
- Related to the above, the facilities that emphasized engagement in social support groups, such as 12-Step groups, appeared to have greater success at assisting their residents in maintaining their recovery programs.
When looking for a sober living home, aim for those that offer significant support, are structured, have concrete rules and regulations for occupants to follow, and encourage the development of a new network of friends who are also committed to recovery. One can expect greater success and a significantly shorter stay in a program that is committed to helping the individual by providing them with support and structure. While the individual is a member of a recovery residence, they should also be developing a new support group, a new skillset, and a new attitude that fosters their recovery once they leave the program.
Leaving the program does not mean leaving therapy. Individuals should maintain a strong aftercare program once they leave the recovery residence. It is important not to attempt to rush one’s recovery in order to get into an independent living environment, but instead to take time and slowly develop an individual program of recovery while in the sober living home. Because relapse rates for substance use disorders are typically high, even with structured treatment, individuals in sober living homes should take advantage of the structure and assistance they receive in order to develop a solid foundation of recovery.