Recovery Housing

The Issue

The struggle with opioid addiction has overwhelmed people across the entire country. In 2016, opioid overdoses were the cause of over 42,000 deaths in the United States. Ohio in particular, where drug overdose is the leading cause of injury-related death, is an epicenter of the epidemic. 

In 2017, the U.S. Department of Health and Human Services declared the national opioid crisis a public health emergency and unveiled a plan to try to stop its spread. This plan emphasized access to better addiction prevention, treatment, and recovery services. Since then, funding has poured into states from the federal government to help them track and prevent deaths. 

One of the main approaches to prevention that many states have taken is decreasing the amount of opioids prescribed by physicians. And in recent years, the number of opioids dispensed across the country has decreased. By 2019, the dispensing rate fell to its lowest level in 14 years. 

Still, even as we’re slowing some opioid access routes, overdose deaths continue to increase. Decreasing opioid prescriptions may help prevent new people from being drawn into an addiction, but it does little to help those who are already suffering from substance use disorders. Though the drugs aren’t being supplied by medical professionals as frequently anymore, they are still available through other means. 

Although substance use disorders impact people in all economic circumstances, those living in poverty experience even greater barriers to recovery. Even with the will to get clean, they often do not have access to or the insurance coverage for expensive rehab programs. And addiction is often intertwined with limited access to opportunity and housing instability. When unemployment or homelessness is added to the challenges of addiction, recovery can be really hard. 

It’s still not clear how to best help people struggling with addiction successfully recover to reach their full potential. But we do know that basic needs, like shelter, must be met before people can start to tackle other complex issues. Safe and stable housing is an important foundation for building a new life away from drugs and alcohol.

One way to lighten the intense pressure on people working to recover from substance use disorders is by offering them recovery housing--a specially designed living environment that supports a clean and sober life. The place to live is a start and resolves some uncertainty about the future. But the strength to embark on the recovery process comes from being part of a community with a shared commitment to avoid drugs and alcohol.   

Recovery housing connects residents to community treatment and recovery services, but the crown jewel of the model is the peer support--people who have been on the journey to sobriety themselves walking with newer residents in empathy and understanding. After all, the opposite of addiction isn’t just sobriety; it’s human connection. 

Existing research has shown us how crucial peer support is in communal recovery living environments. Building relationships with other people in recovery who want to give and receive help gives residents a greater shot at staying clean and sober. As a result, they're more successful at finding and keeping jobs and they are able to steer clear of the criminal activity that can accompany an addiction. 

Safe housing paired with peer support is an important part of helping those recovering from substance use disorders navigate successful transitions back to their communities. Every person deserves a place to call home and the best chance at a life of well-being.  Still, we don’t have much rigorous evidence to tell us what impact recovery housing has on health, long-term housing, and employment outcomes. More research is needed to help ensure that recovery housing networks are providing people with exactly what they need to succeed.

The Intervention

Responding to the opioid crisis in Ohio is a network of recovery housing operators--Ohio Recovery Housing (ORH)--offering affordable and high-quality recovery housing services for those with substance use disorders. These living environments aim to help residents build a strong foundation in recovery that ultimately leads to positive outcomes in future health, employment, and housing. All of the homes in the ORH network implement an approach called the social model of recovery. Under this model, residents are not only given a safe, clean, affordable housing environment free from alcohol and illicit drug use, but they also participate in services and activities designed to help them sustain recovery. Each resident develops their own recovery plan and the home and other residents support them as they work to achieve their goals, staying true to ORH’s value of human connection and positive relationships at every step of recovery.

Research Question

Does recovery housing improve the health, housing, and employment outcomes of those with substance use disorders?

Intended Outcomes

• Participants in the social model of recovery housing will have improved health outcomes, such as fewer recurrences of addiction and lower emergency health department use, than those who do not participate.
• Recovery housing residents will also have fewer cases of housing instability, steadier employment, and less involvement with the criminal justice system.

Research Study Design

The Ohio Recovery Housing evaluation is a quasi-experimental study involving ten recovery homes in the network. Each recovery home can only accommodate a set number of residents, and units become available unpredictably as people move out. If there is an opening at an ORH home when an eligible person contacts the network for services, they are given the recovery housing spot and become part of the treatment group. If there are no openings, the person is referred to other services and becomes part of the control group. 

At the conclusion of the study, LEO researchers will compare outcomes between the two groups to identify the impact that recovery housing has on long-term sobriety and other health, housing, and employment outcomes.

 

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