Academic journal article Journal of Drug Issues

Challenges and Rewards of Conducting Research on Recovery Residences for Alcohol and Drug Disorders

Academic journal article Journal of Drug Issues

Challenges and Rewards of Conducting Research on Recovery Residences for Alcohol and Drug Disorders

Article excerpt

Introduction

Research over the past several decades has shown a consistent albeit moderate impact of treatment on substance use disorders (National Institute on Drug Abuse, 2012). One factor affecting the success of treatment is the availability of recovery capital, which includes the economic and social resources necessary to access help, initiate abstinence, and maintain a recovery lifestyle (Cloud & Granfield, 2008; Laudet & White, 2008). Individuals with substance use disorders who are unemployed, do not have stable housing, or are involved in the criminal justice system are particularly vulnerable given their limited access to recovery capital. Recovery residences (RRs), such as Oxford HousesΤΜ (OHs), sober living houses (SLHs), and other types of recovery homes for alcohol and drug problems, can help increase recovery capital by providing affordable, alcohol- and drug-free living environments and peer support for recovery (Jason, Mericle, Polcin, & White, 2013).

Types of Recovery Residences

There are different types of RR models that vary in terms of administration, services offered, type of residence, and staffing. The National Association of Recovery Residences (2012) is an organization that provides advocacy and standards for RRs and has devised four levels of RRs based on these factors. All levels provide an abstinent living environment and social support for recovery within a communal living arrangement. Level I residences are democratically run by resident peers, offer no on-site services, are small facilities located in residential neighborhoods, and do not employ on-site staff. Resident fees usually cover financing of these homes, and residents are free to live there as long as they wish. OHs are good examples of these residences. Level II residences are similar to Level I houses in most respects, but they typically have an on-site house manager who oversees house operations. The manager is typically paid or receives reduced rent but is considered a recovering peer, not a professional service provider. Good examples of these residences are SLHs, many of which are located in California. A key difference between Level III houses and the first two levels is that they often offer on-site recovery support and other services and employ paid staff. Some of the recovery homes in Philadelphia studied by Mericle, Miles, Cacciola, and Howell (2014) could be considered Level III residences. Level IV houses tend to have an organizational hierarchy, offer on-site clinical services delivered by certified and licensed professionals, and are often larger facilities licensed as treatment programs.

This article primarily addresses research conducted on the first three levels because they have been studied less than Level IV residences. RRs present unique challenges, including recruitment of individuals across multiple sites, describing common and unique characteristics of individual homes, tracking participants for follow-up interviews, enlisting homes as partners in research, and implementing the most appropriate research designs.

Our collective experiences studying recovery homes draw primarily upon research conducted on three types of recovery homes: Oxford Houses (OHs), California SLHs, and a mix of Level II and III recovery homes in Philadelphia. OHs are a good example of Level I homes. They began as a grassroots movement in the late 1970s and have seen continued growth over the past four decades. Currently, there are over 1,700 houses nationwide. Research on OHs has been conducted by a team from DePaul University over the past several decades, and they have documented favorable outcomes relative to control groups for persons who entered OHs after leaving treatment and criminal justice institutions (Jason, Olson, Ferrari, & Lo Sasso, 2006; Jason, Olson, & Harvey, 2015; Jason, Salina, & Ram, 2015). An additional study documented good outcomes for persons who were current residents and followed up over three 4-month intervals (Jason, Davis, & Ferrari, 2007). …

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