A research basis for sober residences

At a time when leaders in recovery home organizations are forming a national association and are pushing for standards of operation, a growing body of research is pointing to why safe housing constitutes a critical element of support for individuals in outpatient addiction treatment or aftercare.

A study published in the October 2010 issue of the Journal of Substance Use, examining 55 individuals living at Options Recovery Services sober homes in Berkeley, Calif., found that residents achieved improvements in substance use, criminal justice and vocational outcomes that were sustained over 18 months.
While the study was not designed to isolate the role of the sober living arrangement in bringing about the positive changes (individuals were receiving outpatient treatment services at the same time), its authors still concluded that the findings bolster the case for recovery homes’ role in the continuum of care. The authors stated in their paper that sober homes “should be considered as an adjunct to outpatient treatment for clients who have access to limited financial resources or reside in destructive living environments.”
What makes this study’s findings especially noteworthy is the prevalence of multiple problems and chronicity in the study sample. The male subjects in the study (average age 43) had a high prevalence of homelessness, with one-third stating that their typical housing situation over the past six months had been on the streets or in a shelter. Three of five subjects reported a cocaine dependence.
“In my research I have always found that in outpatient programs individuals show some desire, but at the end of the day they go home to a dysfunctional environment,” says Douglas L. Polcin, EdD, lead study author and senior scientist at the Public Health Institute’s Alcohol Research Group in Emeryville, Calif. “Their effort then becomes completely undermined.”
Because individuals had to demonstrate sobriety and participation in outpatient treatment before being admitted into the Berkeley sober homes, they entered the residences with relatively low substance use and legal severity as measured by several scales. But they also continued to show improvement at 6-, 12- and 18-month follow-up stages after relocating to the sober home setting, the study found.
The researchers also found that subjects’ level of involvement in 12-Step groups was a strong predictor of outcome, as those with higher levels of 12-Step involvement were 25 percent more likely to be abstinent from substance use. The extent of substance use in the residents’ identified social network was a somewhat less reliable predictor of outcome, the researchers found.
Polcin and his colleagues stated that they believe their study represents the first long-term follow-up of individuals receiving outpatient treatment and sober living arrangements.