An examination of main and interactive effects of substance abuse recovery housing on multiple indicators of adjustment

Abstract

Aims-To assess the effectiveness of community-based supports in promoting abstinence from substance use and related problems.Design and participants-Individuals (n = 150) discharged from residential substance abuse treatment facilities were assigned randomly to either an Oxford House recovery home or usual aftercare condition and then interviewed every 6 months for a 24-month period. Intervention-OxfordHouses are democratic, self-run recovery homes.Measurements-Hierarchical linear modeling was used to examine the effect of predictive variables on wave trajectories of substance use, employment, self-regulation and recent criminal charges. Regressions first examined whether predictor variables modeled wave trajectories by condition (Oxford House versus usual after-care), psychiatric comorbidity, age and interactions.Findings-At the 24-month follow-up, there was less substance abuse for residents living in Oxford Houses for 6 or more months (15.6%), compared both to participants with less than 6 months (45.7%) or to participants assigned to the usual after-care condition (64.8%). Results also indicated that older residents and younger members living in a house for 6 or more months experienced better outcomes in terms of substance use, employment and self-regulation. Conclusions-OxfordHouses, a type of self-governed recovery setting, appear to stabilize many individuals who have substance abuse histories.

Recovery Housing: Assessing the Evidence

“…No meta-analyses or research reviews on recovery housing were found. We identified five articles describing RCTs that compared some version of recovery housing to some control condition (4,(11)(12)(13)(14) and one quasi-experimental study with a within-group, repeatedmeasures design (15). However, four of the five articles describing RCTs reported on the same base study; therefore, only three distinct studies on this topic met the inclusion criteria.…”

“…In an RCT, Jason and colleagues (4,(11)(12)(13) recruited individuals who were completing residential substance use treatment and randomly assigned them to Oxford House or to treatment as usual (for example, outpatient substance use treatment, aftercare, and mutual help). The researchers, who are long-term collaborators with Oxford Houses, facilitated Oxford House entry by identifying those with openings for new residents and assisting with the application process.…”

“…Two studies indicated that outcomes were better with longer stays in the recovery house (12,14). In addition, several studies indicated that success in the recovery house may also depend on other client characteristics, such as involvement in a 12-step program, age, or a diagnosis of posttraumatic stress disorder (11)(12)(13).…”

“…In addition, several studies indicated that success in the recovery house may also depend on other client characteristics, such as involvement in a 12-step program, age, or a diagnosis of posttraumatic stress disorder (11)(12)(13). These differential effects should be examined further, and it is likely that other variations in outcomes may be identified in additional studies.…”

Researching community‐based support networks: what policymakers should know

“…Although some contemporary research (within this century) continues to be informed by the positivist paradigm-for instance, through the use of randomized controlled trials-much of this research does not involve random assignment to a community-based SHSG per se. Instead, it involves random assignment to treatments that ''urged'' attendance (Weiss et al, 2005, p. 178), to interventions that involved intensive referral (Timko & DeBenedetti, 2007;Timko, DeBenedetti, & Billow, 2006), or to a rehabilitation residential setting premised on peer recovery (Jason, Olson, Ferrari, & Lo Sasso, 2006;Jason, Olson, Ferrari, Majer, Alvarez, & Stout, 2006). These examples are somewhat different to the random assignment of individuals to a community-based SHSG that is not situated in a place of residence.…”