Forbes Magazine Article June, 2023
by: Laura Silva / Medically Reviewed by: Carolyn Coker Ross, M.D., M.P.H.
A sober living house provides individuals recovering from substance use disorder with a safe place to live before they’re ready to return to their former lives. There are thousands of sober living homes in the U.S., according to the National Association of Recovery Residences (NARR). However, sober living homes differ depending on the residents they accept and the rules they maintain.
Read on to learn more about sober living houses, including how they function, whether one may be right for you or a loved one and how to find a reputable facility in your area.
A sober living house (SLH) is a residence for people recovering from substance use disorder. Sober living homes are meant to be safe, supportive environments that emphasize the importance of building a community and camaraderie with others. Individuals typically enter an SLH after being discharged from a clinical treatment center before returning to their previous home and routine.
“Sober living houses aim to help individuals sustain recovery [in the] long term and develop independence in terms of managing their recovery and getting back to leading a full life,” says Vanessa Kennedy, Ph.D., director of psychology at Driftwood Recovery, a rehabilitation center in Texas.
Sober living homes typically operate according to established structures and guidelines— including rules for residents, testing requirements and monitoring—though overriding governance, licensure and accreditation rules vary by state. While at an SLH, residents may be able to resume other aspects of their lives before recovery, such as work or family obligations. Specific rules depend on the residence, according to Dan Smith, a Connecticut-based certified addiction counselor and vice president of strategic operations at Mountainside Treatment Center, and Zac Clark, founder and chief executive officer of Release Recovery in New York.
An individual may stay at an SLH as long as they desire, although the National Institute on Drug Abuse recommends first spending no fewer than 90 days in an addiction treatment program for best effectiveness.
How Sober Living Homes Differ From Halfway Houses
Halfway houses fall under the umbrella term “sober living home,” as both terms refer to residences where people in recovery stay before going back to living on their own, says Dr. Kennedy.
Halfway houses traditionally serve individuals recently released from incarceration, acting as a halfway point between prison and their own residence. A stay at a halfway house may be court mandated, but standard SLH residency is entirely up to the individual.
“Halfway houses are often owned or sponsored by the state while most sober living houses are owned privately and/or by a treatment facility that provides continued support to their client(s),” says Stephanie Robilio, a licensed social worker and chief clinical officer at Agape Treatment Center in Florida.
Different Types of Sober Living Homes
Sober living homes vary depending on how they’re run and the services they provide. Some sober living homes may also cater to specific groups, such as women, men, young people, older adults or LGBTQIA individuals. NARR divides sober living homes into the following four levels.
Level I: Peer-Run
A Level I sober living home typically does not have any paid staff and relies on its residents to monitor behavior and enforce policies and procedures. Provided services include drug screenings and resident house meetings. Level I residences are typically operated in single-family homes.
Level II: Monitored
A Level II recovery residence assigns a house manager or senior resident to oversee the workings of the house and has at least one paid staff member. Level II includes the services of a Level I home as well as peer-run group and self-help and/or treatment. A monitored residence can be in a single-family home or an apartment.
Level III: Supervised
Level III homes employ administrative staffers, such as a facility manager and certified staff of case managers, and maintain an organizational hierarchy. Licensing for such SLHs varies between states. Adding on to previous Levels’ services, Level III includes an emphasis on life skill development, offsite clinical services and in-house service hours.
Level IV: Service Provider
Level IV employs an organizational hierarchy of credentialed staff and adds on clinical and administrative supervision. Level IV services include in-house clinical services and programming and life skill development. Level IV recovery homes tend to have a more institutional building framework.
Common Sober Living House Rules and Regulations
SLHs are rooted in structure to aid residents through recovery, which means there are often rules and regulations residents must follow or otherwise risk dismissal from the house. Rules vary between residences, but experts agree common guidelines include:
Maintaining sobriety
Voluntarily completing drug tests
Keeping common areas clean
Submitting to room searches
Attending regularly scheduled group meals and/or meetings
Abiding by established wake-up times and curfews/bedtimes
Participating in a 12-step program (or similar program)
Enrolling in an offsite clinical program
Abiding by limited car privileges and/or visitor rules
Refraining from any violence, theft or inappropriate behavior
Many sober living homes also require residents to pay weekly rent following a one-time move-in fee, according to Robilio.
The cost of a sober living home depends on the type of home, its location, the services it provides and the length of an individual’s stay, but it typically ranges from $450 to $750 per month, according to American Addiction Centers, a provider of addiction treatment and mental health services[1]. However, Clark stresses that more comprehensive home programs—and those in larger cities like Los Angeles—likely come with a much higher price tag.
Sober living homes in the U.S. aren’t covered by insurance and are often paid for out of pocket. Payment plans, scholarships, grants and government-funded programs may be available for residents facing financial hardship. Organizations that offer SLH scholarships include CLEAN Cause Foundation and Ben Meyer Recovery Foundation, per Dr. Kennedy and Clark.
How and When to Seek Help
Smith and Clark recommend seeking out an SLH after completing clinical treatment to best practice the skills learned in the program alongside others in recovery.
If your treatment center doesn’t set you up with an SLH, Robilio suggests asking the following people for guidance:
Medical and mental health providers, such as a primary care physician
A private practice therapist who specializes in addiction
Current 12-step program participants
Friends or family members who have recovery experience
When visiting or looking into an SLH, Smith and Clark recommend looking for the following characteristics and services:
24/7 support staff
A daily schedule for residents
Accountability plans
Frequency of drug testing and breathalyzing
The client-to-staff ratio
Cleanliness
Dr. Kennedy also suggests touring the home and asking to speak with current residents or alumni. Smith recommends asking and looking for what sets one SLH apart from the others to make sure its focus and expertise align with your objectives and personality.
“If there’s not a ‘perfect’ fit, you may still benefit from the structure, support and monitoring that a sober living house provides until you feel more confident in your sobriety,” says Dr. Kennedy.
Are SLH Effective?
A 2018 study of 330 sober living residents found drug and alcohol abstinence to be more closely linked to houses within a larger organization of group of houses and that residents from homes affiliated with a clinical treatment ultimately had better chances of employment[2].
More recently, a 2021 study found sober living residents to be more likely to remain in outpatient treatment programs longer than those who did not attend an SLH. Residents reported that the structure and support of an SLH provided accountability, as well as life and coping skills, all of which contributed to their success[3].
“I’m living proof that sober living works,” says Clark. “Prior to starting my career in the behavioral health care field, I went to treatment, and I lived in sober living for several months, and that was really key for me in my recovery.”
Clark points to the connections and community he built with other residents as crucial to his recovery alongside the clinical aspect. “[Sober living homes] show that there are people out there who are struggling in the same way that [you] are and [you] have a place to go where [you] can connect with like-minded folks,” he adds. “I believe that sober living is absolutely vital and critical to one’s recovery.”
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