Sober Living Guide

Sober Living Homes

The early stages of recovery from alcoholism and drug addiction are generally the most crucial, as it is during this time that a solid foundation must be built in order for any meaningful and lasting progress to be possible. A quality sober living home provides the ideal structured environment for forming new habits, developing a sober network and applying principles learning in treatment – all of which are integral to achieving and maintaining long term sobriety.

What is a Sober House?

Sober living (also referred to as a sober house or sober home) is a general term for any shared housing environment in which each resident is committed to abstaining from the use of alcohol and other drugs. Effectively a recovering individual’s most logical “next step” following release from an inpatient program, sober living might simply be a dwelling cohabited by friends or acquaintances in recovery or be part of a highly-structured program overseen by a hospital or treatment facility – or anything in between.

“Lack of a stable, alcohol and drug free living environment can be a serious obstacle to sustained abstinence.”

U.S. National Institutes of Health’s National Library of Medicine (NIH/NLM)

The National Association of Recovery Residences (NARR) has established the following four classifications for sober living homes:

Level 1 – Peer-Run: Residences most often informally composed of individuals who are friends or acquaintances in recovery. Peer-run homes are usually governed democratically by their residents and may or may not feature periodic house meetings, drug screenings, and/or a senior resident holding other residents accountable, but there are no paid, clinical positions within such homes.

Level 2 – Monitored: Typically single-family homes or apartments supervised by a senior resident or a house manager who is often compensated, either monetarily or via free or discounted rent. House meetings and drug screenings are generally mandatory, and house rules are often well-defined.

Level 3 – Supervised: Facilities which are usually licensed and feature organizational hierarchies, administrative oversight, and policies and procedures. Life skills development is emphasized, and clinical services are provided outside of sober living services. Staff are certified, and drug screenings are standard.

Level 4 – Integrated: Services tend to be provided in a more institutional environment and are often transitional services for those completing an addiction treatment program. Clinical services are provided in-house with a strong emphasis on life skills development. Staff are credentialed, and drug screening is mandatory and administered on a frequent basis.

Combining Sober Living with Addiction Treatment

In general, sober living arrangements are ideally compatible with post-inpatient programs including, but not limited to, the following:

  • Partial-hospitalization programs (PHP): Comprehensive care which usually provides clients with a structured, often day-long treatment environment designed so as not to interfere with evening employment or home life obligations.
  • Intensive outpatient programs (IOP): Generally less rigorous and time-consuming than PHPs, IOPs provide a continuation of recovery-related treatment in blocks of several hours and are usually customized to meet the demands of the client’s increasingly busy schedule.
  • Aftercare: A general term for less-structured assistance, guidance, and support offered to clients following their release from an inpatient program.
  • Alumni Relations: Ongoing fellowship programs and events for the purpose of helping clients maintain contact with members of the recovery community established during inpatient (fellow residents, counselors, clinicians, et cetera).

Halfway House vs Sober Living Homes

Within the context of sober living, a halfway house is an institution that allows people recovering from alcoholism and/or drug addiction (as well as the consequences thereof) to learn (or perhaps relearn) the necessary skills to re-integrate into society and better support and care for themselves. In this regard, at least on the surface it would appear that there is no real difference between halfway houses and other types of sober living, but there are several aspects of halfway houses that set them apart:

Residents of halfway houses are often court-marshalled and required to stay for a pre-determined length of time as parole conditions or future expungement of convictions may warrant.

  • Halfway houses are often run by government agencies as opposed to the private entities which tend to own and operate other types of sober living.
  • Halfway houses tend to be set up like dormitories, whereas most privately-run forms of sober living are often structured more like private residences.
  • Halfway houses generally feature fewer amenities, less structure, and more crowded conditions, resulting in a typically lower cost.
In many parts of the U.S. it is not uncommon to hear the term “three-quarter house” used to describe a variant of the halfway house model in which more freedoms are afforded to residents who have attained a certain level of progress in their recovery and are thus deemed ready for more freedoms than a halfway house typically affords. It is often understood to designate the final stepping stone to total independence. Occasionally a more advanced designation of “seven-eighths house” will be spoken of, but this term is generally considered by those in the treatment profession to be splitting hairs.

Benefits of Sober Living

While it is certainly possible to remain clean and sober in the absence of a sober living environment, numerous studies have shown that the odds of maintaining long-term sobriety are much lower among those who return to their former living environments upon release from inpatient treatment.

It is not difficult to see why residents of sober living have a better chance of remaining free from drugs and alcohol given its many benefits, which include, but are certainly not limited to, the following:

Companionship in Close Proximity – Numerous studies have concluded that one key component to addiction is isolation. In cohabiting with at least one other individual recovering from drugs and/or alcohol, an individual is able to experience more of the interpersonal connection that is vital to recovery.

Accountability and Mutual Support – All of NARR’s sober living classifications feature a built-in accountability structure, whether informal (Level 1) or formal (Levels 2 through 4). Since addicts in early recovery often do not make the best decisions and frequently suffer from unhealthy, self-defeatist thinking, the mutual exchange of feedback and encouragement amongst fellow members of a recovery community, particularly those intimately acquainted with one another in a roommate context, is often invaluable.

Strength and Safety in Numbers – Members of 12-step programs are often advised by trusted elders to remain close to “the middle of the herd.” This concept is particularly vital to individuals in early recovery as their vulnerability to succumbing to the temptation of relapse, particularly in the aftermath of a traumatic event, is often much higher.

Division of Expenditures – Individuals in early recovery are often faced with the task of repairing gravely damaged financial affairs, which is often further complicated by the less-than-ideal compensation afforded by “recovery jobs” which tend to be menial in nature; thus, any opportunities to save money are worth pursuing, and cohabitation allows the splitting of rent, utility, food and transportation bills, provided these expenses are not already included as a package deal, as is often the case in Levels 3 and 4).

Increased Opportunities for Sober Networking – The logic here is simple: the more roommates one has, the more additional people one will likely become acquainted with by mere virtue of association.

Resources for Employment and Professional Services – Institutions which own and/or operate recovery residences typically afford their clients professional networking opportunities; in fact it is not unusual for former clients of such institutions to return as employees.

As noted in the abstract for another study whose findings were published in the NIH/NLM, “relative to persons with stable housing, those who were homeless or marginally housed had worse outcomes and those in sober living recovery houses (SLHs) had better outcomes. Overall, we conclude that individuals entering SLHs show improvement in housing status and psychiatric distress, both of which are associated with better substance abuse outcomes.”

U.S. National Institutes of Health’s National Library of Medicine (NIH/NLM)

Daily Life in Sober Living

A typical schedule can vary greatly based on the sober living program, a resident’s personal needs and stage of recovery, and the particular residence level (a Level 1, or peer-run, residence may have no set schedule at all), but a normal weekday in sober living might be very similar to the example provided below.

7:15 a.m. Wake up.

7:30 a.m. Bed checks performed by sober house residential manager or other designated individual. Disciplinary action taken against any resident who is not out of bed at this time.

7:45 a.m. Morning prayer, meditation or other group spiritual activity.

8:00 a.m. Breakfast with fellow residents.

8:15 a.m. Showers, grooming, other activities to get ready for work, school, IOP/PHP, etc.

9:00 a.m. House check. Disciplinary action taken against any resident who has not left the residence at this time.

9:00 a.m. through 5:00 p.m. Work, school, IOP/PHP, Aftercare, or any combination of several.

5:30 p.m. Return home.

6:00 p.m. Dinner with fellow residents.

6:30 p.m. Mandatory house meeting to discuss residents’ needs, requests for weekend passes, rules violations (if there have been any), and other issues.

7 p.m. Mandatory drug testing.

7:30 p.m. Meet at van to be taken to off-campus 12-step meeting.

8:00 p.m. 12-step meeting

9:15 p.m. Meet at van to be taken back to residence

10:00 p.m. Curfew. All residents must be present and accounted for by residence manager.

10:00 p.m. through 11:15 p.m. Flex/social time (TV, video games, etc)

11:30 p.m. Bedtime. Disciplinary action taken against any resident who is not in bed at this time.

Evaluating Sober Living Residences and Programs

As noted in previous sections, sober living homes are not “one size fits all” and recovery needs can vary considerably between one individual and another; however, there are general questions you should seek to have answered when researching and interviewing potential sober living facilities or arrangements for yourself or a loved one.

Organization Website – Any established sober living entity should have some semblance of a web page that is readily searchable via Google. Focus on objective information pertaining to the nature of the facility and the credentials of the employees. Make note of any professional designations/acronyms and job titles that are unclear so that you may research them as necessary. Keep in mind that any statements about success rates are impossible to verify and should be taken with a grain of salt; a former resident might have been sober “last we heard,” but how long ago was that, and how does anyone know that this person was being truthful?

Reputation – Check Yelp, Google, or other similar review mechanisms to see what others are saying about the organization. Read all commentary discerningly and place more weight on statements made by parents or other family members of residents. Statements made by residents themselves are more likely to be emotive in nature; let’s face it: sober living is not always an enjoyable experience (particularly in very early recovery), so it should not be hard to understand why an otherwise high overall rating may have been marred by a one-star review made by a former resident whose high level of obstinacy caused him or her to butt heads with the residence manager.

Names in the News – Perform general internet searches on the organization itself and its key personnel. Are there any stories giving praise and accolades? Has the organization ever been involved in any type of scandal? Were there ever any allegations or suspicions of illegal activities such as insurance fraud or patient brokering (soliciting or receiving any remunerations in return for referring a patient or patronage to a recovery home, clinical treatment facility, or laboratory) directed against this organization or any of its staff?

Word of Mouth – The most useful and detailed information about a sober living organization or arrangement will always come from trusted friends or acquaintances who are, or have been, residents of it. Recommendations from mental health professionals may prove to be quite valuable as well.

Key Questions Before You Enter a Sober Home

Important questions to ask the directors or other personnel of a sober living facility:

  • What is the overall cost of this program? What does it include? Remember, pricier does not mean better, and often the more expensive sober living facilities offer amenities or programs that add nothing of value to a resident’s recovery experience.
  • What types of insurance, if any, do you accept? What period of time will insurance cover? The second half of this question is extremely important if you do not plan to pay out of pocket; a lot of insurance plans will only cover the first 60-90 (or even fewer) days of the resident’s stay.
  • What is your resident-to-staff ratio? An excessively high ratio might result in you or your loved one not getting the necessary attention and care, while a very low ratio could indicate that the facility is struggling to attract residents and may be closing its doors in the near future.
  • Who are the people who run your facility? How long have they been in the business, and are they themselves in recovery? As noted above, the professional credentials of the program’s staff will likely appear on the website, but there may be no indication of how much experience these individuals have with running a sober living program. In many areas, virtually anyone can open such a facility regardless of qualifications or lack thereof. Additionally, at least in lieu of any formal certifications or other credentials in the field of addiction, a “street degree” is virtually indispensable. As the saying goes, “no one knows an addict like another addict.”
With each passing year, the array of sober living options becomes more and more dizzying. New programs pop onto the scene – and often disappear just as quickly. While the evaluation criteria and other details presented in this article are very important to consider, it is also imperative to visit any potential sober living environment in person to get a feel for the living environment, competency and dedication of staff (where applicable), cleanliness and organization of the residence, quality of amenities and peripheral activities offered, and overall happiness and satisfaction of the residents. Ultimately it is how the many details come together that will often help determine how enjoyable – and successful – one’s sober living experience will be.

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057870/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646694/

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