The Difference Between Recovery Residence, Sober Living and Oxford House’s
A Bed in a Sober Living is not the Same Everywhere.
Sober Living is a general term that refers to a substance-free living environment. Usually when people think of a Recovery Residence, they are thinking about a sober living that has some level of accountability and hierarchy. These houses are more likely to have an owner that is involved and a house manager that lives at the house providing some level of accountability or support.
This term has emerged with the hopes of distinguishing houses that are more supportive than a peer-run house. For example, in Pennsylvania, someone will leave a treatment center and move into a Recovery Residence. They will begin to build their life by attending some clinical services (such as IOP or therapy with a counselor). They will seek employment and gain some stability by following simple house rules and attending 12-step or self-help meetings.
The structure of most Recovery Residence is that there is a live-in House Manager. He/She may be entitled to lower rent/free housing in exchange for this service. He/She may even receive a stipend or salary to live there. Their responsibilities may range from randomly drug testing residents, collecting rent, and monitoring the house to more formal responsibilities, such as case management and support. These individuals usually need to have at least 3 months of continuous clean time. The House Manager is there to provide accountability to the other residents.
Other Recovery Residences have significantly more accountability and structure. The owner or paid staff may be involved in such a way that they check on the house and administer the drug tests. The owner or staff will also provide support and guidance to the residence. They may be involved in all admissions and discharges, collect the rent/program fee, do the shopping for household items and ensure the residents are fulfilling their requirements of 12-step and self-help meetings.
Once the resident gains a solid foundation, they will transition to less structured or basic sober living. At the Sober Living, they may have a later curfew or no curfew and the other rules will be less intensive. One may stay at the sober living for a year or more. The cost of the Sober Living is typically less then the Recovery Residence. The Sober Living may or may not have a house manager or staff monitoring the home and ensuring sobriety of the residents.
The Oxford House
The Oxford House was created in Maryland and may have been one of the first types of Sober Houses. For a full description of Oxford Houses please visit the website at http://www.oxfordhouse.org/userfiles/file/purpose_and_structure.php
The benefit of Oxford Houses is they are a very inexpensive housing resource for people in recovery. The average cost in Atlantic County New Jersey for someone to move into an Oxford House is $480. This includes a 2-week security deposit and the first week’s rent of $160. Rent is paid weekly and covers the cost of the bed and basic bills, such as utilities and cable.
Over the past few years, Oxford Houses have been under intense scrutiny due to their peer-run model. While some have experienced major success in the Oxford House Model (this is where most of the data regarding the importance of sober living was collected), the opiate epidemic has significantly impacted the safety and success of the Oxford House. Sometime a person begins using in a peer-run house and can fly under the radar, with no house manager monitoring each resident. Often the curfews and rules surrounding meeting attendance are ignored, as long as the person is paying rent. Over the last year, multiple houses in Atlantic County have fallen into disarray, where it is common to see people smoking in the house, filthy living conditions, mattresses stacked on other mattresses with no box springs or bed frames, and people using.
These houses are even more problematic because it is almost impossible for providers to determine the health of the house. This is a major problem because while someone spends the time in addiction treatment doing what’s needed to get clean, they are then recommended to a house that is peer run, dirty and potentially has people using at it.
In a peer-run Oxford Model, it is nearly impossible for providers to determine the health of the house. Providers invest significant time and energy in creating a safe, sustainable discharge plan for their clients, only to recommend a home that is peer run, dirty and potentially has people using in it.
What tends to happen is someone starts to digress in their recovery and their peers do not hold them accountable, therefore they start getting away with using drugs or drinking. This can go on for a significant period of time until someone is actually drug tested and asked to leave the house.
Let’s use a real life example, drawing from a recent experience. On October 28th, two individuals who live in separate Oxford Houses (let’s call them Kelly and Jamie to protect their identities), picked up two other friends who reside in a structured recovery residence. The four travelled out of town to a 12-step meeting, where Kelley purchased drugs from an acquaintance. Both Jamie and the 2 gentlemen from the structured sober living were unaware that Kelley bought heroin, but after they returned to town and dropped off their friends, Jamie confronted Kelley about her odd behavior that evening. Kelley confessed to Jamie that she had been using for over a week while living in her Oxford house and offered Jamie some of the heroin. Jamie used after 8 months of clean time, overdosed and was transported to the hospital. Luckily, Jamie survived the overdose.
Not only did Kelley put the lives of 3 people at risk, but also gave a lethal batch of heroin to someone in recovery. This all could have been avoided if Kelley had not been getting away with using for as long as she did.
Recovery Residence Standards
The National Alliance or Recovery Residence has issued a set of standards for recovery residences. This helps providers refer to appropriate homes. It also gives operators and owners the ability to have some oversight and accountability to the community and consumer. In 2015 NARR released a metric that determines 4 levels of Recovery Residences. The least structured is “level one,” which is similar to the peer run model. Level four is the most structured model and this includes having clinical services at the home that are required for the resident to participate in.
The NARR website: www.NarrOnline.com