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What are Sober Living Guidelines?

At the micro-level, we have seen a variety of community and local-efforts to combat the opioid epidemic and improve the quality and regulation of sober living residences.  What about at the macro, federal level?  Well, in 2018, the federal government signed into the law the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities, or SUPPORT.  A crucial component to this law can be found in Subtitle D: Ensuring Access to Quality Sober Living (SEC. 7031), which mandates that the Secretary of Health and Human Services will identify or facilitate “the development of best practices for operating recovery housing.” In conjunction with the SUPPORT Legislation, the Substance Abuse and Mental Health Services Administration (SAMHSA) identified ten specific guiding principles to assist federal policy makers in qualifying acceptable sober living programs.  In summation, the SAMHSA sober living guidelines can be used as an overarching framework for sober living to provide the highest quality of care and safety for residents.

This is a two-part series for SAMHSA sober living guidelines.  We will break down Principles 1-5 here, and stay tuned for parts 6-10 coming soon.

SAMHSA Sober Living Guidelines

1. Have a Clear Operational Definition

First off, a sober living residence must outline the type of services offered and to what degree these services are provided in a clear, concise operational definition.  Transparency and honesty should be rooted in the program’s foundation so that prospective residents and regulatory agencies, such as the FDA, are not sold false information.  Services to be outlined include: staffing, clinical services, and governance- all based on the sober living’s National Alliance for Recovery Residences (NARR) Level.  Check out the graph below for a full breakdown.

sober living guidelines

Source: The National Alliance for Recovery Residences

2. Recognize That a Substance Use Disorder is a Chronic Condition Requiring a Range of Recovery Support

Recovery from addiction is multi-faceted. Abstinence from alcohol and drugs is only one piece of the puzzle, albeit a crucial piece.  An individual in early recovery will face an onslaught of trials and tribulations that will put his or her recovery to the test: unresolved grief or trauma, dysfunctional family dynamics, emotional instability, and lack of practical life skills.  A young man or woman who discharges from addiction treatment should have a stockpile of “social capital” to work with as they navigate through life in recovery.  If one does not have a community of support who can show him or her how to deal with life on life’s terms, a relapse will inevitably come to fruition. A sober living residence should provide individuals with the appropriate level of professional and peer support to supply residents the “social capital” they need to live independent, sober lives.

3. Recognize that Co-Occurring Mental Disorders Often Accompany Substance-Use Disorders

According to the 2018 National Survey on Drug Use and Health, SAMHSA concluded that 9.2 million adults live with co-occurring mental and substance-use disorder. It is vital that sober living staff and operators are aware of and qualified to handle the different mental health situations of each resident.  The sober living guidelines suggest that each resident be handled with compassion and empathy, regardless of his or her current mental health status.

4. Assess Potential Resident Needs and the Appropriateness of the Residence to Meet These Needs

At the end of the day, addiction treatment and sober living facilities have one goal: provide an individual with the best chance to recover.  All sober living programs should predicate their admission process on that simple fact. Are we giving this individual the best chance to recover? The answer to this question resides in the admission process before the resident even enters the sober living home.  A sober living facility must assess each prospective resident and determine if he or she matches the program’s current program operations.  To achieve the proper match, thorough communication must exist between sober living facilities and referral sources.

Some criteria that facilities should consider: house culture, level of care, current residents, medication assisted treatment, staff qualifications, reputation, relapse policy.

5. Promote and Use Evidence-Based Practices

Addiction should not be taken lightly.  It is very much a life-or-death matter.  Sober living programs should not “wing it” or rely solely on an alcohol and drug free environment to benefit their clients.  SAMHSA sober living guidelines implores that evidence-based practices and operations be used on a daily basis to give residents the best chance to recover.  Some of these practices include, intensive outpatient programs (IOP), medication assisted treatment (MAT), and peer recovery support.  Each practice should be carefully and dutifully incorporated into the program’s curriculum throughout the resident’s stay.


Don’t worry, we will be back with the rest of the list shortly. For now, enjoy Principles 1-5 of SAMHSA Sober Living Guidelines and consider the best sober living options for your loved one.

If you need help navigating treatment services, please do not hesitate to reach out.