Food, shelter and clothing are the three basic necessities for all human beings. For those individuals healing from active substance use, the lack of stable alcohol and drug-free living environments can make it difficult for them to build and sustain their recovery. Unsafe or risky living spaces can derail the recovery process for even the most determined person who wishes to become abstinent or reduce harm. (Polcin, Korcha, Bond & Galloway, 2011)[i]

Research shows that alcohol and drug addiction are most effectively addressed through a chronic care management model that includes recovery-supportive housing. Formally known as “sober housing”, recovery housing is one of the major Recovery Support Services (RSS), and as such, is part of the continuum of care for individuals recovering from alcohol and drug addiction.

The necessary components of recovery housing are that they be substance-free, not tied to any particular formal treatment services, strongly encourage attendance at 12-step or other mutual aid groups, have agreed-upon house rules, involve rent and / or other fees, involve residents in how the house is cleaned and operated, and allow residents to stay so long as they function within the house norms. (Polcin & Henderson, 2008)[ii]

Recovery housing often functions in two ways: as a substance-free environment and as a community of mutual support from peers who are also recovering. Residents may begin their length of stay in recovery housing during treatment and continue for several months or even years. In some places, residents share resources with each other, and support one another through shared, lived experience. Some recovery housing is connected to the National Alliance of Recovery Residences, a not-for-profit organization that serves 25 regional affiliates organizations that collectively support more than 25,000 people across the country. One of the leading examples of recovery houses is Oxford House – a network of peer run, self-sustaining and substance-free residences that house up to 10 recovering individuals per house and require residents to be abstinent.  (Surgeon General, 2016)[iii]

The Massachusetts Alliance for Sober Housing (MASH) has certification standards which every recovery house that receives Medicaid reimbursement, must adhere to. They must operate with integrity, collect data for continuous quality improvement, operate with prudence, and uphold residents’ rights. In addition, MASH certified homes are recovery-oriented, peer staffed and governed, promote health, safety, recovery, and well-being, inspire purpose, and cultivate community. (MASH, 2016).[iv]

While much debate surrounds abstinence versus harm-reduction models of housing, it is important to note that the use of harm reduction practices as well as medication-assisted treatment have not always been viewed as viable pathways to recovery. It is important that recovery housing provides individual choice to support various pathways to recovery. While many people engaged in recovery focus on abstinence-only living environments, supporting individuals’ choice must also include communities that ensure that housing options are available for people in all stages of recovery, including those who continue to use alcohol or drugs. Such choice will ensure that people are supported in recovery through the four SAMHSA dimensions of health, home, purpose, and community. (SAMHSA, 2012)[v]

[i] Polcin, D., Korcha, R., Bond, J., & Galloway, G. (2011). What did we learn from our study on sober living houses and where do we go from here? Retrieved from
[ii] Polcin, D. & Henderson D. (2008). A clean and sober place to live: philosophy, structure and purported therapeutic factors in sober living houses. Retrieved from
[iii] U.S. Department of Health and Human Services. (2016). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Retrieved from
[iv] Massachusetts Alliance for Sober Housing. (2016). Certification Standards. Retrieved from
[v] Substance Abuse and Mental Health Services Administration. (2012). SAMHSA’s working definition of recovery update. Retrieved from