Reasons for choosing sober living houses and their associations with substance use recovery outcomes

Abstract

BackgroundSober living houses (SLHs) offer abstinence-based housing for people in recovery. Studies have shown that these supportive environments are associated with positive outcomes, yet little is known about why residents choose SLHs and their relationship to recovery outcomes. MethodsLongitudinal data were collected from SLH residents who completed an interview six months after baseline (N = 462). Participants rated the importance of eight reasons for choosing SLHs. Multilevel models assessed whether reasons for choosing were associated with outcomes abstinence on the Timeline Followback, psychiatric distress via the Psychiatric Diagnostic Screening Questionnaire (PDSQ), employment problems severity on Addiction Severity Index (ASI), and length of stay (LOS). ResultsThe most frequently cited reasons residents chose SLHs were affordability (74.4 %) and wanting to live with others in recovery (63.2 %). Reasons for choosing were not associated with neither LOS nor abstinence, except for not wanting to live with others in recovery predicting abstinence from all drugs except marijuana. Choosing SLHs due to affordability was associated with less psychiatric distress; no other place to live was associated with increased psychiatric distress (Ps < 0.05). Severity of employment problems was associated with choosing SLHs based on location, transportation, and someone else paying fees (Ps < 0.01). ConclusionResidents seek entry into SLHs to live affordably with others in recovery. Those who had no other option had greater psychiatric distress, thus supporting findings of housing instability being related to mental health. Reasons for choosing related to employment problems severity may reflect how concerns about employment impact housing choices.