Oxford House Residents Research Articles

Perceptions of virtual versus in‐person recovery meetings: A cross‐sectional survey of Oxford House residents

AbstractThis study investigates shifts in the modality of addiction recovery communities from person‐to‐person interactions to virtual platforms in the context of the coronavirus disease of 2019 (COVID‐19) pandemic. Our study involves members of the Oxford House recovery homes (n = 284), a major network of recovery‐supportive housing in the United States and abroad. Many residents participate in 12‐step meetings during their stay, traditionally conducted in‐person, but due to physical distancing regulations, many of these meetings transitioned to virtual platforms. We collected cross‐sectional survey data focusing on user perceptions of virtual 12‐step meetings in terms of accessibility, cost, convenience, support network strength and recovery network quality. Our study found significant differences in perceptions among different demographic groups, suggesting challenges in transitioning recovery support to online platforms. Notably, participants aged 46 and older showed a greater propensity to use online recovery forums and found online meetings convenient. Non‐White individuals and women demonstrated a more favourable perception of online meetings—a trend that also held true among those with at least some college education. Furthermore, the results show that those who initiated their recovery prior to the COVID‐19 lockdown viewed online methods more favourably, particularly in terms of accessibility and cost. Our data also revealed that participants who were categorically involved in 12‐step recovery (Alcoholics Anonymous/Narcotics Anonymous) demonstrated a more positive perception of online methods in terms of the strength of social networks and social support quality, despite some resistance to virtual transition and maintaining focus. Further research is needed to understand these nuanced impacts and develop strategies to enhance the effectiveness of online recovery meetings.

Understanding length of stay in recovery homes

ABSTRACT The current study was based on a longitudinal study of 602 Oxford House residents of which this study focused on 155 who at their first assessment, or baseline, had been in residence for 2 months or less, and we tracked them over time to see how long they remained in the recovery homes. By the time a resident had 6 weeks of residence in the recovery homes, the hazard for leaving the homes had dropped to about 25%. In addition, having an important person from the recovery home in one’s social network predicted lower hazard rates, given accumulated time in residence. The study indicates that the first few weeks in recovery homes are particularly vulnerable times for residents to leave prematurely, so more efforts are needed to better understand why some residents are able to maintain residency during these critical first weeks in these settings.

Lived experiences of Oxford House residents prescribed medication-assisted treatment.

Qualitative studies have examined the recovery experiences of individuals prescribed medication-assisted treatment (MAT), including their experiences within treatment facilities. However, the literature lacks qualitative studies exploring the recovery process of individuals prescribed MAT while living in recovery housing, such as Oxford House (OH). The purpose of this study was to explore how OH residents, who are prescribed MAT, make sense of recovery. The fact that OHs are drug-free recovery housing is what makes the issue of using MATs potentially contentious in these settings. Interpretative phenomenological analysis (IPA) was used to document the lived experiences of individuals prescribed MAT in OH. The sample included: five women and three men, prescribed either methadone or Suboxone, that were living in an OH in the United States. Participants were interviewed on four topics: their recovery process, their transition to OH, and their experience living in and outside of an OH. Analysis of results followed the recommendations for IPA from Smith, Flowers, and Larkin. Four general themes emerged from the data: Recovery Process, Managing Logistics of MAT Utilization, Personal Development, and Familial Values. In conclusion, individuals prescribed MAT did benefit from living in an OH to manage their recovery as well as stay compliant with their medication.

Complex Contexts Within Oxford Houses: Psychiatrically Comorbid Social Networks

ABSTRACT This study aimed to explore whether there are differences between Oxford House recovery home residents with psychiatric comorbidity in their ability to form, maintain, and dissolve loaning ties and seek advice, when compared to Oxford House residents without comorbidity, and if differences do exist, are those ties mono- or bi-directional. Findings indicated unique interdependencies among individuals with psychiatric comorbidity for advice seeking, loaning, and recovery factor scores. The results of this investigation are consistent with the dynamic systems theory conceptions of community-based recovery. Recovery homes provide access to social capital, via the residents’ social network, by facilitating recovery-oriented social exchanges, which can lead to changes to the recovery home social dynamics. Upon interpreting the results of this study, components from a dynamic systems theory emerged (e.g. explaining the processes that preserve or undermine the development, maintenance, and dissolution of a network); and provided a framework for interpreting the loaning, advice-seeking, and the latent recovery factor networks and their relationship with psychiatric comorbidity. A deeper understanding of the interplay among these dynamics is described providing an understanding of how Oxford House recovery homes promote long-term recovery in a shared community setting for those with high psychiatric comorbidity.

An exploratory study of Romanians’ attitudes toward community-based substance abuse recovery housing

This study reports results of a measure of a Romanian community’s attitudes toward addiction and the hypothetical creation of self-run substance abuse recovery homes called Oxford Houses in Iași, Romania. We list five factors needed to sustain an Oxford House: affordable housing, residents following OH principles, resident income, institutional support, and community support. Because individual Oxford Houses are located in ordinary residential neighborhoods, they rely in part on community support. Descriptive data analyses provided information on four groups based on participants’ status: (1) no contact with someone with alcohol misuse; (2) having a potentially alcohol addicted person(s) in their family; (3) definitely having alcohol addicted person(s) in their family; and (4) having an addicted alcohol in recovery person(s) in their family. Results indicated Romanian’s favorable attitude toward alcohol addiction as a treatable condition, benefits of being part of an Oxford House, Oxford House rules and principles, and willingness to organize or to participate in events for integrating Oxford House residents into the community. These findings suggest that Oxford House could potentially be accepted by neighborhood residents in Iași, Romania, and this research could inform future efforts to create Oxford Houses in Romania.

Life after incarceration: The impact of stability on formerly imprisoned Oxford House residents

According to the National Institute on Drug Abuse, roughly 65% of the US prison population is diagnosed with a substance use disorder (SUD) and over 600,000 individuals are released from incarceration yearly. Thus, it is important to better understand the factors that allow individuals recovering from SUD to reintegrate into communities after incarceration. This study sought to understand the relationship between a personality mediator (stability) and quality of life (QOL) and belonging support (BS), as well as the relationship between this mediator and QOL and psychological sense of community (PSOC) for 131 individuals living in Oxford House (OH) recovery homes. Stability was found to mediate the relationship between BS and QOL, as well as PSOC and QOL. The findings suggest that OH is a supportive and positive recovery community for those with criminal justice backgrounds, particularly those with higher stability.

‘Maybe this is the place for me:’ a qualitative study examining needs and length of stay in recovery house residents

ABSTRACT The current qualitative study recruited 10 first-time Oxford House residents to participate in semi-structured interviews to explore their needs and factors affecting their length of stay. Interviews were analyzed using the Interpretative Phenomenological Analysis (IPA) approach. Findings suggest lower-resourced residents are more likely than higher-resourced residents to achieve the therapeutic dose due to higher need fulfillment and the drawbacks associated with group living minimized. For higher-resourced residents, increasing investment in the house through the development of friendships with housemates and participation in service activities could increase their length of stay by increasing their investment in the house. Implications are discussed.

Social Network Cohesion among Veterans Living in Recovery Homes

Recovery homes for individuals with substance use disorders (SUD) called Oxford House (OH) have been shown to improve the prospects of a successful recovery across different sub-populations, and these homes may be particularly beneficial for veterans in recovery. An estimated 18% of OH residents are veterans; however, not much is known about their experiences living in these homes. Participants included 85 veterans and non-veterans living in 13 OHs located in different regions of the United States. Using social network analysis and multi-level modeling, we investigated whether the social networks of veterans residing with other veterans were more cohesive compared to veterans living with only non-veterans. Results indicated that veterans residing with other veterans had stronger relationships with other OH residents than veterans who reside with all non-veterans. The implications for theory and practice are discussed. Further research is needed to determine if greater social network cohesion leads to better recovery outcomes for veterans.

Homophily Effects Among Oxford House Residents Utilizing Medication Assisted Treatment

ABSTRACT The effects of social support among persons utilizing medication assisted treatment (MAT) living in abstinence-based recovery homes is not clearly understood, and there is a need to identify social process components that engender social support for this population. The present investigation examined whether homophily (i.e., living with/without fellow MAT residents) among recovery home residents would moderate the mediating effects of social support on the relationships between stress and two recovery outcomes (quality of life, abstinence self-efficacy) among a sample of persons utilizing MAT living in recovery homes (Oxford Houses) in the U.S. Moderated mediational analyses were conducted to test whether potential mediating effects were moderated by homophily. Mediating effects were observed in both models, but they were significant only through the moderator (homophily) in that social support buffered the effects of stress among MAT residents who lived with other MAT residents in their recovery homes. Findings suggest that homophily effects are related to social networking for persons utilizing MAT living in abstinence-based recovery homes.

Medications for Opioid Use Disorder Utilization Among Oxford House Residents

Medications for opioid use disorder (MOUD) and recovery homes that have traditionally served those not taking medications for their recovery are important resources for treating opioid use disorder. However, little is known whether such recovery homes are a good fit for persons utilizing MOUD, and whether residents' characteristics such as drug histories and the composition of recovery homes in terms MOUD and non-MOUD residents are related to attitudes toward MOUD. The present investigation examined characteristics of persons utilizing MOUD, and attitudes regarding MOUD utilization among residents living in recovery homes (Oxford Houses, OH) in the U.S. consisting of MOUD and non-MOUD residents. Residents living with others who were utilizing MOUD reported more favorable attitudes than residents who were not living with such residents, but this was observed only among residents whose primary drug of choice involved heroin or opioids. There were no significant differences observed in terms of abstinence rates, involvement in 12-step groups, or previous MOUD treatments between residents utilizing or not utilizing MOUD. Findings suggest that persons utilizing MOUD benefit by recovery homes such as OHs whose residents have favorable attitudes toward MOUD, especially when living with fellow residents who utilize MOUD.

Social Support among Oxford House Residents Utilizing Medication-Assisted Treatments

ABSTRACTSocial support is a resource frequently utilized by persons recovering from substance use disorders. However, little is known about the effects of social support among persons utilizing medication-assisted treatments (MATs) living in abstinence-based recovery homes. The present investigation examined whether social support would mediate the relationship between stress and two recovery outcomes (quality of life and abstinence self-efficacy) among a sample of residents living in Oxford House abstinence-based recovery homes in the U.S. Moderated mediational analyses were conducted to test whether potential mediating effects were influenced by whether residents were (or were not) utilizing MATs. Mediating effects were observed in both models, and these were not moderated by residents’ MAT status. Findings suggest abstinence-based recovery homes such as Oxford Houses provide valuable social support that helps persons utilizing MATs in their recovery.

Quality of life as a predictor of social relationships in Oxford House

Improved access to housing and recovery support is a low-cost, high-potential opportunity to help people recovering from alcohol and substance use sustain their recoveries. Oxford House (OH) recovery homes represent a recovery-favorable social environment for at least some people, but it is still unclear which resident characteristics and relational dynamics affect the social integration of residents. In the current study, OH residents in three geographic locations completed a social network instrument and self-rated their quality of life (QOL). The instruments were administered to the current (per wave) residents of 42 OHs at three time points over a period of a year. Findings indicated that those with a higher QOL were more likely to form friendships with those with a lower QOL than with their similar QOL peers, and vice versa. This finding would not have been predicted based on relationship mechanisms typical of broader social contexts, where homophily (similarity-based assortativity) is common. The self-governance model that characterizes OH residences, in which success among residents is necessarily viewed as mutually dependent and therefore mutually beneficial, seems a likely explanation for our result. Specifically, and aligned with current knowledge about what works in peer oriented recovery, our results suggest the governance mechanisms of OH favor relationships between those more stable in their recovery and those who are at a higher risk of dropout or relapse. This study reveals a potential research avenue examining an important ingredient for the effectiveness of OH.

Gender Differences in the Association Between Romantic Relationships and Relapse Among Individuals in Early Recovery in Oxford House

ABSTRACTAlthough clear gender differences exist in the effect of romantic relationships on substance use, little empirical evidence is available about whether romantic relationships affect recovery differently for men and women. To test potential gender differences in associations of romantic partner relationships with relapse among Oxford House residents. Self-reported presence or absence of a romantic relationship among Oxford House residents ages 18–59 (N = 306) in early recovery was assessed at baseline and 4 months later, beginning in 2001. Odds of relapse over 8 months was assessed by the interaction of presence of romantic relationship at each occasion and gender. Relapse was most common among men in a relationship at baseline and follow-up and women not in a relationship at either occasion, occurring with significantly greater odds than women in a relationship at both times, after adjusting for days of sobriety at baseline (adjusted odds ratio [ORadjusted] = 3.50; 95% confidence interval [CI] [1.29, 9.51]; ORadjusted: 3.35; 95% CI [1.24, 9.10]). These findings provide initial empirical understanding of gender differences in the influence of romantic relationships in early recovery.

Correction to: Oxford House Residents' Attitudes Toward Medication Assisted Treatment Use in Fellow Residents.

The original version of this article unfortunately contained a mistake in the author group, where co-authors Isabel Dovale, Noah Gelfman and Sarah Callahan were missed to include and Brandon Isler should be removed from the author group.

METHODOLOGICAL PLURALISM AND MIXED METHODOLOGY TO STRENGTHEN COMMUNITY PSYCHOLOGY RESEARCH: AN EXAMPLE FROM OXFORD HOUSE.

This article evaluates how a plurality of research methods has served a research program that has functioned in a much-needed area of research: the role of housing and recovery residences in addiction recovery. The review focuses on one mutually supportive recovery residence model, called Oxford House, which represents more than 1,700 democratic, self-governing residences. To date, there has been no comprehensive evaluation of the research methods used with Oxford House or any other recovery residence. In this article, research methods, including study designs and data analyses, are summarized for 114 peer-reviewed empirical studies that included data on Oxford Houses or Oxford House residents. This review of a pluralistic research program can inform community researchers about the value of recovery residences, the many ways in which recovery residences may be assessed, and the benefits of using multiple methods. Implications for future recovery residence research are discussed.

Vocational Training and Employment Attainment among Substance Abuse Recovering Individuals within a Communal Living Environment.

The present study explored the effects of length of stay in an Oxford House (a sober living environment) with the number of days attended school/vocational training and days worked in the past 90 days with 292 women and 604 men. This paper presents quantitative data. Results indicated that number of days residing in these recovery homes was related to number of days attending school/vocational training and days worked. The present study suggested that in addition to staying abstinent from alcohol and drugs, Oxford House residents may gain useful life skills through vocational education, training, and employment. This is an area of further exploration for the substance abuse recovery community.

Gambling Behaviors Among Oxford House Residents: A Preliminary Investigation

ABSTRACT The present study investigated the prevalence of gambling behaviors among 71 individuals recovering from substance-dependent disorders and living in self-run recovery homes (Oxford Houses). Residents were given the South Oaks Gambling Screen to assess gambling behaviors and pathological gambling, and 19.7% of the sample was identified as having probable pathological gambling. These residents reported proportionately more involvement in a variety of gambling behaviors than other residents. Engagement in various gambling activities was consistent with previous investigations and suggested that self-run recovery homes such as Oxford Houses might be suitable referral sources for recovering persons who have comorbid gambling problems.

12-Step involvement among a U.S. national sample of Oxford House residents

A longitudinal analysis was conducted among a U.S. national sample of persons affiliated with Alcoholics Anonymous and Narcotics Anonymous living in self-run recovery homes (Oxford Houses). Categorical involvement in a set of 12-step activities (i.e., having a sponsor, reading 12-step literature, doing service work, and calling other members for help) and averaged summary scores of involvement were examined in relation to abstinence and self-efficacy for abstinence. Participants who were categorically involved in all 12-step activities reported significantly higher levels of abstinence and self-efficacy for abstinence at 1 year compared with those who were less involved, whereas averaged summary scores of involvement were not a significant predictor of abstinence. Participants' number of days in Oxford Houses, but not rates of 12-step meeting attendance, was significantly related to increased abstinence. Findings suggest that categorical involvement in a number of 12-step activities equip persons with substance use disorders with resources for ongoing recovery.

A Longitudinal Analysis of Psychiatric Severity upon Outcomes Among Substance Abusers Residing in Self‐Help Settings

A longitudinal analysis of psychiatric severity was conducted with a national sample of recovering substance abusers living in Oxford Houses, which are self-run, self-help settings. Outcomes related to residents' psychiatric severity were examined at three follow-up intervals over one year. Over time, Oxford House residents with high versus low baseline psychiatric severity reported significantly more days using psychiatric medication, decreased outpatient psychiatric treatment, yet no significant differences for number of days abstinent and time living in an Oxford House. These findings suggest that a high level of psychiatric severity is not an impediment to residing in self-run, self-help settings such as Oxford House among persons with psychiatric comorbid substance use disorders.

Oxford House: Deaf-Affirmative Support for Substance Abuse Recovery

Deaf individuals seeking substance abuse recovery are less likely to have access to treatment and aftercare services because of a lack of culturally and linguistically specific programs and insufficient information about existing services. Previous research indicates that Oxford House, a network of resident-run recovery homes, serves a diverse group of individuals in recovery. However, research has not addressed the experiences of Deaf Oxford House residents. The present study found no significant differences between Deaf and hearing men living in Oxford House in terms of sense of community and abstinence self-efficacy. However, while most of the hearing participants were employed, none of the Deaf Oxford House members were. The study's findings indicate that Oxford House may be a promising Deaf-affirmative alternative for individuals seeking recovery from substance abuse. However, since Oxford Houses are self-supporting, Oxford Houses designed for the Deaf community may face unique economic challenges.