Oxford House Research Articles

NASADAD head wins Oxford House award

Last week Robert Morrison, executive director of the National Association of State Alcohol and Drug Agency Directors (NASADAD) received the 2024 Tom Fellows Award for service from Oxford House Inc. at the world convention held in Orlando, Florida.

Positive Associations between Women’s Employment at the Community-Level and Opportunities and Interpersonal Sharing within Recovery Homes

The background of this study was an investigation of a sustainability issue involving how to deal with increasing deaths due to substance use as well as housing instability among those with substance use problems. Our study investigated the relationship between community-level women’s employment and two key variables within Oxford House recovery homes: levels of employment and the sharing of resources among residents. These variables are crucial for the sustainability of recovery homes as they contribute to maintaining an ecological balance in communities. For our methods, we gathered data from recovery homes located in three different regions of the United States. The focus was on examining how women’s employment rates in these communities correlate with the employment statuses of house residents and their resource-sharing behaviors. Regarding the results, we found a positive association between rates of employment among women in these communities and employment within the recovery housesand resource lending among residents. We conclude that women’s employment at the community-level appears to be a significant macro-level factor that promotes supportive social and environmental policies. These community-level policies enhance employment opportunities and encourage interpersonal sharing within recovery homes, contributing to ecological balance and sustainability in terms of environmental, economic, and social dimensions.

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.

Effects of strength of relationship ties in recovery homes: A conundrum

Recovery homes are a widespread source of support for those attempting to maintain abstinence. For those who are able to remain in these settings for at least 6 months, outcomes tend to be favorable; however, many leave prematurely. There is a need to better understand the social integration processes that play a major role in giving recovery home residents access to available recovery-related social capital that is associated with better outcomes. The current study involved Oxford House recovery homes in 3 states and examined the strength of relationship ties among house members. We found that those who associated with peers who have higher recovery scores tend to improve their own recovery scores over time. However, we also found that those with higher recovery scores tended to create “strong” ties with similarly high-scoring alters; likewise lower-scoring individuals preferentially formed strong ties with each other. These findings suggest a conundrum: recovery home residents most in need of relational support from more recovered housemates are the least likely to obtain it. We discuss possible pathways to creating more ties between high and low-recovered residents.

The Fur Trader: From Oslo to Oxford House, Einar Odd Mortensen Sr. with Gerd Kjustad Mortensen Edited by Ingrid Urberg and Daniel Sims

The Fur Trader: From Oslo to Oxford House, Einar Odd Mortensen Sr. with Gerd Kjustad Mortensen Edited by Ingrid Urberg and Daniel Sims

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.

The Fur Trader: From Oslo House to Oxford House, by Einar Odd Mortensen Sr. with Gerd Kjustad Mortensen

The Fur Trader: From Oslo House to Oxford House, by Einar Odd Mortensen Sr. with Gerd Kjustad Mortensen

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.

Benefits of Continuing Linkages to Recovery Homes Following Departure

There is a need to better understand social mechanisms that increase or decrease successful departures from recovery homes. A prior study found that involuntary departure as well as one’s personal social capital were important to sustaining recovery following the departure from recovery homes. Little is known about what house contextual or interpersonal factors explain who successfully exits these recovery settings. In the present study, we examined continued linkages to Oxford House recovery homes following departure, using questions concerning 1. Continuing to visit their previous recovery home, 2. Maintaining contact with the Oxford House Organization, 3. Continuing to see people they saw as residents following departure, and 4. Continuing to attend the same AA/NA meetings that had been attended as an Oxford House resident. Residents with continued linkages to the recovery home were found to evidence significant increases in self-efficacy as well as abstinence following departure. For those that remained most linked by answering all four questions positively, 95% remained abstinent following leaving the recovery homes. The implications of these findings are discussed in terms of possible changes in constructing a new social identity.

The growth of recovery capital in clients of recovery residences in Florida, USA: a quantitative pilot study of changes in REC-CAP profile scores

BackgroundThere is a growing evidence base around predictors of retention and completion in a range of recovery residence models, particularly Oxford Houses and Sober Living Houses, and recovery housing is recognized as a clearly evidenced area of recovery intervention. The aim of the study was to quantitatively assess recovery capital in a sample of recovery residence clients.MethodThe study used a repeated measures self-completion of a standardized recovery capital instrument (REC-CAP) for clients retained across various houses within one Level 2 recovery residence provider whose program was based on a 12-step approach. While 823 clients participated in the baseline assessment, a sample of 267 clients was achieved for six-month follow-up interview, based on those retained in the residence. A logistic regression model examined factors associated with retention and a repeated measures marginal mixed model evaluated the factors associated with changes in recovery capital between the baseline and the follow-up assessment.ResultsMembers of the group that remained in recovery residences were more likely to be older with a record of high participation in recovery groups, with greater drop-out among younger residents, female residents and those with an identified housing need. For those retained to follow-up, greater recovery capital growth was associated with employment, higher levels of social support and more recovery group involvement, as well as age and a higher quality of life. The need for family support was shown to reduce levels of recovery capital. However, those younger people who were retained reported better recovery capital growth during the initial six months of residence.ConclusionThe key conclusion is that while recovery capital generally increases during a stay in a recovery residence, it does not do so consistently across the sample population. This has implications for how pathways to recovery group engagement are supported for women and young people and how social support (encompassing housing, employment and family issues) is provided to those populations during periods of residence. This suggests the potential need for training and guidance for house managers working with these groups.

Social integration in recovery living environments: A dynamic network approach.

Oxford Houses (OHs) are a large network of self-runcommunity-based settings for individuals with substance use disorders. This present study explored a model based on conceptualizing recovery home social systems as dynamicmultirelational (multiplex) social networks. The model is developed from data obtained from 42 OH recovery homes in three parts of the US, addressing whole networks of friendship, close friendship, and willingness to loan money. Findings indicated that close friend and loan relationships mutually reinforced each other over time as they coevolved. These types of insights can help community psychologists to better understand complex network dynamics in community-based settings.

Willingness to lend resources is associated with increases in recovery and participation in community activities

ABSTRACT Recovery homes may facilitate individuals with substance use disorders re-integration back into community settings by providing friendship, resources, and advice. Participants of the current study were over 600 residents of 42 Oxford House recovery homes. Findings indicated that willingness to share resources in the form of loans was associated with higher levels of house involvement in recovery home chapters. Active involvement in house and community affairs may influence more recovery within homes or may be an indicator of houses with residents with more capacities and skills for positive long-term health outcomes. Such findings suggest that recovery is a dynamic process with multiple ecological layers embedding individuals, their immediate social networks, and the wider community.

An examination of abstinence social support among recovery home residents with psychiatric comorbidity

BackgroundAlthough social support is a resource that helps persons in their recovery from substance use disorders, it is not clear whether specific types buffer the effects of stress and optimize outcomes for those with psychiatric comorbidity. This investigation examined two types of social support in relation to lengths of stay to identify mechanisms related to retention among individuals with psychiatric comorbidity living in community-based settings. MethodsBaseline rates of social support (abstinence specific and general types) and stress were examined in relation to follow-up lengths of stay (at four-months and beyond) among individuals (N = 368) with psychiatric comorbidity (n = 90) and no psychiatric comorbidity (n = 278) living in community-based settings (Oxford Houses) in the U.S. The psychiatric severity index of the Addiction Severity Index was used as a proxy measure of psychiatric comorbidity. Moderated mediation analyses were conducted to test the potential mediating effects of abstinence social support and general social support on the relationship between stress and lengths of stay, and whether these were influenced by psychiatric comorbidity. ResultsA full mediating effect was observed for abstinence social support for residents with psychiatric comorbidity, whereas a partial mediating effect for general social support was observed for all residents. ConclusionsFindings demonstrate qualities of social support have differential effects, substantiating the notion that specific components of social support optimize outcomes for those with psychiatric comorbidity living in recovery homes.

Dynamic interdependence of advice seeking, loaning, and recovery characteristics in recovery homes

ABSTRACT Recovery homes in the US provide stable housing for over 250,000 individuals with past histories of homelessness, psychiatric comorbidity and criminal justice involvement. We need to know more about how these settings help those who remain in recovery. Our study measured advice seeking and willingness-to-loan relationships, and operationalized them as a dynamic multiplex social network—multiple, simultaneous interdependent relationships—that exist within 42 Oxford House recovery homes over time. By pooling relationship dynamics across recovery houses, a Stochastic Actor-Oriented Modeling (SAOM) framework was used to estimate a set of parameters governing the evolution of the network and the recovery attributes of the nodes simultaneously. Findings indicated that advice and loan relationships and recovery-related attitudes were endogenously interdependent, and these results were affected exogenously by gender, ethnicity, and reason for leaving the recovery houses. Prior findings had indicated that higher advice seeking in recovery houses was related to higher levels of stress with more negative outcomes. However, the current study found that recovery is enhanced over time if advice was sought from residents with higher recovery scores. Our study shows that social embedding, i.e., one’s position in relationship networks affects recovery prospects. More specifically, the formation of ties with relatively more recovered residents is an important predictor of better outcomes.

Medication assisted therapy and recovery homes

There is a need to better understand improved recovery supportive services for those on Medication Assisted Treatment (MAT) for opioid use disorder (OUD) and, at the same time, enhance the available treatment interventions and positive long-term outcomes for this vulnerable population. A growing empirical literature supports the assertion that improved access to housing and recovery support is a low-cost, high-potential opportunity that could help former substance users who are utilizing MAT to sustain their recovery. Recovery home support could serve the populations that need them most, namely servicing a significant number of the enrolled in MAT programs. The two largest networks of recovery homes are staff run Traditional Recovery Homes (TRH) and self-run Oxford House Recovery Homes (OH). There is a need to better understand how substance users on MAT respond to recovery homes, as well as how those in recovery homes feel toward those on MAT and how any barriers to those utilizing MAT may be reduced. Recovery may be an outcome of the transactional process between the recovering individual and his/her social environment. In particular, how recovery houses can help people on MAT attain long-term recovery.

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.

"It's like a Brotherhood": Thematic analysis of veterans' identity processes in substance abuse recovery homes.

This exploratory study aimed to understand how veterans' social identity influenced their experiences living in Oxford Houses (OH)-the largest network of substance use recovery homes in the United States. We conducted three focus groups, with 20 veterans who were current or former OH residents. Thematic analysis revealed several ways in which participants' veteran identity influenced their experiences living in OH, including: (1) thriving through OH organizational similarities with the military, (2) relationships with other OH residents, and (3) and growth and reintegration. The themes were interpreted using the Social Identity Theory and the Social Identity Model of Identity Change perspectives. Social identity processes were found to play an influential role in veterans' experiences in their recovery homes and reintegration into civilian life. Findings highlight the importance of veterans developing a community within a culturally congruent setting to facilitate their recovery from substance use disorders and adjustment to life post-military service.

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.

Individuals in sober living: Effects of contact with substance using family members

This study examines the effects that substance-using family members have on those working to maintain recovery from substance use disorder. Participants (N = 229) were recruited from Oxford Houses (OH) across North Carolina, Texas, and Oregon. A stepwise linear regression with variables including abstinence self-efficacy, gender, substance use, attendance of Alcoholics Anonymous, and conflict with family and non-family was run to examine associations between the amount of substance using family members in the participant’s social network. The abstinence self-efficacy mean score, gender, and days of serious conflict with non-family members were significantly associated with total number of substance-using family members in a participant’s social network. These results may indicate that OH’s serve as a buffer between substance using family members and one’s abstinence self-efficacy. It remains unclear if individuals are at an increased risk of relapse from this familial influence when perceived abstinence self-efficacy drops. If so, OH residents could benefit from interventions that help them maintain their perceived abstinence self-efficacy.