Transitional Planning for Life After Rehab

Life After Rehab: Important Considerations

Where you live after rehab is central to long-term recovery, and it’s one of the most important components to successful abstinence from drugs and alcohol. Relapse rates are significantly higher during the first year of recovery, and one of the biggest predictors of relapse is exposure to drugs or alcohol via family members or friends. These environmental cues were among the top triggers of relapse for those in early recovery, according to a study in the Journal of Addiction Research & Therapy.

Lower levels of social support also tend to correlate with higher risks of relapse. In contrast, research cited by the Substance Abuse and Mental Health Services Administration has found that at least four forms of social support—emotional, informational, instrumental and affiliational—can facilitate recovery.

Your post-treatment living environment will thus be critically important to your recovery. Two basic but very important related questions to ask when considering any post-rehab living situation will be:

• What degree of exposure to drugs and alcohol will I encounter there?
• What level of social support will it offer me in my recovery?

Sober Living Houses

“Sober living houses” (SLHs) are drug- and alcohol-free residences for those in early recovery. They are meant to provide a stable living environment that supports abstinence from drugs and alcohol, via shared rules and expectations governing members’ behavior and participation. One frequent prerequisite is participation in a 12-step group, and if 12-step meeting attendance is not expressly mandated, it is strongly encouraged.

A decisive factor for many who choose a SLH after rehab is the social network these residential communities provide, which is also associated with better recovery outcomes according to a scientific overview of sober living houses by the National Institutes of Health. The same study evaluated six-month recovery outcomes for residents in one coalition of sober living homes and found SLHs improved recovery outcomes at the six-month mark.

Knowing the particular policies of any SLH under consideration is critical to making a wise decision regarding the SLH that is right for you. Whenever possible, it is advisable to visit the residence in person.

This tip and others for evaluating prospective SLHs appear in a blog post by Director of Alumni Success Micah Robbins at Beach House Center for Recovery. Robbins recommends some helpful resources for researching SLHs. He also provides advice about specific questions to ask when visiting a prospective SLH.

Along with operating policies, there are various models for SLHs. The Oxford House model is a well-known example. These communal recovery settings are democratically run; there are houses for men, houses for women, and houses for women and children; and the number of residents in a house can range from six to 15. Other SLHs follow a non-democratic model, with one landlord or manager in charge of day-to-day operations.

The National Alliance for Recovery Residences is a reliable source of information about SLHs and a good way to connect with one in your area.

Halfway Houses

Halfway houses are another post-treatment living option for some people in early recovery, depending on their circumstances. Like SLHs, halfway houses ideally provide the benefits of a drug and alcohol-free living environment and access to greater social support in the journey to full recovery.

Halfway houses differ from SLHs in some crucial ways. For as often as the terms SLH and halfway house are used interchangeably—and some states (depending on their legal requirements) may recognize SLHs and halfway houses as essentially the same thing—there generally are a number of differences worth noting:

• Halfway houses require residents to be involved in treatment (either on-site or via another outpatient program), whereas SLHs do not mandate this treatment component and exclusively emphasize peer support for recovery.
• Halfway houses depend largely on government funding. That means residents often stay there at little to no charge. SLHs are private, self-sustaining entities that are able to exist because their residents pay rent.
• Residents of halfway houses stay there for a limited period of time, at the end of which they are required to move out whether or not they feel ready for independent living. In contrast, because residents of SLHs are responsible for their own rent, they generally can live there until they choose to leave (so long as they are fulfilling the requirements of living there).
• Halfway houses are often a mandatory form of transitional living for those in the substance abuse population whose addiction has involved the presence of a severe mental illness and/or incarceration immediately prior. SLHs, on the other hand, are entirely voluntary associations.