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William Glanz

Senior Writer at the National Council for Behavioral Health

Recovery Homes Build a Following, but There’s Plenty of Room to Grow

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Korey McCreery (center, with helmet), COO at Phoenix Recovery Support Services, in Canton, Ohio, poses with a group of military veterans from the program’s intensive outpatient program residence at the Pro Football Hall of Fame.

Korey McCreery knows exactly how much time he spent in a recovery home.

“Thirteen months and one day,” he said.

He also knows spending more than a year at the Canton, Ohio, home operated by Phoenix Recovery Support Services did much more than keep his alcoholism and substance use disorder under control.

It kept him alive.

“If it wasn’t for the clean, safe, sober living environment provided by the recovery house, I would not be talking to you today,” McCreery said. “The recovery house helped save my life.”

Stories of recovery like McCreery’s are less common than they could be because widespread adoption of the recovery housing model among state governments remains elusive.

The homes – peer-run or peer-managed drug and alcohol-free supportive housing for people in recovery from substance use disorders (SUD) – have slowly gained traction in the U.S. as a crucial element of treatment and recovery because they help residents access outpatient treatment and peer support services. While people in recovery can voluntarily choose to live in recovery housing, many end up in the homes after receiving a referral from a treatment provider or the criminal justice system.

“Some states really get it,” said Dave Sheridan, executive director of the National Alliance for Recovery Residences (NARR), which establishes standards for recovery homes and works with state agencies to ensure those homes are recognized by state health departments. “If a state agency understands they need to support treatment and recovery through support for recovery homes, that helps people in recovery. But some states are behind the curve and have yet to adopt this more expansive vision to support recovery.”

Sheridan and a group of others – including the National Council’s Tom Hill – began their efforts to formalize standards for recovery homes 10 years ago, at a meeting in Atlanta in May 2010. They were motivated by the firm belief that people in recovery had too few options, which in turn led them to experience relapses, recidivism, and other life-threatening pitfalls. They were also motivated by the understanding that substance use disorders are a chronic condition that require long-term treatment.

Relying on short-term inpatient care does not allow a person to overcome a substance use disorder, Hill said.

“The growth in the number of recovery homes in the U.S. matches the realization that this is a necessary service,” he said.

In states including Ohio, West Virginia and Oklahoma, state health directors understand the value recovery homes provide to people and communities. The National Council – in partnership with NARR – has prepared an extensive resource, Building Recovery: State Policy Guide for Supporting Recovery Housing, to help states develop the policies to ensure development of recovery housing.

Ohio officials embraced recovery homes soon after a 2013 study demonstrated the demand the homes would meet. Elected officials in the state approved formal language in 2016 to define recovery housing and established a requirement that communities include the homes in required community plans as a way of responding to the opioid crisis.

The state also has leveraged both federal and state resources to support recovery homes, providing funding that covers everything from planning, to construction or renovation, to operational and technical costs. That funding also provides support for Ohio Recovery Housing, the non-profit group that certifies recovery homes and is a NARR affiliate.

Few states have had such a progressive response.

“We have a long way to go,” said Danielle Gray, executive director of Ohio Recovery Housing. “But every time I talk to people in other states, I realize how lucky we are. We have made so much progress in Ohio.”

In 2017, 93 certified recovery houses in Ohio had 1,012 clients.

Today, 225 certified recovery houses in the state have 2,076 clients.

In Ohio, as in other states, the number of people who would benefit from a recovery home far exceeds the space to accommodate people in recovery.

“There’s more demand than available housing,” Gray said.

With the nation’s opioid crisis surging – overdoses and overdose deaths are on the rise – demand continues to grow.

“These homes support recovery,” said Mike Maddox, director of the Oklahoma Alliance for Recovery Residences, which formed this year and affiliated with NARR.

Oklahoma’s nascent support for recovery housing has received a big boost from the state’s Department of Mental Health and Substance Abuse Services, which has set aside $500,000 for vouchers to subsidize housing costs for clients, and the number of recovery homes in Oklahoma will grow from seven at the beginning of October to 21 – with an estimated 450 residents – by the end of the month as Maddox races to license homes throughout the state.

“Inpatient treatment alone is not the answer. There should be a continuation of services once inpatient treatment is completed – recovery housing and outpatient treatment,” Maddox said. “Levels of care are vital to recovery. Our state has helped us legitimize recovery housing, and now we’re trying to make sure we have them throughout Oklahoma because there’s a huge need.”

And NARR continues its efforts to increase the number of licensed recovery homes nationwide.

Estimates vary widely, but one study published this year in Alcoholism Treatment Quarterly determined there are 17,943 recovery homes in the country. But the absence of a single, agreed upon national standard for recovery home standards and oversight means the number of homes varies depending on which organization is doing the counting. The study counts 1,470 homes affiliated with NARR. Intervention America, a California-based drug and alcohol treatment resource that publishes a directory of recovery homes, includes more than 14,000 residences.

The discrepancy illustrates the problem with an absence of standards and conflicting criteria about what constitutes a recovery home, Sheridan said.

What’s more important, is the number of people who rely on the recovery homes. Just 1.2 percent of people with a substance use disorder use recovery homes, according to the authors of the study published in Alcoholism Treatment Quarterly, despite the finding that “recovery homes are an important and widespread post-treatment recovery resource.”

Recovery homes also have proved crucial for people who don’t require treatment, Sheridan said, which demonstrates that there are many pathways that lead people in recovery to the homes.

The winding path McCreery took began with a litany of arrests and culminated in the understanding that he had to commit to his recovery or risk more time in incarceration.

“I said to myself ‘you’re not going to make it in prison’,” he recalls. “I knew I needed to find a way not to drink.”

When he left the program in 2010, he emerged with first-hand knowledge of the value of the homes and the programs they provide people in recovery. Now he delivers that message every day because McCreery, a former recovery home resident, serves as the chief operating office at Phoenix Recovery Support Services.

“I wouldn’t be the person I am today if it wasn’t for the peer services provided by the recovery house,” he said. “Recovery happens in these homes.”