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Once a person completes a rehabilitation program, they must focus on staying sober. For people who need to stay out of their original environment due to emotional triggers or negative friends and family, returning home after an inpatient rehabilitation program may cause a lot of stress; this could, in turn, trigger cravings and compulsions around substance abuse. It is very important for people working to maintain their sobriety to have options that can help them stay sober and healthy. Sober living homes are working to fill that need.
A sober living home is a transitional environment for people who want to develop a regular routine, including finding a job or entering school. The point of sober living homes is to offer a safe, supportive environment for a small number of people working to maintain abstinence and continue to overcome their addictions. Based on halfway houses from the 1970s, sober living homes are becoming more and more popular, so states with numerous sober living homes are working to regulate these facilities. There are typically between four and eight residents in these homes, depending on state regulations, and they are in safe, residential neighborhoods.
People who go into sober living do so with the understanding that they must pay their own way. Insurance does not cover these facilities. The point, instead, is for the resident to find a job or a source of income while they are going to school, like a grant or fellowship. This pays for rent and bills; they must also pay for their own groceries and personal expenses.
Sober living homes and facilities say that residents can stay as long as they want, provided they follow the rules. However, people typically stay for less than one year while they transition into a stable routine. Sober living should not be confused with long-term residential treatment, as residents of sober living homes have more freedom to find work or get an education, and they undergo less intensive therapy.
The National Institute on Drug Abuse (NIDA) recommends that a person overcoming addiction go into a rehabilitation program for at least three months, or 90 days. This recommendation does not include the time it takes to detox from the substance of abuse, and it does not consider additional, ongoing support after the person leaves rehabilitation.
Sober living homes are not rehabilitation programs, and many require that residents complete a rehabilitation programbefore applying to the facility. Although NIDA recommends 90 days in rehabilitation, then other transitional programs after that, most insurance companies do not cover this length of stay. Since the Affordable Care Act passed in 2010, insurance companies have been required to cover some of the costs associated with treatment for drug and alcohol abuse, but most insurance companies cap that coverage at one month, or 30 days. While there are successful rehabilitation programs that last only one month, this does not meet NIDA’s suggestion and may not provide enough therapeutic support.
Increasingly, people turn to sober living homes to fill the gap between the rehabilitation program their insurance would cover and the need for ongoing therapy and social support. Since sober living requires that residents continue attending support groups and therapy, residents get that level of support. At the same time, they have leeway to find a job, or can get financial help from friends and family, to pay their own rent as they develop a sober lifestyle.
An article in Psychology Today noted that maintaining sobriety for at least one year after treatment dramatically improved long-term outcomes, including relapse avoidance. The article quoted an eight-year study involving 1,200 people recovering from addiction. In a follow-up survey involving 94 percent of the original participants, the study found:
While NIDA recommends 90 days of rehabilitation, there is a clear need, backed up by the study, for ongoing support after leaving a drug or alcohol rehabilitation program. Maintaining abstinence for one year or longer requires help from friends, family, and professionals. By entering a sober living home, a person overcoming addiction has found a way to get support to maintain their abstinence, avoid relapse, and get the help they need in therapy and support groups.
When residents of sober living homes were allowed to stay in this supportive environment as long as they wanted, a 2010 study found that residents in one facility stayed an average of 254 days (about 7-8 months), while residents of another facility stayed an average of 166 days (about 5.5 months). As a result, sober living residents maintained abstinence longer in 12-month and 18-month follow-ups.
The focus of residence in a sober living home is for a person to develop habits and skills that can help them maintain abstinence for the rest of their lives. In a secure, supportive environment, the person can continue the work they began in rehabilitation. A blog entry on Psych Central noted that long-term recovery options helped the person’s brain heal, allowed new habits to take full effect, and enforced new skills. They also allowed residents to continue working with therapists and/or support groups to focus on relapse prevention.
In a NIDA publication focused on individual counseling for cocaine addiction, the focus on long-term therapy after three months helped the counselor guide their client on treatment issues like:
Living in a sober home helps provide a safe environment for the person to work on these issues with their counselor, whether they are overcoming cocaine addiction or another substance abuse disorder. A sober living home can help them build a daily routine that supports abstinence from drugs and alcohol. Once they decide to leave the sober living home, the person should have a strong foundation to continue their sobriety.