Oxford Self-help housing for alcoholics and addicts – sobriety plus responsibility

Oxford Houses are democratic, mutual help–oriented recovery homes for individuals with substance abuse histories. There are more than 1200 of these houses in the United States, and each home is operated independently by its residents, without help from professional staff.  In a recent experiment, 150 individuals in Illinois were randomly assigned to either an Oxford House or usual-care condition (i.e., outpatient treatment or self-help groups) after substance abuse treatment discharge. At the 24-month follow-up, those in the Oxford House condition compared with the usual-care condition had significantly lower substance use, significantly higher monthly income, and significantly lower incarceration rates.

KEY FINDINGS

• Given the high costs of substance abuse disorders to society in general, and to the health care delivery system in particular, the results of this randomized test of the efficacy of a low-cost, self-help housing intervention compared with the usual services provided after inpatient substance abuse treatment have major public health implications. • Because residents pay all expenses, these types of self-governed settings have important public policy implications for stabilizing individuals with substance abuse histories, especially in an era of cutbacks in funding for a variety of social service programs.

The Oxford House Model

• The house must be democratically self-run. • The house membership is responsible for all household expenses. Each house is fully responsible for its own expenses and debts.

• An individual recovering from drug or alcohol addiction can live in an Oxford House for as long as he or she does not drink alcohol, does not use drugs, and pays an equal share of the house expenses. The house must immediately expel any member who uses alcohol or drugs.

• The average stay is a little more than a year, but many residents stay 3 or more years.

• There are men-only houses and women-only houses, but no houses for both groups to live together.

• Any recovering alcoholic or drug addict can apply to get into any Oxford House by filling out an application and being interviewed by the existing members of the house.

• Any group of individuals recovering from alcohol or drug addiction can start a new Oxford House. All they need to do is to find a house to rent in the name of the group and apply to Oxford House Inc for a charter.

• Oxford Houses have 6 to 10 members. A house with fewer than 6 individuals is difficult to maintain because of the small size of the group and the fact that any vacancy causes a greater disruption of the financial welfare of the house. A house must have 6 or more residents to be recognized or chartered by Oxford House.

• There is no time limit on sobriety before coming into an Oxford House. Generally, an individual comes into an Oxford House after a 28-day rehabilitation program or a 5- to 10-day detoxification program. 

Leonard A. Jason, PhD, Bradley D. Olson, PhD, Joseph R. Ferrari, PhD, and Anthony T. Lo Sasso, PhD. Communal Housing Settings Enhance Substance Abuse Recovery. (Am J Public Health. 2006;96:1727–1729.)

 

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