Should I go to a sober living house or residential rehabilitation for my addiction?
There are many options available to people in early recovery, seeking help in overcoming a substance addiction. Some people will choose to attend an inpatient treatment detox program.
Following graduation from the detox program, they may then decide to attend residential rehab for substance abuse treatment for up to a month or more.
After leaving drug rehab, clients often move into a sober living house. Living in a recovery residence is a transitional stage, helping a person to go from active substance abuse to living a life of recovery and responsibility.
Is it possible that a sober house could fulfill the needs met by a traditional addiction treatment center? When it comes to sober living vs rehab, it might be possible that a formal treatment facility is not always necessary for all people seeking addiction recovery.
For example, there are people who choose to skip rehab treatment programs altogether, instead choosing outpatient medical care over residential treatment. They may choose to go to a private doctor for Suboxone treatment, if they have an opioid addiction issue. Or, if they have a challenge with managing their alcohol consumption, they may choose to see a doctor for naltrexone treatment.
Sober living can provide excellent support for medication assisted treatment patients.
A Suboxone friendly sober home can make all of the difference in the success of a Suboxone patient. Likewise, a sober living house that allows for residents following The Sinclair Method for alcohol use disorder and gray area drinking would help people to better manage their alcohol consumption with the goal of becoming fully sober.
Recovery housing may be a perfect companion to outpatient medication assisted treatment. Outpatient treatment meets the medical and therapeutic needs, while sober living programs provide the safe, group home environment around the clock.
While a sober living program cannot stand as an addiction treatment program by itself, combined with a small group of treatment providers, it could stand as a rehab replacement. Imagine, a doctor provides the medical care, a mental health provider offers cognitive behavioral therapy, and the sober living community provides a safe space for people to avoid exposure to active drug addiction, drug abuse, and people using psychoactive drugs.
Some people may choose to go directly to support meetings as a solution to help them quit substance use. Support meetings, such as Alcoholics Anonymous, narcotics anonymous, smart recovery, or celebrate recovery, are very effective. These group meetings provide a safe place to listen to motivational speeches who have had success in their recovery, and they are also a place to meet other, like-minded people, who are interested in overcoming an addiction as well.
A sober living program can help this group as well. Going to meetings as a way to recover from addiction is an excellent plan. Recovery residences provide the needed support in early recovery at all hours, when recovery meetings are not available.
How does sober living compare to rehab in supporting long-term sobriety?
Sober homes often require their residents to attend meetings, either onsite, or at local meeting locations. Recovery homes provide an addiction resource that is on par with services provided by many rehab facilities.
An important consideration that should not be overlooked is the possibility of checking into a sober living facility. For some people, a sober living environment, such as a sober home, may even serve as a rehab alternative.
You may already be familiar with what a sober home is. A sober living home is a residential home which is configured in such a way to be a safe place for people who are overcoming addictions to live.
In a well managed sober living home, the home manager watches the residence closely. Residents are drug tested, and they are expected to have safe and responsible their jobs, they are expected to contribute to chores in the household, and they are expected to submit to regular drug testing.
Additionally, most high-quality sober living houses also expect residence to attend recovery support meetings. Some homes even bring the meetings in house. They may arrange for a 12 step meetings, such as Alcoholics Anonymous or narcotics anonymous meetings, to be held in a common area.
What would it take to make a sober living, transitional living facility work to provide rehab-level addiction treatment care?
How is it possible that a sober living home could be used as a rehab alternative? Is it not true that inpatient rehab facilities provide a higher level of care then as possible at a sober home?
The services provided at most rehabs are not proven to be of long-term benefit to many of the client to check in. Typically, rehabs provide individual and group therapy. Most staff members of a residential rehab or certified addiction counselors, but rarely do clients in rehab see a doctor of psychology, a doctor of psychiatry, or even a registered nurse.
The majority of the rehab experience may be attending group meetings on a daily basis as well as engaging in what is called 12 step facilitation. 12 step facilitation is the process of introducing the Rehab client to the experience of attending 12 step meetings, such as Alcoholics Anonymous.
But, aren’t rehabs supposed to provide psychological and psychiatric care to clients? Well some of the very high-end rehabs to provide direct medical care from board-certified psychiatrists and doctors of psychology, this level of care would not be typical of most rehabs.
Additionally, seeing these experts in rehab may not provide any additional benefit to the rehab client. Unless the doctors who say clients and Rehab are prepared to provide proven medical therapies, it’s questionable whether their services will contribute to long-term recovery from addiction.
Medication-assisted treatment (MAT) is essential to the success of opioid addiction clients, and many rehabs are not prepared to support MAT.
For example, a patient with an opioid addiction, such as a heroin or fentanyl addiction, will get the best results with medication assisted treatment. Currently, the gold standard of medication assisted treatment involves the use of sublingual or injectable buprenorphine.
Brand names for injectable subcutaneous pay for nausea and include Sublocade and brixadi. And, the brand-name for sublingual buprenorphine include Suboxone, Subutex, and ZubSolv.
In the recent past, almost no rehab facilities were willing to start their clients on buprenorphine. In fact, they were known to indoctrinate their clients against the use of medication assisted treatment, even though the overwhelming evidence was in favor of the use of these medication to help patient stay opioid free for very long periods of time.
More recently, there are some rehabs that are starting to come on board and provide initial Suboxone therapy. Ideally, when they start this medical treatment and rehab, they should make arrangements for their client to continue treatment with a local doctor after they’ve graduated from the program.
Likewise, in the past, sober living homes were not known to be Suboxone friendly. Unfortunately, clients were turned away from sober living homes if they were currently taking Suboxone as prescribed by their addiction treatment doctor.
Fortunately, things have changed for sober living homes as well. Well many sober living homes are still not Suboxone friendly, there are a select few which have learned to work well with clients who are prescribed Suboxone.
This is a very positive development, because these patients will do much better and staying drug-free in the short term and long term, during their stay in sober living, and for long after they have left the sober living environment.
Sober homes have the unique opportunity to provide support for patients who take medication to help support their early recovery.
Sober home managers will often confirm that the client does have a legitimate prescription for Suboxone or a similar medication, and that they are currently established with a properly credentialed Suboxone doctor. The sober home manager will also conduct routine drug testing, confirming that the client is compliant with their prescribed medication.
What issue that has been a problem in the past for sober living homes is that they sometimes have had to deal with clients who are prescribed Suboxone, but these clients chose to sell their Suboxone on the streets to get money to buy heroin, fentanyl, or other drugs.
Well the majority of Suboxone patients are very appreciative and grateful for the benefits that their medication provides, and allowing him to live without opioid cravings or withdrawal symptoms, these few bad apples have long ruined things for them.
Now, that Suboxone friendly sober home owners and managers are willing to take the extra steps to help their clients medicine medication and enforce medical compliance, this situation is greatly improved for patients who are seeing a Suboxone doctor but also need a safe sober living environment to live in.
Do Sinclair Method friendly sober living houses exist?
The Sinclair Method, or TSM, is a novel approach to managing alcoholism, or helping anyone who feels that they drink too much alcohol to reduce and work towards quitting drinking. The controversial part of TSM, for some people, is that patients continue to drink during the early part of medical treatment.
Sinclair patients are prescribed naltrexone by their doctor, and they take a 50 mg tablet about one hour before having a single drink. TSM patients do not have to drink every day, and over time, they will have more alcohol-free days. An alcohol-free days, also refered to as AF days, a TSM patient will not take their naltrexone tablet.
Naltrexone is an opioid blocker, which is believed to partially inhibit the brain’s reward system by blocking the effects of natural endorphins on opioid receptors. The theory behind TSM, known as pharmacological extinction is based on the work of nobel-prize winning scientist, Ivan Pavlov. Dr. Sinclair first studied the effect of naltrexone use on alcohol consumption in rats, and later, in humans.
In many cases, people following The Sinclair Method would have no need for a sober living home. They would follow the plan at home, either one their own, or with support of a spouse or other loved one.
A sober home that is prepared to support TSM clients would be an excellent resource.
Yet, there are instances where it would be ideal for a person who wants to follow TSM compliantly might benefit from a home away from home, where the Sinclair protocols could be enforced by a sober living counselor, regarding the taking of the naltrexone pill, and the consumption of one standard drink, one hour later, with no additional drinking.
As you can imagine, most sober living residences would not be prepared to facilitate TSM for their clients. The main issue is that, even if they are accepting of the treatment that involves continued drinking, there may be concern that TSM would interfere with the sobriety and recovery of people following an abstinence protocol.
Still, the idea that a sober living facility might find a way to integrate TSM into thier program is very intriguing. The Sinclair Method is highly effective, but not always easy to follow in the home environment, with family who might not be comfortable with it.
A sober home for those who have pledged to work towards sobriety with TSM would be an excellent environment for people who are like-minded to work together and support each other. A TSM sober living home might even help with promoting the movement to increase awareness of The Sinclair Method, and its 78% success rate in treating alcohol use disorder, alcoholism, and gray area drinking.
How can I find a sober living home that might serve as a rehab alternative?
Sober living homes vary significantly from one to another, in the way their programs are implemented. There is not much standardization in the industry, though there is FARR credentialing, which does help somewhat to ensure compliance and consistency, regarding specific practices.
One place to start might be to discuss the issue with a therapist or doctor who is already running a rehab alternative program to see if they can recommend a sober living home which would work well with their program. Surprisingly, you might find that it is not so difficult to locate a perfectly suited sober home to function as a rehab alternative.
Another possibility is to call several sober homes in your area. I believe that it would not be too difficult to screen these facilities to see which ones are open to the possibility of working with a team to provide an alternative to residential rehab, and which ones are not. Many sober living owners or managers may be against the idea, choosing to stick to the traditional model, but some are forward thinking, and see the possibilities of providing better, and more personalized care.
What possibilities are there for the future of the sober living home model?
Looking to the future, there are possibilities for sober living homes to provide care for clients who are in various drug-related situations that are not necessarily addiction-related. Specifically, patients detoxing from benzodiazepines and other other psych meds would benefit greatly from having a living alternative that provides a level of support that cannot often be found at home.
Interestingly, clients who are detoxing from benzos and psych drugs will not respond well to traditional addiction recovery support, including drug test monitoring, 12-step meetings, and addiction recovery talk. Their issue is most often not addiction, but iatrogenic trauma, or trauma caused by medical treatment. They need solid nutrition and understanding.
The future of sober living, or maybe a better term would be “support living”, is in the hands of forward thinking sober living home owners and managers who see the possibility of helping a much wider variety of clients. We look forward to seeing these new challenges addressed.