How to sustain housing for opioid users in recovery
- 3 min. read ▪ Published
Opioid use disorder is an epidemic in the United States. Recovery housing plays a critical role in treatment by providing a stable, supportive environment that promotes long-term recovery.
There has been little research, however, on how to sustain these recovery homes, especially those serving people who take medicine for opioid use disorder.
I. Niles Zoschke, a postdoctoral research fellow in the community health sciences division of UC Berkeley School of Public Health, has sought to start filling that knowledge gap with a study published April 30, 2025, in Frontiers in Public Health.
“No one really has looked at sustainability of recovery homes,” said Zoschke, who conducted the research and started writing the paper while working as a graduate research assistant at UTHealth Houston School of Public Health. They finished it after starting their postdoc at UC Berkeley Public Health.
“Most of them are operated by average people, not major hospitals or major corporations, Zoschke said. “It’s usually just folks in recovery themselves or those in a position to help the community. It’s a disservice that we haven’t thought about helping the operators to sustain their practices, to save money and keep them going.”
To that end, Zoschke, who uses the pronoun they, and their team from UTHealth Houston School of Public Health, interviewed 29 staff and operators from 10 recovery homes in five Texas cities, serving people taking medications for opioid use disorder. Their findings show similar challenges across the state, among them: a lack of standardization, inconsistent funding, and poor insurance coverage.
Recovery home operators and program directors described a complex and demanding funding landscape. They said that they often depended on a combination of private donations and grant funding to meet their financial needs. They said that private donations gave more financial flexibility, but were not dependable. When they lose grants, operators sometimes start charging rent to fill the gap.
One program director participating in the study said, “We kind of just came up with ideas of how to keep us afloat without depending so much on funding. ’Cause that’s our problem… It’s because of our community. Not everybody has the means…some of them are sick, and some of them have dual diagnosis. They have mental [health] issues that have not been addressed in years. They have infections. They haven’t been tested for HIV. So, it’s not just the [medication] program that they’re needing from us. They need everything as a whole.”
Some operators partnered with shelters for the unhoused or mental health service providers to help underwrite residents’ living costs. The operators often applied for grants, but said they faced challenges doing so.
“Drafting a standout application requires substantial investment from staff members who have both the time, which is in short supply, and specialized skills that staff often lack,” the authors wrote about the experiences of the study participants. “The application process could be confusing and highly competitive.”
The authors call on policymakers to support recovery homes by establishing long-term funding mechanisms, as well as reducing financial barriers to professional certification to help promote good standards in the field.
Above all, Zoschke said, “We must advocate that insurance providers and the government offer payment for recovery housing. It’s a critical service for folks in recovery. It’s simply not enough to give somebody medication and psychiatric care if they don’t have a roof over their head.”
