National Organization Setting Standards for Recovery Homes

The National Association of Recovery Residences
(NARR) is an organization that is less than two years
old but garnering growing interest, as the need for
a place to live after treatment has become painfully
important to the field. It’s not clear how treatment
providers can steer their patients to a place to live
that will improve the chance for longterm recovery,
so NARR has been working to create standards for the
many different types of operators of what are referred
to as halfway houses, sober homes, recovery homes
and more.

NARR now counts among its members some of the
best-established recovery advocate associations in the
country, including the California Association of Addiction
Recovery Resources (CAARR) and the Connecticut
Community for Addiction Recovery (CCAR).

NARR has developed four levels of recovery residences:
level 1 (run by peers), level 2 (monitored), level 3
(supervised) and level 4 (service provider). These titles
are hoped to help referral sources, including treatment
providers and families, find the kind of recovery
residence that best suits their patient’s or loved one’s

Level 1 (peer-run) residences are often called
sober homes. The peers are other residents, also in
recovery,and there is no paid staff or services. Oxford
Houses are an example of this type of home (see
ADAW, April 7, 2008). For level 1 homes, residents need
to be abstinent and are encouraged to attend self-help
meetings. People usually stay from 90 days to a few

Level 2 (monitored) residences are similar, except
that they have paid peer staff, including someone
who monitors the house, enforcing house rules. These
homes may work with outpatient programs to create a
comprehensive system of care. Usually these residences
are single-family homes.

Level 3 (supervised) residences have professional
staff, with case management and treatment services
provided on a contract basis in the house, or accessible
in the local community. Different states have
different licensing requirements. Typically, this is the
type of residence patients go to directly from inpatient

Level 4 (service provider) residences are usually
connected with a licensed treatment provider, with
credentialed staff. There is a daily structure and inhouse
services, and the facility is part of the comprehensive
care offered by the treatment provider. Average
stays can be from several weeks to several months.
This is the most costly of the four levels, and the least
likely to be covered by insurance, according toNARR
President Beth Fisher.

Faces & Voices of Recovery, the main grassroots recovery
group for people recovering from substance use
disorders, is enthusiastic about NARR. “Faces & Voices
has been extremely excited about the development
of the National Association of Recovery Residences,”
said Tom Hill, director of programs for Faces & Voices of
Recovery. “I proudly served on NARR’s interim Board of
Directors from May 2011 to May 2012.” Faces & Voices
of Recovery has supported NARR by helping organize
meetings with policymakers and stakeholders, plan
the annual conference in Washington, DC, and provide
media and advocacy training, he said. “We look forward
to many opportunities for future collaboration
with NARR,” Hill said.

Fisher, a licensed social worker, is also founder and
executive director of Hope Homes, Inc., a level 3 supervised
recovery residence organization in Atlanta, Ga.,
and Charlotte, N.C. For the NARR website, go to

By Alison Knopf


National organization setting standards for recovery
homes was first published in Alcoholism & Drug Abuse
Weekly Volume 24, No. 26, June 29, 2012.