Assessing a pilot scheme of intensive support and assertive linkage in levels of engagement, retention, and recovery capital for people in recovery housing using quasi-experimental methods

Introduction: There is strong and ever-growing evidence highlighting the effectiveness of recovery housing to support and sustain substance use disorder (SUD) recovery augmented by intensive support comprising assertive linkages to community services.

Aim: To assess a pilot intensive recovery support (IRS) intervention for individuals (n=175) entering certified Level II and III recovery residences who met at least three out of five conditions (no health insurance; no driving license; substance use in the last 14 days; currently unemployed; having less than $75 capital) and its impact on engagement, retention and changes in recovery capital for individuals compared with a business-as-usual Standard Recovery Support (SRS) approach (n=1,758).

Methods: We deployed quasi-experimental techniques to create weighted and balanced counterfactual groups derived from the Recovery Capital (REC-CAP) assessment tool to compare outcomes for people receiving the pilot IRS compared to intervention against SRS.

Results: After reweighting for resident demographics, service needs, and barriers to recovery, those receiving IRS exhibited improved retention rates, reduced likelihood of disengagement, and growth in recovery capital after living in the residence for 6-9 months.

Conclusion: Our findings from this pilot intervention suggest that intensive recovery support incorporating assertive community linkages and enhanced recovery coaching can improve engagement, length of stay and recovery capital growth compared to a balanced counterfactual group. We suggest that this model may be particularly beneficial to those entering Level II and Level III recovery housing with lower levels of recovery capital at admission entry.