Substance abuse relapse in Oxford House recovery homes: A survival analysis evaluation

ABSTRACT

Background: This study used survival analysis to examine risk factors for substance abuse relapse among residents in Oxford Houses (OH), a national network of self-run, self-financed aftercare homes for individuals recovering from substance use disorders. Methods: Participants who entered OH within 60 days of a 1-year longitudinal study (N = 268) were selected from of a nationally representative US sample. Discrete-time survival analysis compared baseline risk of relapse with 4 hypothesized survival models that included time-invariant and time-varying factors across 3 subsequent time periods. Results: The model predicting higher risk for more severe substance use disorders and psychiatric problems was supported. The hypothesized model that predicted time-varying increases in alcohol (but not drug) abstinence self-efficacy significantly affected risk of relapse. Hypothesized demographic and employment variables did not significantly predict relapse risk. Conclusions: Results suggested that OH recovery homes may reduce relapse by providing closer monitoring and referring additional services to new residents with more severe prior addiction severity. Risk for relapse may also be reduced by enhancing abstinence self-efficacy for alcohol regardless of drug of choice.

KEYWORDS:

• Abstinence self-efficacy
• aftercare settings
• Oxford House
• relapse
• substance abuse treatment
• survival analysis

Funding

The authors appreciate the financial support from the National Institutes of Health/National Institute on Drug Abuse grants DA13231 and DA19935 (Principal Investigator: Dr. Jason). Grant DA13231 funded the collection, management, and analysis of the longitudinal study that produced these data for this paper. Grant DA19935 funded the salary of a graduate student/project director (Ronald Harvey) on an unrelated research project during which these data were analyzed. The authors declare that they have no conflicts of interest.

Additional information

Notes on contributors

Ronald Harvey

Author contributions

Dr. Harvey had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr. Jason is the first author's advisor, dissertation committee chair, and principal investigator (PI) of the grant that generated these research data. Dr. Ferrari was on the first author's dissertation committee and co-PI of the grant that generated these research data.