Addressing Social Factors to Support Recovery

The Substance Abuse and Mental Health Services Administration's (SAMHSA's) Working Definition of Recovery includes 10 guiding principles to support individuals in their recovery from substance use disorder (SUD). One principle states that “recovery is holistic” and involves several social determinants of health that affect well-being. Many rural communities are addressing factors that influence the ability of individuals to lead healthy lives, including healthcare, housing, transportation, and employment.

• Housing Assistance – Lack of stable affordable housing may contribute to SUD, inhibit recovery, and harm overall health in people with SUD. Individuals in recovery from SUD may need assistance in accessing affordable, safe, and drug-free housing. Many communities are implementing recovery housing models to provide a safe, sober, and shared living environment for individuals in recovery from SUD. SAMHSA provides best practices for recovery housing. In 2019, the U.S. Department of Agriculture and the U.S. Department of Health and Human Services partnered to fund additional recovery housing facilities in rural communities.
• Transportation Assistance – Transportation may play a large role in recovery by allowing individuals to access continuing care, support groups, employment, and other key resources to support health and wellbeing. The Rural Transportation Toolkit provides several examples of communities expanding access to transportation and overcoming transportation barriers.
• Vocational Services – Research suggests that employment may help prevent relapse among individuals in recovery. Individuals can also be connected to federal American Job Centers, which connect people to nearby resources for identifying jobs, locating training opportunities, and building new skills. SAMHSA also recommends integrating employment services into treatment for SUD in order to support recovery outcomes. Treatment programs can accomplish this by:
  • Hiring a vocational rehabilitation counselor
  • Developing relationships with local employers
  • Providing employment opportunities within a treatment facility
  • Establishing a referral system between SUD treatment providers and organizations such as job placement agencies, vocational/technical and community colleges, adult education programs, and programs that offer job-related communication and interpersonal skills training.
• Educational Support – The National Institute of Drug Abuse suggests that adolescents who have experienced SUD many benefit from attending recovery high schools. These high schools are specifically designed for students in recovery from SUD and often offer small class sizes, counseling, and family support.