Project Summary

Background: Substance use disorder (SUD) continues to negatively affect communities, overwhelm health systems and cost the country billions of dollars each year. According to the U.S. Department of Health and Human Services, 16.5 percent of the population experienced SUD in 2021. From a resource-use perspective, SUDs cost the U.S. government over $200 billion each year. According to the surgeon general, the existing SUD workforce does not have the capacity to meet the current and future need.

Furthermore, the current model for treating SUDs is not working. It is estimated that 85 percent of those with SUDs will have at least one relapse during their first year of trying to remain sober. Research suggests that a key element of long-term recovery is social factors, including living environment. Sober living Facilities (SLF) are a model that has already paved the way for thousands to achieve long-term recovery. Unfortunately, there is minimal patient-centered outcomes research/comparative clinical effectiveness research (PCOR/CER) exploring the role of SLF in recovery and the critical role it plays in long-term outcomes.

Proposed Solution to the Problem: The goal of this proposed work is to bring together relevant parties from the world of SLF, recovery research and PCOR/CER to communicate about the potential importance use of PCOR/CER principles could have in SUD treatment and long-term recovery that leans on SLF successes.

Objectives: Objectives that support this goal are to educate and align SLF communities about PCOR/CER, build awareness with PCOR/CER investigators about SLF methods and prepare to disseminate findings toward future projects with long-term sustainability.

Activities: Over the one-year Award period, The Milestone House Project Team (Team) will engage in activities to develop and implement a Convening Event, including assembling an advisory committee to provide guidance on the development of the materials required; education of Milestone Staff, their Board and Project Team on PCOR/CER fundamentals through PCORI tools and trainings provided by PCOR/CER experts; and development of post-Convening surveys to assess the project.

Through this process the Team will engage with potential SLF Community participants, SLF stakeholders and PCOR/CER experts to come together and discuss the need for PCOR/CER evidence in the development of SLF better-practice models and identify future stakeholder opportunities to engage in PCOR/CER research. Following this, the Team, in collaboration with the Advisors and PCOR/CER Experts, will translate Convening learnings and key insights into a summary Roadmap outlining future opportunities and possible next steps for engagement of the SLF community in PCOR/CER studies.

Projected Outcomes and Outputs:

Short-term outcomes (during the project period):

  1. Gaining a deeper understanding of the importance of PCOR/CER as a critical tool for establishing SLF services for recovering patients of SUD.

  2. The development of a Roadmap which will translate learnings from Convening surveys and advisors’ guidance into a Roadmap outlining opportunities and next steps for engagement between SLF & PCOR/CER.

  3. A process to share the Roadmap with attendees, the SLF Stakeholder and the wider PCOR/CER communities.

Medium-term outcomes (0-2 years post-project period): Milestone and its partners look to be engaged in further patient-centered research as well as in a support role for patient-centered CER studies.

Long-term outcomes (3+ years post-project period): Improved patient outcomes as a result of patient centered CER studies.

Patient and Stakeholder Engagement Plan: The Milestone House regularly engages its diverse stakeholder community including providers, alumni, legal advocates, patients, government agencies, accreditation organizations, court systems, medication managers, family support groups, detox facilities, short-term intensive treatment, SUD clinical researchers and more as part of its day-to-day operations in providing recovery-focused services to its residents. These stakeholders will be engaged for the Convening event, and many have expressed interest in learning more about PCOR/CER.

Stakeholders vary from recovering residents to major municipal entities such as recovery court. Members of the Advisory Committee and the PCOR/CER expert, Corrie Vilsaint, Ph.D., will play a key role in the planning and promoting of the Convening. The findings from the convening will lead to the creation of a Roadmap spanning several years to align SLF Communities, their Stakeholders and PCOR/CER investigators and their sponsoring institutions, Bridge, National Alliance for Recovery Residences, Harvard Medical School and the Recovery Research Institute, towards improved outcomes for SUD patients.

Project Information

Nikoleta Danicic
The Milestone House

Key Dates

December 2024


Project Status
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: April 3, 2024