Executive function should be part of the nation’s recovery strategy
Recovery succeeds when programs rebuild executive function through structure, counseling, routine, and work readiness supported by funding that looks beyond crisis response.
by Jim O'Connor, CADC
Executive Director, Second Story Foundation
Communities across the country are seeing a rise in severe addiction, repeated overdoses, and long periods of instability. The people arriving in treatment programs, shelters, and emergency departments today face more complex challenges than they did a decade ago. They carry high levels of trauma, significant health burdens, and years of disrupted routines. Recovery systems need to reflect this reality with programs that help rebuild the cognitive skills required for long-term stability.
Executive function is central part to that work. These skills help people manage daily tasks, control impulses, regulate emotions, and plan ahead. Trauma, chronic stress, and severe substance use erode these abilities. Many lose the capacity to stay organized, follow routines, attend appointments, or manage money. These skills can be restored, but the process requires time, structure, and consistent support.
I run the Second Story Foundation in Illinois. Our program provides long-term recovery housing at no cost, and residents take part in counseling, routine, job readiness training, and community reintegration. Many enter with high Adverse Childhood Experience scores, strained family connections, and long periods of economic insecurity. Some arrive with no income or identification documents. Others have survived multiple fentanyl overdoses and struggle to manage daily tasks. With structure and stability, they regain executive function and rebuild the skills needed for work, family, and independent living.
Research shows that structured recovery environments improve outcomes. Peer-run models such as Oxford House demonstrate better employment, abstinence, and social stability compared with low-structure settings. Additional studies confirm that long-term abstinence supports stronger housing and workforce participation. Policymakers can draw on this evidence when shaping federal grants, state block grants, and opioid remediation plans.
Several approaches can support this progress. Housing First and Permanent Supportive Housing are essential for people who can maintain stability with voluntary services. Communities depend on these programs, and they should continue. At the same time, individuals with severe addiction often need a setting that offers routine, accountability, and clear expectations. This is not a punitive model. It is a clinical approach that supports cognitive recovery and gives residents the time they need to rebuild healthy habits.
Funding trends have not kept pace. Many states direct large portions of opioid settlement funds toward crisis mitigation, prevention, and low-barrier services. These investments matter, but they must be balanced with recovery housing, long-term counseling, and employment preparation. A comprehensive strategy requires multiple housing pathways operating together.
Workforce reintegration is another important part of the solution. Employers across the country report difficulty finding reliable workers. People in early recovery often need time to rebuild the habits that support employment. Programs that combine structure, counseling, and daily expectations help residents regain readiness for work. When residents secure jobs, they contribute to local economies and reduce their reliance on emergency systems.
Federal and state leaders can strengthen the nation’s response by investing in programs that restore executive function and support long-term recovery. Communities need housing options that include routine, counseling, peer support, and workforce partnerships. These programs cost far less than prolonged use of emergency services and repeated involvement with law enforcement.
Recovery takes time. People rebuild their lives when they have safe housing, consistent expectations, and support that lasts beyond the crisis. A national recovery strategy that includes executive function as a core component will help more people move toward stability and independence.
Jim O’Connor is the founder and executive director of Second Story Foundation, a Chicago-area nonprofit that provides long-term recovery housing, job training, and community support for men rebuilding their lives after substance use disorder. He writes about long-term recovery, housing stability, and community-based care. His perspective draws on lived experience and professional practice.
