National policy needs a recovery strategy that matches today’s addiction crisis
Crisis tools save lives, but lasting recovery requires structured housing, routine, counseling, and workforce support. Communities need long-term strategies that match the complexity of severe addiction.
by Jim O'Connor, CADC
Executive Director, Second Story Foundation
Federal and state agencies have invested heavily in crisis interventions for addiction during the past decade. Naloxone access, syringe exchange programs, and supervised consumption sites now form the foundation of many public health responses. These tools prevent deaths, and they remain essential during a period of historically high overdose rates. The national challenge is that survival alone does not move people toward long-term stability. Communities need a recovery strategy that keeps pace with the complexity of the population entering treatment, homelessness systems, and emergency departments.
A growing share of people seeking help have severe substance use disorders, chronic health conditions, and long periods of instability. Many have survived multiple fentanyl overdoses and carry significant cognitive and behavioral health challenges. Short-term treatment episodes do not provide the time required to rebuild daily structure or regain the capacity to handle appointments, medication management, documentation, or employment. The national system is designed around brief interventions, yet the people arriving today require long-term engagement.
I run the Second Story Foundation in Illinois. Our program provides long-term recovery housing at no cost. Residents participate in counseling, routine, job readiness training, and community reintegration. Many enter with high Adverse Childhood Experience scores, strained family ties, and extensive histories of economic insecurity. They often begin with no income, no identification documents, and no workable support network. With sustained structure, they regain executive function, reconnect with relatives, and rebuild the skills associated with stable housing and employment.
National research supports the value of structured recovery environments. Research on peer-run sober living programs, including Oxford House, shows a clear pattern. People tend to make steadier progress when they have consistent support and daily expectations. They are more likely to hold jobs, stay sober, and rebuild relationships. Studies also find that individuals who maintain abstinence for several years are far more likely to keep stable housing and stay in the workforce. Policymakers can draw on this evidence when shaping federal grantmaking, state block grants, and opioid remediation plans.
A comprehensive national strategy requires multiple housing pathways. Housing First and Permanent Supportive Housing remain essential for people who can maintain stability with voluntary services. These models should continue. At the same time, individuals with severe addiction often need a setting that provides routine, accountability, and clear participation expectations. This is not a punitive approach. It is a clinical one. Structure supports cognitive recovery and allows residents to build the habits needed for long-term health.
Funding trends have not kept up with this need. The Illinois Opioid Remediation Advisory Board offers one example. The board directed more than 101 million dollars toward prevention and harm reduction, including major investments in low-barrier housing and supervised consumption sites. Those efforts are important, but the board did not set aside funding for recovery housing, long-term counseling, or employment preparation. Other states have taken a similar approach. Federal guidance calls for a full range of recovery supports, yet many state plans still focus mainly on short-term crisis response.
Workforce reintegration must also be part of the national conversation. Employers in many regions struggle to find reliable workers. People in early recovery often need time to rebuild routines that support employment. Structured recovery housing gives people the routine and support they need to get ready for work again. Once residents find jobs, they contribute to the local economy and rely less on emergency services. Policymakers can help strengthen this progress by encouraging partnerships between recovery programs, workforce boards, and employers.
The United States can make meaningful progress by aligning funding with the full continuum of care. Crisis services are critical. Treatment is essential. Long-term recovery supports are the link that keeps people from returning to emergency rooms, shelters, and law enforcement contact. A national strategy that includes recovery housing, routine, counseling, peer support, and workforce pathways will give communities a more effective and sustainable response.
People need environments that support healing and skill-building after the crisis has passed. Federal and state leaders can strengthen the nation’s response by investing in programs that provide consistent expectations and long-term stability. Recovery is possible when the system gives people enough time and structure to rebuild their lives.
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.
