Key takeaway
SAMHSA says a move into recovery housing starts with an interview, so both sides can decide whether the house fits. Ask about certification, medicines, fees, and what happens after a return to use. The written rulebook is a different page. Programs vary. A question list is not a directory of houses.
Last updated: Mon Oct 05 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
You are about to sit across from someone who can offer a bed, and you do not want to agree to a rule you have not heard. SAMHSA's 2023 recovery-housing guide says people who want to move in apply and sit for an interview. Both sides are supposed to decide whether the house fits. The person should be able to choose a house, or a room, that lines up with their needs. That is a two-way conversation. It is not a test you pass by agreeing with everything.
SAMHSA's list for referrers becomes questions you can ask out loud. The written packet once you are a resident, including rights, a handbook, and what a substance-free rule does not include, is the house-rules guide. How staffing levels differ is the sober-living guide. The fee is the paying guide. The clock is the length guide. If you are interviewing a treatment program rather than a house, the clinical call is the admissions guide.
If someone overdoses, has a seizure, or will not wake, call 911. For a mental health crisis, call or text 988. Finish the interview another day.
Start with fit, not with a speech
SAMHSA says placement should follow the person's needs, goals, and choice, and that houses should use a person-centered look at strengths, preferences, challenges, and the supports the person already has. You are allowed to decide the house is wrong. A referrer, whether that is a clinician, a family member, or a criminal-justice officer, is told to learn the program before sending someone. You can ask for the same facts the referrer is supposed to know.
Ask whether the house holds a current certification or charter to a national standard. SAMHSA names certification as evidence that the home operates to a published standard. A certificate is a document you can ask to see. It does not promise you will stay abstinent, and it does not make an uncertified house illegal by itself. Ask which standard, which year, and who checks it.
Ask what recovery pathway the house expects. SAMHSA's culture question is whether the home promotes healthy behavior, requires a recovery maintenance program, and keeps a living environment that supports recovery. A required pathway is the house's rule. It is not proof that the pathway is the only one that works. If the house expects a specific mutual-aid meeting, ask whether that is a condition of the bed. The levels guide explains peer-run homes versus staffed ones. Do not let the interview skip the condition and call it a suggestion.
The building, the block, and the people
SAMHSA tells referrers to consider the surrounding area, including whether it is safe and whether public transportation is easy to reach. You can ask how residents get to work, to a clinic, and to a store, and what the operator will say about the block. You can visit at the hour you would actually come home.
Ask about the building itself. The guide's living-environment question covers health and safety, how many people live there, and whether people with disabilities can use the space. A photo in an ad is not that answer. Ask to see the room, the exits, and where medicines would be stored if storage is part of the house's practice.
Ask about the people who live there now. SAMHSA suggests referrers notice whether residents are welcoming, whether they are committed to recovery, whether they are working, and whether responsibilities are clearly split. You are not entitled to another resident's medical story. You are entitled to ask how chores, meetings, and quiet hours are decided, and whether a new person has a vote. In a peer-run house, that vote may be the whole government. In a staffed house, the operator may decide. Either answer is useful. A shrug is not.
Medicines, staff, and emergencies
Ask the medication questions in plain language. Does the operator support prescribed medicines for mental health and for substance use disorder? Are there procedures to reduce diversion? Does the house treat medication-assisted recovery as part of recovery, or as something to hide? SAMHSA's guide tells operators not to put up barriers to prescribed medicines, and it names buprenorphine, methadone, and naltrexone. NIDA describes those three as the FDA-approved medicines for opioid use disorder when they are prescribed. A rule that you must stop them to get a bed conflicts with the SAMHSA guidance. Ask before you pack. Do not stop a prescription to sound easier to house.
Staff questions depend on the level. SAMHSA notes that Level I homes, including Oxford Houses, are entirely peer-run and do not have professionally trained staff on site by design. Many Level II homes are monitored by a senior resident. If the house advertises a higher level of support, ask what training the staff have, including co-occurring conditions and what the house does in a crisis. If the house is peer-run, do not demand a nurse who was never part of the model. Do ask who calls for emergency help, where naloxone is kept, and whether anyone is forbidden to call. SAMHSA lists the availability of an opioid-overdose reversal drug such as naloxone as its own referral question. How to recognize the emergency is the overdose guide. An interview that never mentions it is unfinished.
Paper you should see before you pay
Ask whether residents are told their rights, and whether complaints go somewhere specific, including a local or state ombudsman if one exists. The list of rights SAMHSA wants in the move-in packet lives on the house-rules page. In the interview, the question is simpler: will you receive that packet, sign it, and keep a copy, or will the rules stay verbal?
Ask about ethics in a way that can be answered. Has the business been cited for fraud or for abuse of residents? SAMHSA puts that question on the referrer's list. You may not get a complete answer. A refusal to discuss complaints is itself information.
Ask what a return to use means in this house. SAMHSA says the expectations should be written, explained, and signed so the resident is not guessing. A dismissal rule, a requirement to leave the same day, or a requirement to enter treatment are house policies. They are not a national penalty, and they are not a medical order. Ask whether outpatient care is expected beside the bed. The guide recommends that operators help residents get and stay in outpatient treatment. The house is still not the clinic. Record privacy may or may not follow the federal substance-use confidentiality rule, depending on what kind of program the house is. That rule is the privacy guide. Ask which one you are entering.
Cost is on the list too. Ask for the fee, what it covers, and the missed-payment rule. The paying guide is the longer version, including grants that sometimes help and offers that deserve a second look. Do not sign a fee page you have not read.
FindTreatment.gov lists treatment programs. A room is a different search. Call or text (800) 653-9376 if you want help sorting a clinical program from a house. Ask the house the questions yourself, and read the handbook before you pay.
Additional Resources
Sources cited on this page:
- SAMHSA: Best Practices for Recovery Housing (PEP23-10-00-002)
- NIDA: Medications for Opioid Use Disorder
- SAMHSA FindTreatment.gov
- 988 Suicide & Crisis Lifeline
Common Questions
Is there a national interview script?
No. SAMHSA's 2023 guide says people apply and interview so both sides can decide whether moving in is the right fit, and that the person should be able to choose a house or a room that matches their needs. It then lists what referrers should know: certification, culture, support, the surrounding area, the building, the current residents, medicines, staff training, ethics, rights, cost, the return-to-use policy, and naloxone. Those are topics. They are not a form every house must use.
What should I ask about medicines?
Ask whether the operator and the house leadership support prescribed medicines for mental health conditions and for substance use disorder, whether diversion controls exist, and whether the house culture treats medication-assisted recovery as acceptable. SAMHSA tells operators not to create barriers to medicines including buprenorphine, methadone, and naltrexone. A house that requires you to stop them is out of step with that guidance. Do not stop a prescription to win the interview.
Should every house have professional staff?
No. SAMHSA notes that Level I homes, including Oxford Houses, are peer-run and do not have professionally trained staff on site by design. Many Level II homes are monitored by a senior resident. Training questions apply when the house claims a higher level of support. Asking a peer-run house for a clinician on the night shift misunderstands the model. Asking any house what happens in a medical emergency does not.
What if I use again after I move in?
Ask for the policy in writing before you decide. SAMHSA says residences should define how they will address a return to use, give every resident that policy in writing, and have the resident sign it. The policy is the house's rule. It is not a clinical plan, and it is not permission to manage an overdose inside the house. If breathing slows, call 911.
Can a referral conversation pick the house?
No. A referral conversation does not inspect residences and is not an interview with a landlord. The house-rules guide is the expectations document after you are accepted. The questions below are the conversation before that. You still have to ask the house and read what they hand you.