Martha’s Vineyard leads the State in unhealthy alcohol consumption (Vineyard Gazette, March 28, 2013) but Martha’s Vineyard is also a leader in helping people gain long term recovery through its sober living facilities. The Vineyard House plan to build a new and expanded sober house campus is a very strong statement that the entire community will come together to support individuals who are ready to recapture their lives.

Many years of research have shown that sober houses can play a major role in helping people achieve long-term recovery. For example, a recent study reported in the Journal of Substance Abuse Treatment (2010, June, 38(4) 356-365) followed residents in sober houses over an 18-month period. The study documented significant reductions in alcohol, psychiatric and criminal law problems for residents. These authors, like others who have studied the impact of sober houses, said the keys to successfully entering recovery for the residents were having a stable place to live, developing a social network that does not abuse alcohol, and attending mutual support groups like AA.

Vineyard House has provided this foundation to more than 400 Vineyard residents since it opened in 1997. Now, the program needs modern, sound buildings to continue to provide a safe environment. It is clinically important that the effort to build a new sober housing center on the Vineyard succeed because the new houses will improve the long term recovery prospects of the people who live in them. Individuals who are early in their recovery need strong clear signals that they are doing the right thing and that their community cares about them. The facilities in which they live send this signal. If their surroundings are old and crumbling, they get a message that the community doesn’t care about who they are and how they do. On the other hand, a decent physical setting, no matter how simple, sends a strong message of community support for their recovery.

When people enter recovery from addiction, they are giving up their “best friends;” the substances that gave them highs and altered realities and the social network that supported their use. Think about it. Even if your “best friends” really aren’t any good for you, it is really hard to give them up all at once for a very uncertain future. A well run sober house provides the critical first step in helping an individual discover and build the possibility of a new social network that does not depend on alcohol and drugs. Mutual support programs like Alcoholics Anonymous also provide strong new social groups, so added facilities and opportunities for more supportive social networks are an important part of the new Vineyard House facility.

Even with a new facility and the important message of support it will send from the entire community, not all the residents of the sober house will be successful. Supporters of a sober house program should not feel let down or angry when some former residents have difficulties again, any more than supporters of a cancer center should feel they have wasted their money because not everyone is cured. Addiction is a complex brain disease; critical parts of the brain that control craving and impulse are damaged by the alcohol and drugs. Research has shown that through treatment and recovery support, damaged areas of the brain can literally be rewired or worked around. But this often takes several episodes of treatment and recovery for individuals with severe addiction disease. Some residents of a sober house will relapse, even after a glimpse that life can be better for them. Scientists no longer consider relapse as failure. Like other chronic conditions, if the disease comes back more treatment and support must be provided. Vineyard House will need to be there to help them.

David Rosenbloom, PhD, is a professor of public health at Boston University’s School of Public Health.