Assessing the role of cannabis in sober living houses

The National Institute on Drug Abuse awarded Public Health Institute $1,084,374 on June 15, 2026, under the Drug Use and Addiction Research Programs (CFDA 93.279) to conduct a prospective cohort study examining cannabis use among sober living house residents and its relationship to substance use, mental health, and recovery outcomes.

The study will recruit 400 residents from 35 sober living houses, stratified into groups with recent cannabis use (past 30 days) and non-recent use, and follow them longitudinally over three time points across 12 months. Aim 1 employs quantitative analyses to examine associations between cannabis use and alcohol or other drug use, mental health, and recovery capital outcomes. Aim 2 uses mixed methods—quantitative and qualitative interviews—to assess motivations for cannabis use, medical cannabis use patterns, and alignment with recovery in abstinence-based environments. Aim 3 identifies the range of current cannabis use policies and practices in sober living houses and develops an assessment tool to evaluate them. The research addresses a gap in evidence regarding cannabis substitution among specific populations with substance use disorders and the policy challenges facing sober living houses as cannabis legalization evolves.

Performance occurs in Oakland, California, with a period of performance through March 31, 2031.

Abstract

Some studies suggest that cannabis is a safer substitute for other substances, including for those with substance use disorders (SUD). Historically, sober living houses (slhs) have been abstinence-based environments for individuals in recovery to live with others in recovery, yet mixed evidence regarding cannabis substitution along with rapidly changing laws have left slhs in a difficult position regarding policies related to cannabis use among residents. Furthermore, few studies have examined cannabis use among specific populations of individuals with SUD or among those embarking on recovery from SUD. The proposed study, assessing the role of cannabis in sober living houses will address these issues via three specific aims: aim 1 will examine how cannabis use is related to alcohol or other drug use, mental health, and recovery capital outcomes among SLH residents. Aim 2 will assess why individuals who live in slhs use cannabis, medical cannabis use, how these are related to outcomes, and how these align with their recovery and living in an abstinence-based environment. Aim 3 will identify the range of current cannabis use policies and practices in slhs and begin to develop an SLH policy assessment tool. This study requires the recruitment of slhs (n=35), SLH managers, and SLH residents (n=400; 200 in recent cannabis use group, 200 in non-recent cannabis use group). Aim 1 involves following a prospective cohort of 400 residents, where exposure is defined by cannabis use in the past 30 days, and collecting data longitudinally over three time points across 12 months from both the use and non-use groups. Aim 1 analyses are all quantitative. Aim 2 is mixed methods and involves (1) quantitative analyses assessing how reasons and motivations for cannabis use are related to outcomes and (2) qualitative interviews focused on motivations for cannabis use and views regarding cannabis' role in recovery. A focus of aim 2 is medical cannabis use. Finally, aim 3 involves qualitative interviews with house managers to document SLH cannabis policies. After analyses for all aims are complete, we will hold focus groups with house managers, residents, and our community advisory board to interpret findings, develop future research questions, and begin forming recommendations for dissemination to slhs. The definition of SUD recovery is evolving, and how cannabis use might affect specific subpopulations of individuals with SUD, e.g., SLH residents, remains an open question as research on cannabis use in other populations might not apply to this population. Thus, if slhs base policies on research from other populations, some residents might risk their recovery efforts. As more states legalize cannabis and the tension increases between proponents of abstinence and harm reduction, the question of how SLH operators should address cannabis is becoming more pressing. This project will also be the first to document cannabis use policies in slhs, including issues and challenges faced by house managers in implementing these policies. Findings will enable service providers to develop policies that best support SLH residents and managers.