The Business of Recovery: Understanding Operational Costs and Funding Sources in Recovery Housing in the United States

Background: The expansion of recovery support services, such as recovery housing, is critical to continue to meet the needs of individuals with substance use disorder. Many unknowns exist regarding the business operations of the recovery housing industry. This study aims to estimate the annual operating costs, cost components, and revenue sources of recovery housing using data from a national survey. Methods: A cross-sectional survey was employed to assess the financial landscape of a national convenience sample of recovery housing organizations, including their annual operation costs, cost categories, and revenue sources. Data from 408 recovery housing organizations operating 1458 residences were collected between January 2024 and February 2025 through a survey of recovery houses in 19 states. The survey yielded a response rate of 46% of residences in participating states. Results: Of the 265 recovery housing organizations that provided annual estimated operating costs, the median annual operating cost of recovery housing organizations in 2023 was 155 000 (average of 420 716), ranging from 1500 to 20. 5 million. The median annual cost per resident served annually was 6464 (average of 12 172). Most costs for recovery housing organizations were related to operational costs, including property costs and staffing costs. Resident fees were, on average, the largest source of revenue for recovery housing organizations, yet most organizations reported they did not receive all resident fees charged. Conclusions: Recovery housing organizations are diverse in terms of their operational cost makeup and service mix. Compared to other recovery support services and treatment modalities, recovery housing operates at a relatively low cost per resident served.