Implementing the Oxford House Model in Bulgaria: Challenges Faced and
Lessons Learned
Abstract
Oxford Houses (OH) are a widely adopted model of self-run aftercare
settings originally established in the United States for people in
recovery from substance use disorders (SUDs). However, OHs have had
relatively limited success being established outside of the U.S. This
article represents first person accounts of two multi-year
collaborations to implement the OH model in Varna, Bulgaria in 2016-2017
and 2020-2023. This article describes the origins of the projects, basic
steps in creating these OHs, and what was learned from our
collaborations’ successes and challenges. A total of 11 Bulgarian male
volunteers in recovery from SUDs lived in these two OHs. Both efforts
demonstrated the OH model was difficult to sustain and may not be
replicable in Bulgaria for two reasons: the common problem of attrition
and low interpersonal trust presented a barrier to recruiting potential
new residents who did not want to live with people they did not know,
and a nascent recovery culture resulting in low levels of recovery
capital. These accounts offer an analysis of the barriers to creating
sustainable OHs in Bulgaria and perhaps in other cultural contexts
outside the United States.