Implementing the Oxford House Model in Bulgaria: Challenges Faced and Lessons Learnt

Area of Science:

• Addiction research
• Social science
• Public health

Background:

• Oxford Houses (OH) are self-run recovery settings for substance use disorders (SUDs).
• OHs have seen limited success outside the United States.
• Bulgaria presents a unique cultural context for recovery support.

Purpose of the Study:

• To document the implementation of the OH model in Varna, Bulgaria.
• To analyze the successes and challenges of establishing sustainable OHs in a new cultural context.
• To identify barriers to OH replicability in Bulgaria and similar settings.

Main Methods:

• First-person accounts of two multi-year collaborations (2016-2017, 2020-2023).
• Description of project origins and steps for OH creation.
• Analysis of participant experiences and program outcomes.

Main Results:

• Implementing OHs in Bulgaria proved difficult to sustain.
• Participant attrition and low interpersonal trust impeded recruitment.
• A nascent recovery culture limited residents' recovery capital.

Conclusions:

• The OH model faces significant sustainability challenges in Bulgaria.
• Barriers include low trust, attrition, and underdeveloped recovery infrastructure.
• Replicability of OHs outside the U.S. requires careful consideration of cultural factors.