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

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 learnt 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.