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Recovery High Schools

Written by Dr. Brittany Whitley and Dr. Alan Moss
Published on February 28, 2022
Research Highlights

Recovery high schools are diploma-granting secondary schools that exclusively serve students recovering from substance abuse and dependency.

  • Substance use during adolescence is more common among students who drop out of high school and has been associated with substance abuse later in life.
  • Around 17,000 Missourians between ages 12-17 have a substance use disorder (SUD).
  • Most recovery high schools are publicly funded. Missouri currently has one privately funded recovery high school in St. Louis.
  • Recovery high schools can increase graduation rates and decrease relapse incidence among students.
  • In order to provide the required staff and services, the cost per student tends to be higher at recovery schools. Because each school can only serve a relatively small number of students, there may be limited onsite course offerings.

Executive Summary

Recovery high schools are diploma-granting secondary schools that exclusively serve students recovering from substance abuse and dependency. There are fewer than 50 recovery schools in the United States, and only one in Missouri (St. Louis). Although per-student costs at recovery high schools are higher than traditional high schools, students who attend recovery high schools are more likely to graduate and less likely to relapse than their peers at district high schools. Senate Bill 769 and House Bill 1753 introduced in the 2022 Missouri Legislative Session would allow for the establishment of public recovery high schools in Missouri. In the proposed legislation, up to four pilot programs could be established by school districts (or groups of school districts) in metropolitan areas. The resident (or sending) school district would be responsible for paying either the student tuition of the recovery school student or the state adequacy target plus local effort, whichever is lower.


  • Most information about adolescent drug use relies on self-reports (via surveys), which may underreport the prevalence of drug use (especially illegal drugs) and abuse.
  • Because it has not been possible to randomly assign high school students recovering from substance use disorder to a specific type of high school, research in this area must rely on observational studies and may be influenced by selection bias. Additional studies in recovery schools across diverse regional contexts will be important to understand the magnitude of their impact.
  • Most research about the effectiveness of recovery high schools has been performed by researchers affiliated with the Association of Recovery Schools.

Research Background

Substance Abuse & High School Students

Early substance use (e.g., alcohol, tobacco, opioids) is a risk factor for substance use disorders later in life.1 According to the 2019 Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Survey, one-fifth of high school students in the United States had been offered, sold, or given an illegal drug on school property in the past year.2 Between 2017–2019, 7.5% of Missourians between ages 12–17 (~35,000), on average, reported past-month illicit drug use (predominantly marijuana), compared to 7.1% among neighboring states and 8.2% nationally.3

Consistent with national and regional trends, approximately 3.7% of Missouri adolescents between the ages of 12–17 have substance use disorders or have recently received treatment for a substance use disorder.4,5 Illicit drug use, especially marijuana, in this age group is slightly higher in the Kansas City and St. Louis metro areas but there do not appear to be significant regional differences in the prevalence of substance use disorder in this age group.4 Additional data specific to the Kansas City area, including student survey results and existing local recovery assets, was recently compiled by the State Targeted Response Technical Assistance Consortium.6 Substance use disorders are often co-occurring with mental health challenges (e.g., depression, ADHD), both of which have been exacerbated by the COVID-19 pandemic. For more information see our Science Note on COVID-19, Mental Health, & Substance Abuse.

What are Recovery High Schools?

Recovery high schools (or “sober schools”) are designed for high school students who are committed to recovery from a substance abuse disorder. In addition to providing a supportive recovery environment, students at recovery high schools often have access to additional resources, including mental health professionals and staff with substance use disorder recovery experience. Publicly funded recovery high schools (charter and non-charter) are the most common form of recovery school. These schools are rarely affiliated with a particular recovery program, but rather emphasize counseling and positive peer and staff support. Many provide drug tests and resources for students who relapse as opposed  to immediate expulsion which is more common at schools affiliated with treatment centers and within correctional facilities.

There are currently around 45 recovery high schools in the United States (Figure 1), one of which is located in St. Louis (Great Circle Academy).7 The St. Louis recovery high school is privately run and charges tuition of approximately $20,000. Michigan is opening a recovery charter high school in the SE region of the state. Some states (e.g., New Jersey, Pennsylvania) have passed bills to open public recovery schools but no schools currently exist due to a lack of funding.

Positive Effects of Recovery High Schools

Students who attend recovery high schools are less likely to relapse and more likely to graduate than students recovering from substance abuse disorders who attend non-recovery schools.8-10 There is also evidence that peer accountability is an effective strategy to preventing relapse.11 Many students in recovery report that several of their peers continue to use drugs, which presents a strong temptation to use at a traditional high school. Additionally, recovery high schools often are equipped to treat students with co-occurring mental health disorders, providing a level of specialization that is often not available in traditional public schools.

Per-pupil Costs at Recovery High Schools

Recovery high schools serve a relatively small number of students but the cost of educating each student is significantly higher than that at non-recovery schools, due in part to specialized staff/programs and high faculty to student ratios.10 Depending on the location, the per-student tuition difference between recovery and non-recovery high schools varies from $1,000–$16,000.

Because of the relatively small number of students served, these schools also may not be easily accessible in more rural areas of the state and tend to have limited onsite course offerings (fewer AP, or extra languages). It is not clear the extent to which supplementary virtual education in these settings may be able to provide additional academic rigor for some students. Finally, some community members where recovery high schools are opened have expressed concerns about the potential for an increased presence of drugs in the community; school advocates argue that recovery high schools are often more drug-free than traditional public schools.


  1. Jordan, C. J., & Andersen, S. L. (2017). Sensitive periods of substance abuse: Early risk for the transition to dependence. Developmental Cognitive Neuroscience, 25, 29–44. https://doi.org/10.1016/j.dcn.2016.10.004
  2. Centers for Disease Control & Prevention. (2020). Youth Risk Behavior Surveillance System Results, 2019. https://www.cdc.gov/healthyyouth/data/yrbs/results.htm.
  3. Substance Abuse and Mental Health Services Administration. (2020). Behavioral Health Barometer: Missouri, Volume 6: Indicators as measured through the 2019 National Survey on Drug Use and Health and the National Survey of Substance Abuse Treatment Services. HHS Publication No. SMA–20–Baro–19–MO. https://nsduhweb.rti.org/respweb/estimates.html.
  1. Smith, R., Kalugina, K., Rothermich, R., & Norton, P. (2020). Status Report on Missouri’s Substance Use and Mental Health, Twenty-sixth edition. Missouri Department of Mental Health. https://dmh.mo.gov/sites/dmh/files/media/pdf/2021/01/sr2020-section-b.pdf.
  2. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. HHS Publication No. PEP20-07-01-001, NSDUH Series H-55.https://www.samhsa.gov/data/release/2019-national-survey-drug-use-and-health-nsduh-releas es.
  3. Harper, K. (2019). Kansas City Metro Area Recovery High School Report. State Targeted Response Technical Assistance Consortium (STR-TA). https://befreekc.org/s/Kansas-City-RHS-Report-Revised-21119.pdf.
  4. Capacitype Recovery Resource Hub. https://www.recoveryresourcehub.org/?zoom=5&view=map&center=36.812660448131055,-97.4 5203495025636&facets%5Bservices%5D%5B0%5D%5B%5D=Recovery%20High%20School
  5. Finch, A. J., Tanner-Smith, E., Hennessy, E., & Moberg, D. P. (2018). Recovery high schools: Effect of schools supporting recovery from substance use disorders. The American Journal of Drug and Alcohol Abuse, 44(2), 175–184. https://doi.org/10.1080/00952990.2017.1354378.
  6. Moberg, D. P., & Finch, A. J. (2008). Recovery High Schools: A Descriptive Study of School Programs and Students. Journal of Groups in Addiction & Recovery, 2, 128–161. https://doi.org/10.1080/15560350802081314
  7. Weimer,D.L.,Moberg,D.P.,French,F.,Tanner-Smith,E.E.,&Finch,A.J.(2019).NetBenefitsof Recovery High Schools: Higher Cost but Increased Sobriety and Increased Probability of High School Graduation. The Journal of Mental Health Policy and Economics, 22(3), 109–120.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901088/
  8. Tracy,K.,&Wallace,S.P.(2016).Benefitsofpeersupportgroupsinthetreatmentofaddiction. Substance Abuse and Rehabilitation, 7, 143–154. https://doi.org/10.2147/SAR.S81535
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