I completed my practicum at Assisted Recovery Centers of America (ARCA). ARCA is a free outpatient recovery center that offers resources to assist in the treatment and recovery from substance use disorders. ARCA offers an interdisciplinary approach to substance use recovery addressing the physical and mental health needs of the patient along with their substance use. Through my time at ARCA I conducted ASAM assessments. The ASAM assessment is a multidimensional intake exam that evaluates the patients’ priorities taking into account their needs, obstacles, strengths, assets, resources, support systems and perceived obstacles to recovery. As part of my role, I also evaluated different types of treatment found effective by patients and providers. These included: including medication assisted treatment, intensive outpatient group therapy, and individual therapy. When examining the procedures and policies that impact care delivery I discussed common threats to sobriety in St. Louis with the patients and the provider.Throughout my conversations, unstable housing was a common theme. Patients indicated that not having access to housing as part of a treatment program was the reason they continued to use and/or being kicked out of their housing program was why they relapsed. They reported that while there are short-term options to get to a certain level of recovery, the system is not built for long-term sobriety.