Pubdate: Sun, 17 Feb 2008 Source: Concord Monitor (NH) Copyright: 2008 Monitor Publishing Company Contact: http://www.concordmonitor.com Details: http://www.mapinc.org/media/767 Author: Sarah Liebowitz, Monitor staff Bookmark: http://www.mapinc.org/rehab.htm (Treatment) HELP FOR ALCOHOL, DRUG PROBLEMS HARD TO FIND If you need residential alcohol or drug treatment in New Hampshire and don't have access to a private program, your search will probably go something like this: You'll call each of the six - soon to be seven - crisis detoxification sites in the state, inquiring about open beds. Quite possibly, none will be available. If, by the next day, you haven't changed your mind about seeking treatment, you'll repeat the process, calling each of the sites again, hoping for better luck. "The demand for the services far outreaches the capacity," said Joseph Harding, director of the Office of Alcohol and Drug Policy at the state Department of Health and Human Services. The statistics are stark. The state's public-funded system only has the capacity to treat about 10 percent of the estimated 60,000 New Hampshire residents who, according to a federal survey, meet the criteria for alcohol and drug dependence, Harding said. Although the state's outpatient treatment system isn't overstretched, the residential programs and crisis sites can't keep pace with demand. In all of New Hampshire, there are 54 (with the imminent addition of a handful more) beds in state-supported crisis sites, where individuals go for non-medical detoxification and for referrals to longer-term residential or outpatient programs. The crisis sites serve as entryways to the treatment system for individuals who "need to get into a safe place fairly quickly," Harding said. If, after clients become sober, they need additional treatment, crisis site workers can refer them to residential or outpatient treatment programs. Altogether, there are 171 beds in long- and short-term residential treatment programs, Harding said. The treatment sites - the state contracts with providers - accept patients regardless of ability to pay. "We need more funding and more treatment centers," said Robert Dorley, a licensed alcohol and drug counselor who works at the Merrimack County jail in Boscawen and at the state Academy Program, an alternative sentencing program for nonviolent, low-risk offenders. "It's not that people aren't trying to get things in place to help them, but the funding is not enough." To understand the state's treatment system, you have to know about a decades-old change in insurance policy. About 20 years ago, private insurers ceased paying for the typical 28-day drug and alcohol treatment programs, Harding said. Statistics were the rationale for the shift: Insurance companies argued that treatment providers couldn't demonstrate their effectiveness, since some clients relapsed, returning to drugs and alcohol. In New Hampshire, the fallout was dramatic. Fifteen privately funded treatment facilities eventually shuttered, primarily because of the because of the insurance change. The state-funded system - which "at one time was really designed to provide treatment services for people who didn't have insurance," Harding said - assumed a huge, new burden. "In reality today it's about the only treatment option available," Harding said of the state-funded system. Homeless Challenges For New Hampshire's homeless, securing treatment can prove particularly difficult. What might be a mere inconvenience for many New Hampshire residents - making daily phone calls to inquire about open treatment beds or finding transportation to one of the crisis sites, some of which are located in far reaches of the state - might be nearly insurmountable for someone living on the street. The system "can be cumbersome for a person who has lost either mental or psychological resources, or physical resources, like easy access to a telephone," said David Keller, pastor of First Congregational Church in Concord, which operates an emergency shelter in the winter. Many of the First Congregational shelter guests, like those at other shelters, struggle with alcohol and drug addiction. - --- MAP posted-by: Richard Lake