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. 
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MAP posted-by: Richard Lake