MANCHESTER - Against a backdrop of candidates and politicians hotly debating
health care, one New Hampshire group has quietly been tackling one of the
state's most pressing health concerns.

An incentive called New Futures, which began using an anonymous donation of
several million dollars to the New Hampshire Charitable Foundation, has
spent the past two years focusing on the state's problems with alcohol,
tobacco and drug use and finding innovative ways to combat them. "There were
efforts to look at this in the past, but they were by and large weak
efforts," explained Health and Human Services Commissioner Don Shumway, who
recently joined the New Futures advisory committee. "To a large extent, they
were overwhelmed by cultural messages and the marketing of things like state
liquor stores. [New Futures] has begun to assemble a critical mass of voices
that has not been assembled before." Another stumbling block for addressing
alcohol and drug abuse has been a lack of funding. New Hampshire had the
sixth-lowest per capita expenditure on alcohol and drug programs in 1995 and
spends less than half the national average on treatment services, according
to the National Association of State Alcohol and Drug Abuse Directors.

It's not that the need for such services is not there. What New Futures
found when it began compiling data on the use of alcohol, tobacco and drugs
in New Hampshire was that the problem was much worse than many had perceived
it to be, especially when it came to youths.

In 1997, New Hampshire's high schoolers ranked second highest out of 33
states surveyed for marijuana use and for inhaling household products to get
high. One in every three students said they had been offered drugs on school
property, and one in two reported binge drinking over the previous month.
The troubling statistics were not limited to youths; 16.3 percent of New
Hampshire women who gave birth in 1996 smoked while pregnant. New Hampshire
adults binge drink at rates higher than the national median. One in three
deaths on New Hampshire roads is alcohol-related.

"The major conclusion we reached is that New Hampshire has a very
significant problem with alcohol, tobacco and other drugs," said John
Bunker, executive director of New Futures.

Last year, New Futures published its findings in a report entitled "We Need
to Talk," which was distributed to politicians, educators, law enforcement
officials and others.

It also set up a Web site designed both to inform the public of the work it
is doing and provide information about alcohol, tobacco and drug issues in
New Hampshire.

"New Futures has made the issue of substance abuse far more visible than it
has been in the past," said Attorney General Philip McLaughlin. "It's become
very much a presence in the state." Enough of a presence that McLaughlin
joined New Futures advisory board. "It's the only participation I have in
any role other than attorney general," McLaughlin said. "The objective is so
compatible with the general public policy of the state ... and substance
abuse is one of the primary causes of delinquency and criminality." Shumway
said New Futures is also addressing health issues that are often overlooked
on the state level due to a lack of resources. Philanthropy "is becoming a
much more important voice in setting a true health agenda instead of
strictly practicing illness management," Shumway said. "New Futures is a
wonderful example of that for the state. It's addressing an issue that has
not been addressed by the medical and mental health community nearly
enough." New Futures has begun addressing the issue by facilitating
networking among leaders. That goes beyond recruiting the support of state
officials like Shumway and McLaughlin by reaching out to community and
school leaders who are also in positions to advocate changes in attitudes
and policy. High school students are one of the main targets because they
are at the age when substance problems usually start.

"High school youths are at a great time for prevention," said Gary
Faucher,executive director of the New Hampshire Teen Institute. "If you can
catch them before they're well into addiction, you can really turn them
around." New Futures has been funding Teen Institute retreats that educate
groups of teenagers on how to fight substance abuse in their own schools.
College-aged youth are also a focus. New Futures is working with the New
Hampshire College and University Council to unite institutions to fight
underage and binge drinking on campus.

Last March, New Futures funded a forum in which the presidents of 13 New
Hampshire colleges and universities drew up and signed a joint statement of
commitment that included plans for a student-presidential dialogue to take
place this December.

"The presidents have made this their number one priority of collaboration
over the next five years," said Tom Horgan, executive director of the New
Hampshire College and University Council. "New Futures' support has been
critical in making that happen." Another ongoing project that New Futures
contributes to is the Risky Drinking Initiative, in conjunction with the
Robert Wood Johnson Foundation and the Foundation for Healthy Communities.

"A lot of programs focus on alcoholism, but there is also a huge other group
at risk," said Shawn LaFrance, vice president of the Foundation for Healthy
Communities, explaining that 15 to 20 percent of people practice risky
drinking while only 5 percent are confirmed alcoholics. The Risky Drinking
Initiative gets people to fill out questionnaires while in the waiting room
of their doctor's office that help to identify people at risk for alcoholism
and give their practitioner a chance to intervene. New Futures also is
working with the New Hampshire Coalition on Substance Abuse and the Elderly
to plan and conduct a statewide conference over the next year. Programs like
these would have trouble getting off the ground without the help of
initiatives like New Futures.

"This is a great opportunity for us to try to offer this program in New
Hampshire," LaFrance said. "What's so great about New Futures is that
they're really focused on this issue. Some of this stuff has a stigma
attatched to it, but it is one of the more important problem areas in terms
of health care in New Hampshire."