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.