FORUM ADDRESSES SUBSTANCE ABUSE SERVICES IN COUNTY

TAMWORTH -- A mixed group of social service workers, law enforcement
personnel, healthcare professionals, alcoholics in recovery and others
packed the function room at Sammy's Restaurant April 17 to send a message
to Concord that our state is not doing enough to prevent and treat alcohol
and drug abuse.

The forum was the last in a statewide tour of the Governor's Commission on
Alcohol and Drug Abuse Prevention, Intervention and Treatment.

Originally, there was no scheduled Carroll County stop on the tour. Meeting
facilitator Alice Bruning said Tamworth was added after several people
called and requested the forum.

Bruning opened the meeting, asking what the substance abuse issues are in
Carroll County, what programs are working and not working, and what
additional programs for substance abuse prevention, intervention and
treatment programs are needed in New Hampshire.

Sparse Resources

In a resource guide for alcohol and drug prevention and treatment services
published last month by the N.H. Department of Health and Human Services,
there are no long-or short-term residential treatment facilities in Carroll
County.

And when someone in need of substance abuse services tries to get help,
before them lies a maze of waiting lists, conditions, and people who want
to help but are becoming increasingly frustrated by the lack of options.

Carroll County Mental Health, the only state-funded outpatient treatment
agency in Carroll County to provide substance abuse counseling, assessment
and screening and often the individual's first step towards comprehensive
treatment, has a waiting list, and appointment slots are "booked all day,
every day."

Clinically managed residential detoxification services for people
intoxicated from alcohol or drugs but not experiencing a medical emergency
are short-term "holding facilities" designed as a safe place to go until
appropriate treatment becomes available. The nearest center is in Berlin.

Recovering addicts and alcoholics can go to the low-intensity residential
facility, Friendship House, in Bethlehem, but only if they have completed a
residential program and/or experienced a minimum period of sobriety.

According to Carroll County Attorney Robin Gordon, however, "The waiting
list to get into Friendship House is phenomenal." The other centers,
located in Dover, Manchester and Nashua also have waiting lists.

There are medium intensity centers (residential post-detoxification
programs) for people who have been substance free for 72 hours or more.

In addition to Friendship House, there are centers in Keene and Manchester
- -- but again, long waiting lists.

In fact, it's difficult to find a treatment bed anywhere in the state. And
it's gotten more difficult over the past 10 years.

At least 14 treatment programs have closed in New Hampshire in the past 10
years, including the Veterans Administration Medical Center Inpatient
Program in Manchester, Prospects at Frisbie Hospital in Rochester, and the
Concord Hospital In-patient Program. Current alcohol and other drug needs
exceed the existing capacity for treatment within the state by two to 10 times.

CAP Director of Development Marge Webster highlighted just how frustrating
it can be to find treatment for people begging for it. Webster told a story
of a Saturday when she was in her Center Ossipee office. As the office is
not open on Saturdays, she had the doors locked and was trying to catch up
on some work.

A man stood in the parking lot throwing pebbles at her window until he got
her attention. She let him in and he pleaded with her to help him find
somewhere to go to get help for his heroin addiction.

Webster, not one to turn away someone in need, spent four hours calling
every connection she could think of until, finally, she found help for the man.

Webster said that substance abuse problems have reached a critical level
and that 60 percent of all CAP assistance applicants for housing, fuel
assistance and other services have alcohol or substance abuse issues.

Gordon said that at least 95 percent of people her office sees going
through the criminal justice system have alcohol and/or substance abuse issues.

Gordon also received a round of applause for her comment, "Don't you feel
it a bit disingenuous that New Hampshire funds state liquor stores?" N.H.
Senator Edward Gordon said the state's liquor stores last year boasted $300
million in sales with a $60 million profit.

State of the State

N.H. Division of Alcohol and Drug Abuse Prevention and Recovery has issued
a report profiling substance abuse and need for treatment across the state.

The report divides the state into three regions -- southern, central and
northern with Carroll, Grafton and Coos counties making up the northern region.

The report finds that 87 percent of people who need treatment in the
northern region need it for alcohol abuse, 1.5 percent for drug abuse and
11.2 percent for combined alcohol and drug abuse. The northern region had a
higher percentage of people who need treatment for the combined
alcohol/drug abuse than any other region in the state -- by almost 200 percent.

Nearly 43,000 adult residents of New Hampshire are estimated to be in need
of substance abuse treatment but not receiving it. This is just about equal
to the population of Carroll County.

New Hampshire ranks poorly when compared to other states as far as
per-capita spending for substance abuse treatment and prevention is concerned.

In a1997 report issued by the National Association of State Alcohol and
Drug Abuse Directors, New Hampshire ranked seventh lowest in per-capita
spending for alcohol and drug services, at $7.10 per person, below half the
national average of $15.26.

"Alcohol, tobacco and other drug problems have destroyed countless families
in New Hampshire, and represent the number one threat to the well being of
our citizens," said Donald Shumway, Commissioner of N.H. Health and Human
Services.

The non-profit agency, New Futures, has published a booklet, "We Need
Treatment" detailing the problem in our state.

According to the report, New Hampshire has a high rate of substance abuse
when compared to other states.

Binge drinking among adults 18 and older ranks third highest of 50 states.
Among high school students, binge drinking ranks 16th of 33 states.

Marijuana use is ninth highest of 50 states.

The booklet also reports that 65 percent of New Hampshire victims of
domestic and sexual violence believe that their offenders were using
alcohol during their most recent violent episode, and one out of five
families assessed by the state division of children and youth were found to
have alcohol and/or drug problems.

The Suggestions

Nick, who identified himself as a Kennett High School student in recovery,
wants more attention to the substance abuse issues among teenagers.

"There are a lot of issues with kids -- especially drug problems. People
are aware of it but not doing anything about it. We need in-school
programs," Nick said.

Nick said that appointments with school guidance counselors have been
helpful, but said group settings where teens can get together to discuss
their substance abuse issues would be even more beneficial.

Kennett Guidance Counselor Karen Fogarty said it all boils down to two
things, money and space. Lack of space, she said, also makes confidential
one-on-one appointments with students nearly impossible.

Kennett High School used to have a counselor that dealt only with substance
abuse issues, Laura Crane.

Crane said the funding for her position was cut and she now works at
Kingswood High School as a counselor in Wolfeboro.

"Treatment is lovely but that's the easy part," said Crane, "But when they
come back to their communities and try to transition back into their
routine, they fall on their faces. We need to bring it home. The long
distance to treatment facilities creates barriers for parents and an undue
burden. We need to bring it home (to Carroll County)."

Carroll County Commissioner David Sorenson said that many of the people in
the county jail are repeat offenders who serve their time and return to
society with no supports for their substance abuse issues.

Other issues brought up during the forum were lack of transportation in
Carroll County for people who want to get to counseling appointments or
return to work but don't have a car, lack of recreational opportunities for
youth, lack of employee health insurance coverage, low Medicaid
reimbursement rate for treatment services, and lack of commitment to the
issue by state officials.

Webster said, "When the state starts to recognize addiction as a disease,
maybe people will get the support they need."

Sen. Gordon said the Governor's Commission is responsible to "look and see
what we can do. We need to have success stories."

Bruning said that, based on the Commission's forums held elsewhere in the
state, they have come to a tentative decision on areas that need to be
addressed to combat the rampant substance abuse problem in our state.

The Commission is recommending further study of treatment options for
youth, adults, those with a dual diagnosis and where to get the money to
pay for it.

Secondly, they recommend study of prevention that works.

Thirdly, workforce issues brought forth by the substance abuse problem.

The current level of funding to address the problem is $1 to $3 million but
Commission member William Butynski, Ph.D. said it is unlikely the money
will even begin to make a dent in the problem.

Once the Commission has finished gathering public input, it will develop
its work plan for action, which it will use to refine and expand the
existing substance abuse prevention and treatment system.

People who would like their voices heard regarding the substance abuse
problem in the state can contact New Hampshire Division of Alcohol and Drug
Abuse Prevention and Recovery at 271-6741 or by writing the division at 105
Pleasant Street, Concord, NH 03301.